Implementing Health Policy – Relationships between the Politicians and the Executive Dr E K Yeoh Secretary for Health, Welfare and Food Hong Kong Special.

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Presentation transcript:

Implementing Health Policy – Relationships between the Politicians and the Executive Dr E K Yeoh Secretary for Health, Welfare and Food Hong Kong Special Administrative Region Government

Outline of presentation Factors affecting the relationship between politicians and executive in policy implementation Government structure and health system of Hong Kong Case examples of the United Kingdom and New Zealand Reflection on personal experience Open discussion

Factors affecting relationship between Politicians and Executives Government and political system Structure and organization of the health sector Accountability and power relationship between politicians and the executives The professional background of politicians and the executives, particularly the position of the medical profession.

Profile of politicians and health executives Nature of appointmentWho are they?Qualifications PoliticiansMinisters/ SecretariesNot necessary medical professionals ExecutivesSenior civil servants Permanent secretary Chief Medical OfficerMedical professionals ManagersExecutives of statutory health authorities Predominantly medical professionals Executives of private health organizations Not necessarily medical professionals ProfessionalsDirect health care providers Predominantly medical professionals

Accountability and power relationship Delegation –Hierarchical relationship Devolution –Network of horizontal relationships arising from devolution of authority and contracting-out of public services

Organisation Chart of the Hong Kong SAR Government Chief Executive Secretary for Justice Chief Secretary for Administration Financial Secretary 11 Policy Secretaries, including Secretary for Health, Welfare and Food Bureaus and executive departments under the portfolio of respective policy secretaries Department of Justice

Secretary for Health, Welfare and Food Permanent Secretary for Health, Welfare and Food Five Deputy Secretaries Department of Health Social Welfare Department Government Laboratory Food and Environmental Hygiene Department Agriculture, Fisheries and Conservation Department Hospital Authority Health, Welfare and Food Bureau Hong Kong Structure of the health system

United Kingdom Structure of the Department of Health Secretary of State for Health Supported by a team of Ministers Permanent Secretary Chief Medical Officer Chief Executive of NHS NHS Executive Social Care Group Public Health Group

New Zealand Formal accountability Minister of Health Ministry of Health (Chief Executive) Ministerial Advisory Committees Annual output agreement Reporting Service agreements for some services District Health Boards (with provider arms) Private and NGO providers Negotiation & accountability documents Reporting for monitoring Service agreements Structure of the health system