The reform of the sector covering primary healthcare and welfare is a highly participative project: six project teams have been involved, each with around 40 representatives working in this field, almost 1,000 people registered to participate in the assessment evenings in each province, plenty of people shared their vision by mail or letter not to mention their expert advice using the scientific reflection room and, last but not least, the Primary Care Conference (‘Eerstelijnsconferentie’) attracted over 1,000 participants.
Together with my colleague Sofie De Coninck, I supervised the process in the run-up to the primary conference.
The Primary Care Conference, during which the reform was explained, was held on 16 February 2017. So now is the perfect time to look back and consider: is this kind of participative project worthwhile?
Over a year ago the project teams set to work enthusiastically on their task. Small subgroups worked together, debating and developing texts. This produced a shared vision on many different aspects. However, in some groups it became clear that a consensus was not always possible and that, on some matters, the visions lay far apart. Yet, this was also an enriching process, both for those in the teams and for those leading them. Supporters and opponents formulated and justified their points of view. This led to the creation of proposals for the reform.
In my opinion, this type of participative project depends on a number of success factors:
- Good preparation is essential. Think ahead about the answer you want from the various project teams. Formulate clear objectives and plenty of specific questions.
- Plan tight deadlines, to avoid the project teams getting bogged down with talking or not reaching a result. A little more than a year was scheduled for all the project teams to come up with proposals for the primary conference.
- Appoint a neutral process monitor to ensure that all opinions are heard, to keep track of deadlines and to offer support with reporting.
- Be aware that a consensus is not always possible and that it is valuable to know and understand the various points of view. Document the matters on which no consensus can be reached and formulate arguments for and against.
- Get feedback on the proposals from a large group of stakeholders.
- Make sure that the appropriate expertise is present in the project teams.
- Keep your finger on the pulse. After each working session a short online survey was sent to all participants to capture their feedback on the approach and to allow any adjustments to be made.
- Use innovative discussion methods to come up with ideas in such project teams. The world café is a very well-suited technique (http://www.theworldcafe.com/).
- The chairman’s leadership and management skills have a major influence on the end result. And, was it worth adopting such a participative procedure?
It was, in my opinion. All stakeholders in the field were involved in the reforms, the policy vision is now ready and there’s a momentum for change!