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.
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 Department of Justice Bureaus and executive departments under the portfolio of respective policy secretaries
Hong Kong • Structure of the health system Health, Welfare and Food Bureau 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
United Kingdom • Structure of the Department of Health Secretary of State for Health Supported by a team of Ministers Chief Executive of NHS Permanent Secretary Chief Medical Officer NHS Executive Social Care Group Public Health Group
New Zealand • Structure of the health system Minister of Health Formal accountability Ministerial Advisory Committees Annual output agreement Reporting Ministry of Health (Chief Executive) Reporting for monitoring Negotiation & accountability documents Service agreements for some services District Health Boards (with provider arms) Reporting for monitoring Service agreements Private and NGO providers