The New Brunswick Health Council is a Part 3 public body created by the Government of New Brunswick to promote and improve health system performance. It has a two-part mandate. The first is to engage citizens in ongoing dialogue about important health system performance issues in order to provide recommendations to the Minister of Health and to bring the citizen/patient experience back to service providers and policy makers in a way that is objective, scientific and as useful as possible. The second involves measuring, monitoring and reporting on health system performance to both the public and the health system partners. Together, these two streams of activity will contribute to greater accountability, improved health system performance, and promotion of a more citizen-centered health care system.
The council will provide a formal, arms-length mechanism to facilitate, promote and support ongoing citizen engagement in the planning, monitoring and evaluation of New Brunswick’s healthcare system. It will provide New Brunswickers with objective, credible information about the performance of the health-care system. By developing standardized approaches to measuring and comparing performance across different areas of the province and nationally, the Health Council will help stakeholders to identify areas where improvements in health system performance are possible.
Citizen engagement is decision-makers and citizens working together through deliberation to solve problems, make decisions and take action to address problems. It is a partnership between decision makers and citizens to share responsibility to solve issues or make decisions. It is mostly focused on citizens and less on interest groups, lobbyists, stakeholders and experts.
Citizen engagement goes beyond conventional public consultation by enabling citizens to do more than simply voice an opinion – it also allows them to participate in the deliberation process leading to decisions.
The Health Council’s agenda will be annually planned and decided on through a consultation process involving the council, the Minister of Health and the RHAs. Citizens can influence the council’s agenda by identifying relevant issues either to the council directly through council members or other citizen engagement processes or by identifying issues to the Minister or RHAs. Based on input and consultation from these sources, the council will develop an annual work plan which will be presented to the Minister for approval.
The Health Council could initiate a citizen engagement process to address any type of health system performance issue where broad public input would be helpful in clarifying issues and concerns or making decisions among a number of possible alternative solutions. Some examples include the selection of meaningful performance indicators, population satisfaction with health care delivery, establishment of priorities for the health system, patient safety issues and service quality concerns.
A citizen engagement process could be initiated if there is a likelihood that citizen engagement will contribute to identifying realistic policy options. Conversely, if there is only one way to solve an issue, there may be little additional benefit in holding a citizen engagement process when the final decision is already clear.
Success is achieved through:
- Clear goals and clear expectations of the citizen engagement process.
- Clarifying the process so that everyone understands what is negotiable, what will happen with the recommendations, how much weight citizens’ engagement has in the decision-making process.
- Ensuring legitimacy by having a good representation of the population and different interests.
- A flexible approach -- there is no “one model fits all.’’ Processes must be adapted to allow meaningful participation and the development of sound recommendations that will result in sufficient acceptance so the decision can be implemented successfully.
- Transparency and accountability in all aspects of the citizen engagement process, including keeping the larger public (outside participants) well informed.
Here are some examples of citizen engagement models:
- Deliberative Forums: this process was used for Dialogue on Health in the Acadian Peninsula;
- Consensus Conference: Almost similar to Dialogue on Health except fewer participants (around 25 or more) who have greater input on the process (which experts to consult, etc.) and the agenda and tend to have more meetings.
- Planning Cells: Includes hundreds of participants at multiple sites (one site per planning cell). Participants at each planning cell deliberate on issues and try to find solutions. At the end, reports from all cells are integrated into a final report and participants from all planning cells approve the final report. Once the final report is approved, it is handed to decision makers.
- Citizen’s Jury: A committee of approximately 25 people provided with a specific mandate. A citizen’s jury is responsible for setting its own agenda, obtaining the information and meeting with experts in order to fulfill its mandate.