HOW CAN HEALTH BUREAUCRACIES CONSULT EFFECTIVELY ABOUT THEIR POLICIESAND PRACTICES - SOME LESSONS FROM AN AUSTRALIAN STUDY

Debates about the theory and practice of participation and participato ry strategies have become consistent features of policy development th roughout the world. In Australia, as elsewhere, governments routinely employ strategies such as community consultation as a means of creatin g opportunities for participation. It has been argued that these measu res are as much an attempt to contain or manage the demand for represe ntation by a myriad of interest and pressure groups as they are an exp ression of democratic principles or highly valued public opinion. Neve rtheless, governments and interest groups alike have been advocating e xpanded consultation programs and seeking to refine the process of con sultation in order to achieve optimum benefits for all parties. Much o f this attention is focused on the mechanics of how to undertake consu ltation exercises which are efficient and effective. By contrast, this paper discusses the structural factors in a government bureaucracy wh ich will facilitate or impede consultation with communities. It draws on the findings of a research consultancy conducted by the authors for one large commonwealth government department in Australia. The resear ch suggests that while the skills and performance of individual office rs are important, there are several key organisational indicators in t he government bureaucracy itself which will determine its ability to c onsult effectively.