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

2. Snap shot of Australia
Pop: 22.1 million Long working hours vs
(plus 1 every1 min 11 secs) under employment
44% born overseas or with 12 million cars
a parent born overseas
We’re talking about:
90% live within an hour of - population growth
coast (60% in 5 biggest cities) - maintaining living
standard
- water
About 3 people per square - carbon tax
kilometre - closing the gap
Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

3. Australian health
Life expectancy is 79 for Health expenditure:
men & 84 for women 8.7% of GDP
but 10-12 years less for 9 health departments
Indigenous Australians
Duel health care
16.6% smokers & provider system
22% obese
10 million covered by private
health to some extent
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

4. 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

5. 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

6. 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

7. 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

8. 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

9. Your health site here
Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

10. Your health stats here
Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. More useful website
 Energymark
www.csiro.au/science/Energymark-Trial.html
 Queensland Transcultural Mental Health Centre
www.health.qld.gov.au/qtmhc/comsumer.asp
Participation and Health: 2020 Vision, 16 & 17 February 2010 – Involvement: Learning from Australia (Ann Single) © Ann Single 2010