Politics, laws and budgets
Politics, Laws and Budgets
"Politics means striving to share power or striving to influence the distribution of power, either among states or among groups within states." -- Max Weber
If policies are the outcomes of choices that entities make to achieve their goals, then politics is the means to those ends. The product of the two (policy and politics) is usually legislation and the budgetary process that is required to support implementation.
Politics is an activity whereby people achieve what they want by exerting power and influence. It involves conflict over the distribution of scarce resources. Schattschneider (1960) states that every conflict consists of two parts: the individuals engaged and the audience attracted to the conflict.
Health workers in a community wish to mandate the vaccination of infants against polio.
The individuals engaged are the nurses and midwives.
The audience in this case consists of two groups: government policymakers and the community (with parents who may or may not want vaccinations mandated).
As can be seen in this example, once the audience becomes involved it is never neutral; people take sides and influence the outcome thereby expanding the scope of the conflict. It is important to remember that as long as the conflict remains with the individual and does not engage an audience, the political process is limited, if initiated at all. Therefore health care worker who set out to advocate for a particular position need to understand the political processes and the power bases that might exist within the environment they will be operating. They need to recognize that conflict is an essential ingredient to success and that success is dependent on how that conflict is managed.
Although policy and politics are usually associated with government, there are four spheres in which health professionals may be required to advocate and therefore be involved in political action (Leavitt and Mason 1998):
- Workplace: influencing workplace policy, procedures, funding allocation decisions, and Practice models.
- Government: influencing local, state and national policy and legislation.
- Professional: organizations: influencing the setting of standards, licensure, and credentialing.
- Community: influencing through engagement in community activities such as environmental groups, child care groups, etc.
Effective government relations require an understanding of how government works and what drives government decision-making. The law making and budgetary processes are two key political activities for advocates to be involved in. The mechanics of each process may vary depending on the government structures of a country. It is important to investigate how the system operates, at various levels, wherever and whenever the advocacy effort is being undertaken. Not all policy comes into effect through the law-making process, but it is the ultimate expression of a government's intent.