Whose Best Interest?

06 Jun Whose Best Interest?

When government comes up with ideas (called public policy), they are designed to help us do things that are generally good for society, and help discourage things that are generally bad for society.

That makes sense. Well, that’s the easy bit.

It’s harder to work out the details, especially when the groups you want to help aren’t experienced at communicating with government. This means it’s generally easier to work with large corporates and harder to work with small business to ensure that government decisions work the way they should.

Most professions or industries have peak industry associations that take on this liaison role between business and government. However, many peak industry associations encounter similar issues to government – the smaller the business, the less resources they have and the harder it is to engage with them.

Unfortunately, this can mean that government, peak industry associations, or even larger businesses decide what is in the best interests of smaller businesses. Once a law is created, the smaller businesses may struggle, because the laws don’t work for them.

Let me give two examples.

Example 1 – when I lived in Europe, I met with various government policy-makers to better understand their community consultation practices. I was writing a chapter on this topic for a book. The stand-out response, in my mind, was the Germans. They looked at me rather confused and said something to the effect that “we pay tax too, so we automatically include taxpayers’ concerns in our legislation-drafting process.” Well, I had to bite my tongue very hard not to laugh.

Example 2 – recently, I was admitted to two different hospitals. In both hospitals, I experienced traumatic situations. In fact, I simply waddled out of one, jumped in the car and went home.

Hospital 1 rang me the day after discharge to see how I was going. I expressed my concerns to the nurse, who asked me what I wanted to happen next. She escalated to the head of nursing, who rang me the following business day. The head of nursing listened to my experience with empathy, demonstrated that she understood just how traumatic the hospital’s actions had been for me and undertook to (a) change some processes under her control and (b) escalate my other concerns to the relevant areas of the hospital.

In this case, the hospital gave me a role in determining my best interests and empowered me with ideas and names to help me should I ever experience a difficult situation in that hospital again. I had a role defining my (and hopefully others’) best interests – and the hospital’s responses.

Hospital 2 did not ring me after discharge. I mentioned to a group of senior hospital staff that I had been in hospital recently and they asked for my experiences. I related the incidents and they asked me to write it down for them. Their email responded that the hospital had followed the correct processes.

I expressed disappointment that this seemed to be process-centred care, rather than patient-centred care. Four months after I walked out of the hospital, the head of nursing rang me. It was a difficult conversation.

Essentially, she told me that I had experienced patient-centred care because the staff, from their years of experience, knew what was in the patient’s best interests and implemented this. Their understanding, not the patients’. I told her that I believed patient-centred care put the patient at the centre of decision-making. In fact, I have a right to refuse blood transfusions and resuscitation – why can’t I refuse particular aspects of care that my doctor recommended against anyhow?

It would seem that Hospital 2’s policy of patient-centred care means the medical staff decides what is best for the patient. Hospital 1’s policy of patient-centred care allows the patient a bigger role in determining what is best for themself.

This comes back to my heading “whose best interests?” There is only one way to work out someone’s best interests – invite them to be a part of the conversation. It is important for government to engage effectively with the relevant community while creating policy decisions. This is the only way to understand “best interests”.

I encourage you to talk to government and join your relevant peak industry association, become a part of the conversation, to ensure that it is indeed your own “best interests” that government is taking into account during its decision-making process.

It can – and does – work.

This article comes from my column entitled “Here to Help” in Hunter Local, June 2021. If you have an everyday problem just begging for a simple, real world solution, send it to “Here to Help” and let’s see what we can achieve.

Elaine Abery has a closet full of great ideas and empowering solutions. She’s also the Director of Unravelling Red Tape, a company dedicated to helping everyday people, not-for-profits and companies change the world through improved decision-making and legislation.