This public policy is made not only by politicians,
but by thousands of public servants and the tens of thousands of women and men
who petition parliaments and ministers, who join interest groups, comment
through the media or represent unions, corporations and community movements.
All have a stake in public policy. The entire community is affected by public
policy[2].
In the book Journal
of Public Administration, N.L. Roux suggested that, the formulation of
public policy rests, in practice, mainly with the legislative institutions at
the different levels (spheres) of government and administration, political
functionaries, leading public officials, pressure groups and interest groups.
These institutions and people, however, cannot play a central role in policy
formulation if adequate information relevant to policy is not available. It is
mainly in this context that public officials, who perform their duties on a
daily basis at grass roots level, are in a position to provide valuable
information for the development of public policy. It is the public official who
is confronted continuously with the implementation as well as the cause and
effect of policy. The public official is therefore, in an excellent position
not only to identify limitations and constraints in policy, but also to
initiate effective procedures to rectify them[3].
For instance, due to their knowledge, discipline and
experience in health sectors, we cannot avoid public health manager when
deciding to make any policy concerning health matters. Health policy’ is as
‘authoritative statements of intent, probably adopted by governments on behalf
of the public, with the aim of altering for the better the health and welfare
of the population. Thus health policy consists of a series of governmental
decisions about what type of care is to be provided for the betterment of the
health of its population and how it will be done. Heidenheimer et. al. (1990:
p.59) Therefore, in identifying the components of health policy regarding which
kinds of personnel may provide what kinds of medical care, public health
manager should participate in the whole process of health care policy making to
map out all needed criteria.
In the theory
of Structural Interests in Health Care, Alford (1975) views the total
health care system as a network involving different structural interests.
Alford argues that the medical profession is in a dominant, exclusive and
monopolistic position within the health sector. He states that ‘physicians are
the most important interest group representing professional monopoly[4]’
(p.194). As a result, Alford says, ‘their interests are thus affected
differently by various programmes of reform. But they share an interest in
maintaining autonomy and control over the conditions of their work, and professional
interest groups will (when that autonomy is challenged— act together in defense
of that interest’ (p.192). Hence by including them in policy making process,
you give the room that can pave a way and avoid these autonomy challenge
As stated in standard textbooks on public policy
(e.g., Anderson; Dye) argued on different models of policy making where stated
that Process models attempt to generalize about the sequence of steps or
actions that occur as policy issues are raised, debated and resolved. They
focus more on what happens, when and how than on who the participants are and
why particular outcomes occur. A typical example includes the stages of problem
identification, proposal formulation, program legitimation, program budgeting,
program implementation, program evaluation and problem resolution/program
termination (Jones). Process models are widely used in policy education. They
help answer obviously pressing questions such as, "Where do we
start?" and "What happens next?"[5]
Therefore if policy making process will not include public sector managers who
are expert on the field who will be responsible to answer these questions?
On Rationalism model Anderson argued that rationalism
typically includes the stages of clarifying and ranking goals, identifying an
array of alternatives for reaching the goals, predicting the consequences of
each alternative, comparing the anticipated consequences of the various
alternatives and selecting the alternative that maximizes the attainment of
goals. In this argument you can’t avoid public health managers for instance
when deciding to prepare a policy concerning health care or you can’t avoid
medical officers when preparing a policy concerning reproductive and child
health care. If you exclude these public health managers who will identify and
ranking goals? Who will anticipate the consequences?
Moreover, for a policy making process to be productive
to a social community we can’t exclude public sector manager who are working
closely to grass root community since we
need their knowledge and experience to clarifying and ranking goals,
identifying an array of alternatives for reaching the goals, predicting the
consequences of each alternative, comparing the anticipated consequences of the
various alternatives and selecting the alternative that maximizes the
attainment of goals.
Muhsin Hero - 0717664685
[1] G
Thei, Public Policy Making: The 21st Century Perspective p.6
[3]
N.L. Roux, Journal of Public Administration, Vol 37 no 4, December 2002 p. 429
[4]
Alford, Robert R. (1975) Health Care Politics: Ideological and Interest Group
Barriers to Reform, Chicago: The University of Chicago Press
[5]
Anderson, James E. Public Policy Making, 2nd ed. New York: Holt, Rinehart &
Winston, 1979.
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