Health Advocacy in 2018
Dr Ayman Shenouda
Where are we now?
I’m not the first to say that the 24-hour media cycle has taken a toll on our democracy. Some even say it killed journalism. I think the true damage lies in a loss of thoroughness and depth of thought. More specifically, the effects of the demise of principled advocacy and what it now takes to shape and change policy.
Twitter now seems to set the policy agenda. But we’ve been in this chaotic and unpredictable world for some time now and we’re never going back to the pre-digital era of journalism. In mobilising support, is there the time and patience left to build a policy dialogue? Without it, we are just left with a policy vacuum and random tweets that lead us nowhere.
Considered policy development takes time. Good public policy relies on effective community involvement and consultation.
Good implementation is also important. The process of implementation seems to be skipped entirely from the process these days, which makes the type of incremental change required in healthcare almost impossible.
There seems neither the time nor the inclination for the inclusive process required for good policymaking. Even when good policy process does occur, it can all fall over in an instant as was the case recently for constitution recognition which went down without the noise it deserved.
The doctor as advocate would be familiar with similar policy disappointment. It’s been a long road to reform and there has been plenty of blocks along the way. It’s clear that it is harder to get attention in such a cluttered space.
What does it take to shape and change policy in our own policy space?
We advocate at different levels from individual patient advocacy through to more public advocacy or policy leadership roles on the national and sometimes international level.
In a world ruled by Twitter, there’s not a lot of time for considered well design policy solutions. The type you need to communicate the evidence base or get the required policy reasoning across. But we still need to build that policy dialogue. This is why it is so important for us – as a community of healthcare professionals – to get it right.
By getting it right I mean following good policy process. But how can we avoid the pitfalls of advocacy? Media can certainly help to set the agenda but I think a focus on inclusion is the best place to start.
Right place, right time
Magic happens when the right people are at the right place at the right time.
When things are politically aligned and people at the table are smart and genuine in their intent - the moment when they recognise what leadership is all about - then Magic follows.
When there is no personal or financial gain, leaders start to have a sense of what can be gained through collective advocacy for the benefit of their community. When the vision is clear and simple to understand by all involved implementation becomes a lot easier.
Integrity always shines through
Some people believe that politics is about being smart enough to make a lie look convincing. Sometimes this falls somewhere between a lie and a falsehood or the new “alternative facts” and post-truth era we now find ourselves in.
Some politicians think they know better. They might even get away with some temporary gain but believe me, the power of truth has a longer and more effective success. People can smell dishonesty no matter how enticing a master deceiver may be. It is integrity that always shines through the brightest here.
Making collective impact work
When there is a genuine and clear goal that addresses the common agenda, people get together to make what look like impossible change feel like a walk in the park. This requires a collaborative approach to creating change to facilitate mutual support and collective impact.
When you win the hearts and souls of people, what seemed impossible becomes not only possible but a lot easier to achieve. When everyone in the room feels safe and heard by others, suddenly they will be able to see and value others contributions.
In my opinion, you should leave your personal views and judgment of others outside the room. After all, we need to be clear about one thing - it is not about you, it is about others and the trust they’ve placed in you to present their opinion. Some may not agree with me but at the end of the day, everyone is entitled to have their own views.
Let’s hope health advocacy in 2018 is a place of inclusive reform. That we work together towards collective impact and a common agenda that will see sector-wide improvements.
Dr Ayman Shenouda