How can health bureaucracies consult effectively about their policies and practices?: some lessons from an Australian study

Abstract

Debates about the theory and practice of participation and participatory strategies have become consistent features of policy development throughout the world. In Australia, as elsewhere, governments routinely employ strategies such as community consultation as a means of creating opportunities for participation. It has been argued that these measures are as much an attempt to contain or manage the demand for representation by a myriad of interest and pressure groups as they are an expression of democratic principles or highly valued public opinion. Nevertheless, governments and interest groups alike have been advocating expanded consultation programs and seeking to refine the process of consultation in order to achieve optimum benefits for all parties. Much of this attention is focused on the mechanics of how to undertake consultation exercises which are efficient and effective. By contrast, this paper discusses the structural factors in a government bureaucracy which will facilitate or impede consultation with communities. It draws on the findings of a research consultancy conducted by the authors for one large commonwealth government department in Australia. The research suggests that while the skills and performance of individual officers are important, there are several key organisational indicators in the government bureaucracy itself which will determine its ability to consult effectively.

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