Influencing decisions
Respondents
were asked if they could have an impact on or influence decision
making in relation to health and social wellbeing. Many did not
think that they could and the reasons for this are summarised
below. However, community respondents believed that impact has
often been made in other areas and these experiences could be
learned from and applied to other health and social wellbeing
issues.
Influence of community groups
Over
half of the community group respondents did not believe that local
communities could have an influence and impact on decision making.
Health issue groups, the Board respondents and statutory workers
perceived that groups were able, in some cases, to have an impact
but this was usually limited.
Some
of the respondents' reasons for not being able to influence decisions
are listed below
§
due to the bureaucracy, communities do not
have the opportunity to make their feelings clear. "These
bodies would not come along and let you have a local meeting where
they could just go and talk"
§
"people do not know how to deal with
them. It is not like dealing with your local authority ie the
Council where your local group would be listened to. You can lobby
your local councillor but who do you go to in the Health and Social
Services?"
§
"small groups do not have the expertise to identify or assess their
problems".
To
have an impact some felt that
§
it "takes years and years of dedicated community work"
§
information has to be relevant with voluntary organisations
on a regional level often having more of an impact on decision
making than local groups
§
there is a learning process and that more recently local
communities are beginning to voice their concerns
§
sometimes professionals are needed to stimulate awareness
and once people are empowered, they can take on the issues themselves.
The
respondents gave some examples of where communities did have an
impact but mainly outside the Causeway area, such as the Well
Women Clinic in Derry. They achieved a lot through lobbying their
Board, by carrying out surveys, identifying people’s problems
and by going directly to the Board to get problems in particular
areas addressed. "They have had access to a lot of funding
and to people with a lot of expertise in particular fields over
the years."
Specific
issues such as the Spina Bifida Association were also raised.
They have been "able to bring pressure to bear on those who
could get things done. They have the advantage of being the expert
in that field".
Others
identified issues that need to be overcome if community groups
are able to have an impact and influence decision making:
§
it must go beyond consulting
and building up people’s expectations. Currently "community
groups would think that they feature very low" in this area
of decision making but "this will improve as they develop
and have a stronger voice"
§
time needs to be spent with groups to build their
confidence. Groups need to be encouraged to recognise "that
they have a bit of clout. In this part of the country they seem
to sit back and wait to see what people will give them. They
do not realise the potential of empowerment"
§
"most professionals do not want consultation and participation
as it makes life too awkward for them".
Informing
others of a group's impact on decision making
When
community groups consider that they have been successful in influencing
decisions around other issues of concern to them, they use group
newsletters, press releases and the existing networks to inform
and inspire others. The health and social care issue groups use
forums, advice centres, Annual General Meetings and the groups’
newsletters at a local, regional or national level. Other alternatives
include the ‘Practice to Policy’ which is a new European
funded project established by the Community Development and Health
Network for Northern Ireland; the function of which is to create
a comprehensive training and development programme on community
development within health and social care settings. Information
from this pilot project is informing practice and is shared through
a range of networks including the Rural Community Network and
Community Development and Health Network (NI). Another example
is the Northern Health Social Services Council members who include
Councillors and voluntary groups who feed information back to
their own organisations.
