Transcript
Transcript: Fostering Federal, Provincial and Territorial Relations in Health Policy Development
[00:00:01 Text appears onscreen: "Fostering Federal, Provincial and Territorial Relations in Health Policy Development – With Jocelyne Voisin, Senior Assistant Deputy Minister, Health Policy Branch, Health Canada."]
[00:00:16 Jocelyne Voisin appears onscreen.]
Jocelyne Voisin: My name is Jocelyne Voisin, or Jo Voisin, everyone calls me Jo, and I am the Assistant Deputy Minister of the Health Policy Branch at Health Canada.
[00:00:27 Text appears onscreen: "What is the process of being able to do something in collaboration with others?"]
The first thing is really to understand the perspective of experts in the fields that also influence health systems in the provinces and territories. So, it is really about understanding what the experts are telling us about the best ways to address the problem or tackle the problem, and then really taking that information and having a conversation with the provinces and territories.
So I am co-chair of five different tables with the provinces and territories on different subjects, so we use this mechanism to discuss with them whether these are—are these the right priorities, what are you doing in your field to move things forward in these areas? That then helps us to inform whether we are going in the right direction, and whether we can eventually have an agreement with them based on those priorities.
[00:01:39 Text appears onscreen: "How important is timing in determining when and how to engage different stakeholder groups and solicit their input?"]
First, I would say that, you know, often we do a lot of work in policy, there is no perfect time to bring it forward or advance it, or make an announcement, et cetera. But I always tell the people who work with me that it's not lost; maybe it's not now, but it will be, you know, in a year, in a few years, we don't know. But the work will continue and it's not lost.
The other thing is to really think about the context. So, what is the general context? What is, what is happening in the world, in the country, in the province or territory—if the issue is really specific to that context—that might influence whether this is a good time or not?
[00:02:32 Text appears onscreen: "How would you identify key partners, relationships and priorities in a new policy area?"]
So, I can imagine if I'm all of a sudden stepping into a completely new job that I know nothing about, but the first thing would be to read the seminal works. Like a lot our… a lot of the policy areas, I think step into any policy area and you'll have sort of some seminal reports. So, what gives you the history of that policy, how it's evolved in the country over years, so you can kind of see what the patterns are and what things have been tried and how they worked out. And that will also give you a sense of who the experts are in the field, because they will reference, you know, other people and then you'll find other people, and then… So you kind of get a very good sense then of who are the kind of people who know a lot about this. And I think that's especially important in the context that we find ourselves in today, because society has changed a lot in Canada over the past decades, and we really need to understand that new perspective from a diverse view when we're making our policies.
[00:03:40 Text appears onscreen: "How can federal, provincial and territorial partners work together towards common goals?"]
Once you kind of get your head around what those major issues are, try to put some sense around the buckets of things that you need to unpack, and think about what levers that you have within the federal sphere to influence that. There's spending power, used heavily in the health domain. There's, of course, tax policy in the domain of finance. There's legislation, regulation, and the convening power, I think, can't be underestimated. And I think the federal role in convening partners and really bringing not just provinces and territories, but all sorts of stakeholders together to advance a common goal is really important.
We've done a lot of work in the health sphere in terms of indicators and working with Canadian Institute for Health Information on what common indicators you would use across the country to measure success, and part of that is really working with provinces and territories to come up with those. We can't come up with those on our own; we need the experts and the people who actually have the data in their health systems to really define what those key indicators will be for success.
[00:05:00 Text appears onscreen: "What strategies or tactics have you found helpful to support consensus-building?"]
Building consensus, especially… I mean, I think the health-… in the health sphere, the federal provincial territorial relations are especially contentious given the amount of money at stake for the provinces and territories. Health funding represents at least 40% of provincial and territorial budgets. So you can imagine there's a lot at stake for them in terms of those discussions. And often the policy discussions get mixed up with the health funding discussions because they are so tied together.
So, building consensus, I would say, first, is start incrementally. So you can't go to the table with something cooked, with here are the five pillars of the strategy and I want you to sign on today. Right? Like you really have to build up to getting buy-in, at least understand the issues and building up that policy development. The second thing is really listening, like understanding where they are, knowing your… doing your research, like, understanding where each province is, what are their specific issues. So, really understanding where they're coming from so that when you do come forward with something, you're sensitive to the context and how you can arrive at consensus, and come with something that will be appealing to them.
[00:06:30 Text appears onscreen: "What advice would you offer policy analysts?"]
First, I would say that personal relationships are very important, absolutely very important. So, it will try . . . it will fill the gaps that, in another context where there is not a good relationship, we would not be able to resolve. That is therefore really important in the context of relations between provinces and territories. And also important in the context of relationships with other departments, other stakeholders, if people know you and have a relationship with you, they will ultimately be more willing to help you.
The other is to be curious, to really do the research, to understand your policy area to have more value in your opinions and advice. And then finally, I would say have fun. Like, it's fun to do research like that. So if you're like me, I really enjoy learning new things every day and meeting all kinds of interesting people. So, have fun!
