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Local Government Planning for Health & Wellbeing
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Preparing A Municipal Public Health Plan
Since it is not possible to address every actual or potential public health danger affecting a local government area, a planning and priority-setting process has to be undertaken. A strategic planning process ensures that expenditure is targeted to the areas of greatest need and where it is likely to be most effective. Whether explicitly or not every council and health agency is already making these kinds of planning decisions.
MPHPs enable such decisions to be made more systematically and to be documented. They are fundamentally a management tool for helping local councils determine the direction of public health priorities, identifying the key programs and strategies required to accomplish their objectives and evaluating progress.
Most key programs are likely to be in place already; some new programs may replace existing activities so as to respond to changing conditions. A plan will incorporate both maintenance and change strategies.
MPHPs are oriented on practical results which maximises outcomes within available resources. Effective implementation depends largely on the planning process itself. An effective process will include liaison with local communities on the key issues and the action which needs to be taken.
MPHPs represent a vehicle for councils and H&CS to plan public health programs and strategies in partnership. State and regional health policies and priorities establish the context for MPHPs. Improved co-ordination of Public Health planning will be achieved through consultation between council and H&CS in the development of municipal plans.
The information provided by councils in their plans will be used by the department to monitor key public health issues in local areas, to gauge the effectiveness of different strategies and to assist in the sharing of information among councils across the State. In the course of plan preparation, the department will provide feedback and to ensure that State and regional public health objectives are addressed.
Effective planning requires a structured methodology and a team approach. Nowhere is this more clearly true than in the field of public health, which cannot be the preserve of any one agency, sector or level of government, it is the shared responsibility of all. Within individual councils all staff including; community services, engineers, town planners, environmental health officers, medical officers of health, maternal and child health nurses and recreation officers, make decisions and carry out programs which have an impact on public health.
A MPHP is not so much the plan of the City of Healthville, but a plan for the City of Healthville. This recognises that the planning and delivery of public health services should be a partnership between the relevant groups. Planning provides an opportunity to develop a common purpose and sense of direction.
Once a decision has been made to proceed with the preparation of a MPHP, a number of important organisational issues must be addressed.
A steering committee should form the core of the process, although its functions and role will vary from council to council, depending on the particular needs of each municipality.
It is a useful means of bringing together appropriate representatives to oversee the preparation of the municipal public health plan. Its role is to:
The steering committee establishes preliminary objectives and sets limits on the scope and scale of the project to ensure that it remains manageable. For this reason, the group members should have a thorough understanding of the key (not all) public health characteristics, trends and events that may affect the community, as well as management and operational skills.
The steering committee should represent all the main interest groups, such as community health services, hospitals, community agencies and local government. Nevertheless it should not be so large as to be unwieldy. Fifteen members is the recommended maximum; a dozen is preferable. More than fifty percent of the membership should be from the local community, with the balance to include representatives from council and staff.
The committee should be reasonably representative of the community involved, considering socio-economic and ethnic groups, geographic spread (particularly in a large rural shire), women, young people and older residents. If this is not possible on the steering committee, other efforts should be made to ensure that these groups contribute to the strategy.
Interest groups that could be considered for representation on the committee include:
The most direct approach to selecting a committee is to identify and invite potential members. A more equitable approach is to contact all relevant organisations and seek nominations. It may also be worthwhile to advertise in the local newspaper, calling for nominations from individuals with knowledge and interest in health issues.
If a choice has to be made between nominations, individuals who are open minded, constructive and willing to contribute time and effort to the plan are clearly preferable. Ideally they would already be active in local organisations and thereby capable of following through the implementation of some of the proposed action strategies.If some nominees are not selected, they should be thanked for their nomination and invited to contribute to the process in other ways. The council may wish to ratify the proposed membership of the steering committee.
Selecting the steering committee chairperson could be one of the initial steps in setting up the plan, or could be undertaken at the first meeting. In most cases a councillor is the logical choice, in order to maintain close contact between council and the plan. Alternatively, a retired older resident may have the required experience, and more time to devote to the position.
Committee members need opportunities to get to know each other, to develop a team spirit, and to improve their motivation to contribute. For example, having supper after meetings and perhaps a dinner for the first meeting.
It is more efficient to fix committee meeting dates and times well in advance. Monthly meetings will probably be necessary to keep abreast of the plan formulation process. Evening meetings are likely to suit the majority of members but the most convenient time should be discussed at the initial meeting.
The steering committee will determine how formal its meetings will be and how it will make decisions. It may operate on a consensus model or vote on motions. A vote may only be necessary on major or contentious issues.
Meetings should be run in a way that provides plenty of opportunity for discussion and airing of views. The aim is to give fair consideration to all viewpoints and to come to informed and reasoned decisions.
Urgent decisions may need to be taken between steering committee meetings. The power to take these can be delegated to an executive group consisting of the chairperson, community representative and council officer.
It is likely that the steering group will nominate a plan co-ordinator or project manager as responsible for carrying out the work of plan development. (In some larger councils these tasks might be shared among a small working party). However, while this work can be quite demanding, particularly in periods of intensive activity, there is no reason for plan preparation to be the sole or even the major focus of any one officer's work.
The particular person(s) selected for this task will not necessarily come from the same professional group or unit within council. This will depend on local circumstances and organisational structures. However, it is essential that the plan co-ordinator has access to information and advice from key staff responsible for the main public health programs and services provided by council. The person should have strong written and oral communication skills, and be able to relate effectively with external organisations.
A time schedule for the MPHP preparation process needs to be drawn up as one of the initial steps. Realistic estimates of the time required for each stage may be difficult so early in the process, but a schedule is essential to maintain progress towards the end product.
There are a number of factors to be considered in drawing up a schedule . This might include the amount of time of the coordinating officer is able to provide to the steering committee and time allowed for the preparation of information material, its distribution, and dealing with responses received.
It is virtually impossible to schedule for major delays due to, for example, rejection by council of a draft document or major changes to the steering committee. Such unforseen hold ups would require readjustment to the schedule if they should arise.
View Sample Schedule (37 k image)
