The document provides guidance on approaching government to discuss crucial issues like antimicrobial resistance, outlining the different stakeholders involved including ministers, departments, and advisory councils, and emphasizing developing a strategy that works with the Chief Medical Officer, accepts advice, and takes a flexible approach with multiple avenues of discussion.

1. CRUCIAL CONVERSATIONS
A guide to approaching government(s)
ICU UPDATE
Chris Baggoley
25 May 2017

2. THIS PRESENTATION
 The situation
 A different world
 The Chief Medical Officer
 Budgets
 Strategy
 The meeting
 The conversation
 Consider Anti Microbial Resistance
 In summary

3. THE SITUATION -TIMELINE
August 2015 - President of CICM meets Minister and Adviser
September 2015 - Letter and proposal to Minister
October 2015 - CICM inquiry ofAdviser
February 2016 - CPMC meets Minister
April 2016 - Funds not available; develop a pilot
- Contact with Health Department
May 2016 - Further contact with Health Department
July 2016 - Election
Unclear 2016 - President CICM meets Minister, Shadow Minister
October 2016 - COAG HealthCouncil communique
January 2017 - New Health Minister
February 2017 - AHMAC funds $40K project via CCPHPC

4. THE SITUATION - PROPOSAL
 13 pages
 9 recommendations
 14 references
 $60M saving over 5 years
 Product – a course; e-module
 Cost $4.57M over 5 years - Page 11
 Evaluation - Page 12

5. A DIFFERENTWORLD
 Different pressures, timescales, processes, thinking, stakeholders
 Ministers office
 Arms length from Department, but do communicate
 Ministerial appointees, mainly but not solely
 Promote and protect Minister & Minister’s agenda
 Department
 Policy development
 Policy experts, not content experts
 May not have a program in your area
 Australian Health Ministers Advisory Council (AHMAC)
 COAG Health Council (CHC)

6. THE CMO
 Supported by senior medical advisers
 Represents the medical profession within government
 Understands this different world
 Trusted
 Widely connected
 Key support for clinical initiatives

9. Middle East
Respiratory
Syndrome
Coronavirus
(MERS CoV)

10. BUDGETS
 SA experience
 Preparation
 Commonwealth and state flexibility differences
 Authority to spend may be outside Department, Minister

11. STRATEGY
 Consult with CMO
 Understand and utilize influence of AMA and RACGP
 Understand Commonwealth and State roles in Health
 May need multiple, different approaches
 Respectful approach, reasonable request
 Timing may be everything and out of your control
 Be flexible and be prepared to accept (much) less than 100%

12. Map of Government roles and responsibilities in Health
Source: Reform of the Federation – White Paper: issues 3 – Dec 2014

13. THE MEETING
 With the Minister
 Well done, you’ve made it!
 It may be Minister and/or Chief of Staff and/orAdviser
 Response rarely instant, establish follow up
 With the Department
 Secretary and/or Deputy Secretary plus Officials
 Ask for CMO

14. THE MEETING
 Behind the scenes
 Department likely to have briefed Minister
 Do not play Minister off with Department and vice versa
 Do not play politics
 Forget bringing your commissioned economic analysis

15. THE CONVERSATION
 With the Minister
 Plain language
 Early, quick summary of issue
 Minister may be late, especially if meeting in Canberra and may be distracted
 Be flexible and willing to depart from your script
 Do not seek $$ straight up
 A Minister is a politician
 With the Department
 Expect more content knowledge
 They, too, may be briefed
 Roles of policy development, advice to Minister

16. CONSIDER ANTI MICROBIAL
RESISTANCE
 Decades of advocacy
 JETACAR, EAGAR, Senate Inquiries, Senate Estimates
 Conversations technical
 Now have national strategy, implementation plan
 Superbugs front page
 SAB is superbug
 Have we got deal for you:
 NHHI
 Reporting of SAB rates
 WHO Global Strategy

17. Responding to the Threat of
Antimicrobial Resistance
Australia’s First National
Antimicrobial Resistance
Strategy 2015-2019
2 June 2015

18. IN SUMMARY
 Work with the CMO
 Accept advice
 Be flexible; adopt more than one approach
 Not always successful, but
 Persistence often pays off

19. THE HEALTH “SYSTEM”
Rock or bird?
y = x2 – b
f = ma
?