Systemic advocacy - What works?

1. Systemic advocacy - What works? Jim Simpson jcsimpson@optusnet.com.au

2. One current campaign • An assessment item in Medicare • A joint campaign of CIDs and AADDM

3. What’s your aim? • Work from the goal to the options for getting there? Goal - Better health for people with intellectual disabilities Options – Lots! Most useful are ones that will make a big contribution to the goal and appeal to the decision makers.

4. Pros Evidence it will work In line with developments in Medicare and internationally A valuable signal Cons Uncertainty of eligible population Uncertainty of take-up rate Medicare item

5. Getting on the agenda • Initial lack of receptiveness in the Department. • Sought a meeting with the Minister – CID in Canberra, parent in his electorate. • Can anyone help you get a meeting? • You’ve got about half an hour!

6. A crisp presentation • Keep to the essential points • A clear, straight forward message • One or two pages – bullet points • Think about your audience – Will s/he like anecdotes or data? Etc A man focused on practical chunks of reform.

7. What to cover • Who you are – we represent lots of voters, we know what we’re talking about • The problem – People with intellectual disabilities are in poor health • Why its like this – Communication barriers, five minute consultations • The evidence – Research and our experience • Some options for solutions • What you are seeking – Something s/he can say “Yes” to. Anything from a dialogue to specific action, eg the Medicare item • What will help win him– Cost savings etc

8. Pros Serves up a solution A concrete election promise A good middle ground - Cons What if they don’t like it? There might be an option they like better Use the specific as an option for action, not the only option To put a specific proposal?

9. So what happened with Tony? It resonated with him We sought - an election commitment We gathered support including AHCRA We got - an acknowledgment of the problem and a commitment to look at it and other options. A valuable step forward!

10. After the election • We met with the Minister’s adviser – very important people • The Minister sought advice from the GPs • The RACGP emerged as a champion • A joint budget proposal 2005 – detailed rationale, specification, costing

11. We gathered support Australian Association on Developmental Disability Medicine Australian Consumers Association Australian Council of Social Service Australian Federation of Disability Organisations Australian Medical Association Australian Psychological Society Australian Society of Special Care in Dentistry Australasian Society for the Study of Intellectual Disability Dietitians Association of Australia Down Syndrome Australia Network Human Rights and Equal Opportunity Commission National Council on Intellectual Disability National Ethnic Disability Alliance Royal Australian College of General Practitioners Saint Vincent de Paul Society National Council

12. But we didn’t quite get there Instead, the Department to look at it closely. Time to work with the Department • There issues? Respond. Adjust the proposal. • Try to see senior people Gather more support Keep talking to the Minister’s office.

13. So, bringing it together • Who are the key decision makers – eg Minister, Director-General, Premier, How can you get to them? • Who else do you need to have on side? Eg ministerial advisers, departments. • Whose support will help? In the disability sector, outside – avoid a narrow support base. • Who might oppose you? Can you avoid this? • Opposition, minor parties?

14. Think “interests” and options, not just positions Eg Our position – A Medicare assessment item Our interests: • Better health care • Regular health assessments Options • Nurse based assessments • Salaried doctors • Use of other Medicare items?

15. Decision maker’s interests Eg: • Better lives for people with disabilities • Consistency with govt policy, political philosophy • Contain costs • A practical solution I can say yes to! • Avoid conflict with important groups • Kudos • Votes • What flows from their personality/background? Ask open questions, “Why?”, “What are your thoughts?” Ask yourself, “What will appeal to them”? “What might worry them?”

16. A good outcome • Best available alternative • Satisfies interests, especially ours! • Amongst many options • Legitimacy – measured objectively eg based on research about what works, best practice • Compliance prone commitments • Builds relationships

17. But never sell your soul Be true to principles of advocacy: • On the side of people with disabilities • Vigorous action • Fidelity to people with disabilities And so, for example, you might advocate sweeping reform while also advocating some practical initial priorities.

18. Build a strong coalition • Consult with your constituency, and report back • Fact sheets, discussion papers • Go looking for valuable allies • Email groups • Letter writing campaigns • Position statements • Media

19. Is the time ripe? Consider this when deciding what issues to concentrate on BUT, never underestimate the power of • persistence and • flexibility

20. Will we get there with Medicare? Yes!!!!!!!!!!!!

21. References Fisher R, Kopelman E,& Schneider A (1994) Beyond Machiavelli, Tools for Coping with Conflict. Harvard University Press Fisher R & Uri W (1982) Getting to Yes – Negotiating Agreement Without Giving In. Arrow Books, London Ury W (1991) Getting Past No – Negotiating with Difficult People. Century Business, London