Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Involvement

Learning from Australia

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Snap shot of Australia

Pop: 22.1 million

(plus 1 every1 min 11 secs)

44% born overseas or with

a parent born overseas

About 3 people per square

kilometre

90% live within an hour of

coast (60% in 5 biggest cities)

We’re talking about:

- population growth

- maintaining living

standard

- water

- carbon tax

- closing the gap

Long working hours vs

under employment

12 million cars

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Australian health

Life expectancy is 79 for

men & 84 for women

16.6% smokers &

22% obese

10 million covered by private

health to some extent

Duel health care

provider system

but 10-12 years less for

Indigenous Australians

9 health departments

Health expenditure:

8.7% of GDP

About ⅔ of hospital beds

are public

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Involvement snapshot

80s HIV/AIDS strategy

90s mental health consumer led reform

No. of deliberative processes, but dominated by

WA & planning

Indigenous engagement in research projects

All health departments have a statement/

strategy about consumer involvement

eg Victoria’s Doing it with us not for us

EQUiP standards – ‘governing body is

committed to consumer participation’

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Involvement overview

National - Consumer Health Forum

State groups - eg Health Consumers Qld

District – health councils, eg Health Community

Councils

Population & condition specific

Population & region, eg Health Actions Teams

Great variation in capacity & activity

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Involvement overview

Consumer engagement in Australian health policy

is poorly understood, inconsistently practiced, and

under theorised

Dr Judy Gregory, Australian Institute of Health Policy,

Consumer engagement in health policy: Final report of the

AIPHPS research report (November 2008)

Has it gone off the boil?

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Lessons from Australia

Isolated & sparse populations call for new ways

of working

Working with different cultures raise questions

about how we work with similar cultures

‘Involvement’ can go in & out of fashion (& back

in again)

Communication skills (or lack of) can weaken

the experience

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Sparse & geographically

isolated populations

Online opportunities, eg Your health

You’ll never never know if you never never go

Existing social infrastructure & networks, eg

Country Women’s Association

Peta Ashworth, CSIRO, Energymark

small, community based networks

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Your health site here

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Your health stats here

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Lessons in culture

Who are you?

Time to build relationships

Methods of participation developed by the

dominant culture will very likely not be

appropriate for other cultural groups,

particularly those that are quite different from

Australian culture Queensland Health Action Plan for Consumer and Carer Participation in Queensland Mental Health

Services, 2003, p. 2.

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Surviving ‘off the boil’

Keeping it relevant

Maintaining relationships

Monitoring over the border

Role descriptions as an opening position

Supporting allies & sharing knowledge

Maintaining the values

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

The way we talk & listen

The facilitator

Assumptions

Judgements

Defensiveness

Respect for each others knowledge

Do we need to focus more on communication in

training for all parties?

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

An example – Marshall B Rosenberg’s

Non-violent communication

Observations

Feelings

Needs

Requests

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Judgement leading to

defensiveness

Doctors just have their own pet treatments and

they don’t listen to what we want

or

Patients can’t handle that sort of information. They

just can’t be expected to understand that sort of

technical detail.

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Observation leading to

expressed need

When I talk about treatment options with my

doctor she says some of the options I suggest

are not suitable. I need to feel that my ideas are

being considered so I would like her to explain

why she has ruled them out so I can

understand

or

I have tried to communicate that information to

some patients. I felt concerned that it confused

them. I need to be sure the information I give

patients is not adding to their worries.

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

So ...

At the heart of involvement are relationships

Participation is a two way process – we must go

out to communities and do things their way not

just expect them to come to us and do things

our way

Starting from the bottom up (with commitment

from the top) may support broader & more

sustainable involvement

Don’t assume the communication skills

Finally, involvement changes the tone of policy

& a genuine desire to involve changes the tone

of involvement

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

Useful websites

Health Issues Centre

www.healthissuescentre.org.au/participate

Consumer Health Forum of Australia

www.chf.org.au

Doing it with us not to us

www.health.vic.gov.au/consumer/

Health consumers Queensland resource kit

www.health.qld.gov.au/hcq/network_reps/

consumer_kit.asp

Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

More useful website

Energymark

www.csiro.au/science/Energymark-Trial.html

Queensland Transcultural Mental Health Centre

www.health.qld.gov.au/qtmhc/comsumer.asp