Introduction by Croakey: As reported recently, the Health Issues Centre (HIC) hosted on online forum last month to hear from health consumers about ethics and healthcare decision making during the pandemic.
This Thursday (7 May), the HIC is hosting another online forum to examine the implications of COVIDsafe, the Government app intended to assist with contact tracing during the projected easing of pandemic restrictions.
In the article below, he argues the vital importance of community consultation in providing directions along the road to recovery.
Danny Vadasz writes:
“It’s one thing to act unilaterally when you’re bailing the lifeboat, it’s another to not consult when deciding in which direction to row.”
One remarkable feature of Australia’s COVID-19 response has been the absolute trust the general public have invested in their governments. It’s doubly remarkable given the contrasting total collapse of trust after the summer bushfires (remember them?).
Perhaps it has been the non-partisan approach across all governments; perhaps the water-tight alignment between government and science (unlike the bushfires), but as a country we permitted our leaders to make whatever unilateral decisions they considered necessary and we fell in line with hardly a whimper.
As a consequence, we can be relieved and proud of our collective success in demolishing the dreaded curve. But also as a consequence, we have foregone any semblance of community consultation at a time of community crisis.
This may have been understandable during the first phases of the epidemic, given its rapid escalation and the necessary focus on its epidemiology and the urgent need to ramp up testing, tracing, treatment capacity and personal protective equipment (PPE).
But the absence of consultation is now entrenched in the ongoing epidemic response, straining the social license granted by the community for the government to act in its best interests.
The trust earned by authorities in the context of an emergency will not be sustained over the longer process of recovery without a reciprocal investment in collaboration and partnership. It’s one thing to act unilaterally when you’re bailing the lifeboat, it’s another to not consult when deciding in which direction to row.
Now that we are entering the “recovery phase” of the epidemic (let’s hope that’s not contemporary hubris asking for a biblical smite), the next wave of policy decisions will reshape how we live our lives.
Will we sit out reintegration and wait for a vaccine? Will we create a two-tier society where most people return to a new normality while a significant minority remain in a bubble of heightened vigilance? Do we really want politicians and economists to make that call without inviting our reflections on the implications?
But community consultation is not just a question of civil rights; it is an essential component of managing the crisis trajectory and obtaining a 360 degree view of the road to recovery.
Why consultation matters
Consultation is necessary to ensure that Australians understand and comply with initiatives to contain infection.
It ensures that we better understand the barriers to their compliance and the unintended by-products of policy decisions – so-called perverse outcomes (for example, the impact of extended social isolation on mental health and the consequences of lapsed treatment for other conditions).
Most importantly, it enables consumers to participate in policy debates that will profoundly impact their futures and reshape our society. And for this to lead to successful outcomes there needs to be a sense of common ownership.
As a health consumer advocacy organisation we have watched with dismay how quickly and comprehensively the health system has discarded its much lauded commitment to consumer engagement and a patient-centred health approach as soon as the COVID crisis manifested – suddenly consumers have become an inconvenient obstacle to managing their own health circumstances.
A case in point is that a long time ago, when it looked as if we would have a drastic shortage of intensive care unit resources (three weeks ago), it seemed evident that there would need to be an ethical framework to determine how scarce resources could be rationed fairly.
In the absence of any interest from governments to initiate a community discussion on this (I exempt only Queensland State Health from this criticism, who set the gold standard in how to engage), we scheduled an on-line community forum to measure interest in a public discussion.
In less than a week we had over 200 registrants. This has encouraged the combined state consumer health peak bodies to host a series of COVID-19 community forums to discuss a variety of emerging issues and challenges in the COVID journey.
These are partly to allow those who will be impacted by government decisions to voice their concerns but also to allow policy makers and health professionals to hear firsthand how the community is faring.
Airing privacy concerns
The next forum will be held on 7th May and you can register for the event and a package of background material here.
Unsurprisingly the theme of the Forum is “Will the Road to Recovery Cost our Privacy?”
In the case of COVID-19, Australia’s governments have demonstrated that they can put the interests of the community foremost – something we don’t always see.
But having the best interests of the community at heart doesn’t translate to always knowing what is best for the community.
The only way to understand the unintended consequences of good intentions, the experiences of those who fall between policy gaps or the lived experiences of those who must cope with special circumstances…is to ask them.
It’s not enough to think of community participation as the complaints you get when policy goes wrong.
Society should have the opportunity to input into policy deliberation, not just report on the impact of that policy after it has been enacted.
Trust in government is hard earned but can easily be frittered away if it is not reciprocated. As the survivors in a lifeboat would attest: “We’re all in this together”.