6 October Pledging Allegiance: the dual loyalties of the public service (Harrison Thorn) October 6, 2021 By ACHSM Admin career, government, health service delivery, internship, placement, public health, public service, Victoria 0 By Harrison Thorn 1st Year, Health Management Intern, Victoria From the ‘West Wing’, to ‘Parks and Recreation’, and Australia’s own ‘Utopia’; there are many enjoyable and humorous representations of life in the public service. This semester I am excited to join its ranks at the Victorian Department of Health and learn about life as a government employee. While first impressions have not been as intense as the Presidential inner sanctum, as comical as life in sleepy Pawnee, or as frustrating as a department filled by Australian comedians: I have already gained some exposure to some of the unique challenges faced by our diligent, hardworking public service. One challenge that has already stood out is the competing priorities and influences the Department faces in the execution of its day-to-day responsibilities. These influences arise from the way government is structured, and the resulting responsibilities placed on the government departments: Governments (which are inherently political by nature), are voted in by the public to represent and make policy and funding decisions in the voter’s interests but to also administer the responsibilities of the state that affect all voters such as health, education, law and order, transport, and infrastructure. Government departments are charged with delivering these public services in line with existing laws and regulations, and policy decisions by the government of the day. Each department is responsible for reporting on activity within the services, along with providing advice about the impacts of potential policy changes. While the primary purpose of government is to benefit the good of all its constituents, politicians inevitably make policy decisions to aid future election outcomes. Governments are ultimately responsible for oversight and operation of the public service. The nature of the political cycle means that Governments running of the state, and by extension, the work of the public service, is judged at the end of the election cycle. The work of the public service can have significant consequences on the political outcomes of the government of the day. These consequences can be direct, such as the implementation or lack thereof of a government promise or commitment, or indirect, such as through mismanagement or oversight of safety and quality. Consequences can vary, ranging from scandal, Ministerial resignation, or the loss of an election. Additionally, regular communications provided to a Minister and their advisers such as policy advice, reporting and briefings could be moulded and shaped to assist the political ambitions of the government. As a result, government departments can be vulnerable to influence from the political motivations of the government in power, rather than remaining an independent arm of government administration. However, in the same way that politicians ought to serve the public over their political fortunes (not that this is always common), and to provide public services to all, not just those that voted for them; government departments are responsible for ensuring the effective delivery of public services independent of the political implications for the government in power. And while history provides some examples of poor department administration, most if not all strive to ensure their work is done diligently and with impartiality, something that has been excellently modelled for me during my placement so far. Consequently, we can see there exists a dual loyalty that department employees experience, both to the general public who directly experience the fruit of departmental labour, and to the governments that have the final oversight over the implementation of public funds and institutions they administer. For these reasons, public service employees are charged with ‘speaking truth to power’ and providing impartial and objective, or as it is known in the Department, ‘frank and fearless’ advice. This ensures advice is provided to government that is apolitical, accurate and impartial, and allows for truth to reach the powerful, who from there are accountable to the public for the decisions they make. Chris Eccles, who has led the Department of Premier and Cabinet in SA, NSW and most recently in Victoria described ‘frank and fearless advice’ as the following: providing the information ministers need, as well as the information they might want, to make a decision dealing honestly with issues, including those that are difficult and complex, and ensures that ministers are not misled advice that is fair, objective, and that ignores a public servant’s own private or political interests advising ministers of risks and potential outcomes adding apolitical value to the commitments of the government of the day advice that is politically neutral, but not naïve, allowing the public service to provide trusted advice to successive governments and above all, advice that respects the right of democratically elected governments, having received that advice, to pursue their lawful policy agenda, with the expectation that their agenda will be implemented faithfully and diligently. My work so far at the department has provided me an opportunity to try and provide this sort of advice to the Deputy Secretary. The ongoing pandemic and associated restrictions have impacted many business-as-usual oversight processes the department is responsible for, with many being delayed to an unknown time creating uncertainty for health services regarding when these will resume. Recently I was charged with developing a briefing that investigated whether a specific oversight measure should be deemed ‘essential’ within COVID restrictions and provide recommended guidance for how the Department and Health Services should proceed. An early consideration was to further delay this oversight, given this was the recommendation in 2020 and that the understanding of the public regarding COVID-19 would result in limited push back politically. However, upon assessing the issue and the standards the Department had agreed to for this area of oversight, I felt that a case could be made that the subject matter was too significant to continue delaying, especially given its role in quality and safety, even if there was broad public and political support for policy adjustment. In light of this, I was able to develop a rationale for implementing this oversight and develop guidance that worked in line with existing CHO orders, knowing that these recommendations would need to be approved by the Public Health Unit before approval. At the time of writing, my recommendations are being finalised and I am hoping they will be put to senior management in the coming days. Whether my approach, a modified approach, or a different one altogether is decided upon as the right course of action by more senior levels of management, the CHO or the Minister is yet to be seen. But regardless of the outcome, this process has been fascinating from the perspective of learning about and feeling the tension that comes from balancing competing interests and attempting to find the most appropriate and effective solution. And even if working in a government department is not like living in a TV show, I think I am already learning plenty about how worthwhile it is to be one of its servants. Views are those of the individual authors and not those of ACHSM or management interns’ host organisations or employers. Related Posts Walking (more like crawling) among giants (Harrison Thorn) Working with the CEO and the Board of Alfred Health Climate change: the role of health service management in leading for change (Funmi Lamidi) Funmi Lamidi discusses the role that health service management can play in combatting the climate crisis. National Safety and Quality Health Service Standards and the new Health Manager Ensuring the delivery of safe and high-quality patient care is the responsibility of everyone that work within the health service – including the patient themselves. Introduced in 2013, the National Safety and Quality Health Service (NSQHS) Standards stipulate the level of care consumers can expect to receive during their episode of care. Learning the A-Z of health service delivery in Victoria As an Australasian College Health Service Management (ACHSM) Victorian intern we get the unique opportunity to work at four different workplaces within the health sector, complete post graduate study and attend a variety of professional development activities over a two-year period. What is value-based healthcare? Have you ever heard of value-based healthcare? When I was first introduced to the term during my initial days at Dental Health Services Victoria (DHSV) in January 2019 on my very first placement, I thought it was another one of those ‘word salads’ - I understood each of the individual words, but the whole term made no sense! 'Tactics without STRATEGY is the noise before defeat' (By Soumya Shah) My recent experience in the Health Management Internship Program (HMIP) have raised my appreciation for the significance of strategic decision-making and planning within health organisations. Below are my observations and learnings from my development of a long-term Strategic Plan for a public health service during the HMIP. Comments are closed.