PLANNING FOR HEALTH IN LOCAL GOVERNMENT

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PLANNING FOR HEALTH IN LOCAL GOVERNMENT

• THE LOCAL GOVERNMENT PLANNING CONTEXT
• Kerry Stubbings
• Manager Social Policy and Health Support
• Moreland City Council
• Oct. 2003.

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• Provide a brief overview of the
• wider context for planning in Local Government.
• Discuss MPHPs and health planning in this
  context.
• Discuss some key issues and challenges for
  effective planning and action on improving health
  and wellbeing.

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The unique place of Local Government

• Across the life stages Cradle to the grave.
• Focus on community as a whole at a local level.
• Planning, funding, service provision, community
  building and advocacy roles.
• Wider context of State and Commonwealth policies.

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LOCAL GOVERNMENT PLANNING

• DRIVEN BY
• Good Governance Responsibilities
• Legislative Responsibilities
• Funding Agreement Responsibilities
• Changing demands/needs of the community and the
  and the political environment

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LOCAL GOVERNMENT ACT
COUNCIL CORPORATE PLAN
HEALTH ACT MPHPS
BEST VALUE
PLANNING ACT MSS
LOCAL GOVERNMENT PLANNING
Accreditation
OTHER LEGISLATIVE PLANNING RESPONSIBILITIES eg
Roads Plans
SPECIFIC SERVICE PROGRAM PLANNING Eg HACC
LOCAL AREA COMMUNITY PLANNING
PARTNERSHIP PLANNING eg PCP
LIFE STAGE AND POPULATION GROUP PLANNING eg
Early Years
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The Local Government Planning Repertoire
..waltzes, rock and free form flight?

• Sorting out the hierarchy of plans.
• Relationship between legislated plans and other
  plans.
• Different models, processes, timing and
  stakeholders.
• Strategic and/or operational.

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Applying different lenses

• Healthy Public Policy planning
• Addressing goals for improved population health
  outcomes. Health Promotion planning.
• Triple Bottom Line planning
• Addressing social, economic and environmental
  goals. Understanding the interdependencies-enviro
  nments for health.
• Partnership planning
• Links, relationships, collaboration, formal
  agreements
• Community Planning
• Community visioning, community driven,
  processes of engagement and ownership

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Local Government Act 1989

• GOVERNANCE RESPONSIBILITIES/PURPOSE/POWERS
• Currently
• Councils submit a corporate plan comprising
  corporate objectives for 3 years, strategies,
  performance indicators, a resource allocation
  plan plus a one year business plan.
• Proposed amendments 2002
• Formalises role as a distinct and essential tier
  of government.
• Will require a Council Plan for 3 years rather
  than annually plus A Strategic Resource Plan.
• Requires community consultation beyond just a
  statutory process. Public have a right to make
  a submission.
• New election cycle of four year terms aligned in
  November.

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Purposes under the LG ACT

• to provide for the peace, order and good
  government of its municipal district
• to facilitate and encourage appropriate
  development of its municipal district in the best
  interests of the community and
• to provide equitable and appropriate services and
  facilities for the community and to ensure that
  those services and facilities are managed
  efficiently and effectively and
• to manage, improve and develop the resources of
  its district efficiently and effectively.

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MUNICIPAL PUBLIC HEALTH PLANS

• Health Act 1958
• Each Council produces a Municipal Public Health
  Plan every 3 years with an annual review.
• The planning cycle includes needs assessment,
  research, community consultation, partnership
  development.
• Outlines ways councils and their partners can
  prevent or minimise health risk and enable
  residents to achieve maximum wellbeing.

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Environments for Health

• The Policy Framework for Municipal Public Health
  Planning developed in partnership between State
  and Local Government.
• Focus on determinants of health framework for
  developing healthy public policy at local
  government level.
• Supportive environments for health
• Four environmental dimensions - social,
  economic, built, natural.

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The Planning Act- MSS

• The strategic plan for land use.
• Framework for the Planning Scheme.
• Transport, land use zoning, development approvals
  framework, heritage, open space.
• Required to be done every three years.

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Best Value LG ACT

• Replaced Compulsory Competitive Tendering (CCT)
  in December 1999.
• Aimed to enable councils to determine the most
• effective means of providing a service to the
  community.
• Act outlines six Best Value Principles that
  councils must observe.

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Best Value Principles

• Quality and Cost standards for all services
• Responsiveness to community needs
• Accessible and appropriately targeted services
• Continuous improvement
• Regular community consultation
• Frequent reporting to the community

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Common Features of the Legislated Plans?

• Strategic long term view
• Community engagement and consultation
• Grounded in analysis of current and changing
  community needs
• Aim for improved outcomes for community - social,
  economic and environmental goals
• Each has impact on population health and
  wellbeing
• Evaluation, reporting on outcomes

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Planning Linkages
State and Commonwealth Govt Policy Legislation
Funding Agreements
Best Value Business Planning Triple Bottom Line
Reporting Monitoring Evaluation
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Component and complementary plans

• Community Safety Plans
• Leisure Plans
• Life Stage Plans eg Early Years
• Multicultural Plans
• Disability Plans
• Transport Plans etc etc..

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Planning Linkages ..Moreland mark 2
City Vision
CITY PLAN A COMMUNITY PLAN Long
Term Incorporating MPHP and MSS and other
broad strategic plans
COUNCIL CORPORATE PLAN Including annual
budget annual business plan
Department Service Plans
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Environments for Health Linkages

• Identification and agreement on the contribution
  each plan should, can and will make to improved
  health and wellbeing outcomes
• the key determinants of health
• risk and protective factors
• Leading the Way tools..

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Moreland MPHP 2003 14 ACTION AREAS

• Social and Economic Circumstances
• Employment
• Education
• Housing
• Built and Natural Environment
• Early Years Birth to Adolescence
• Personal Well-being and Safety
• Access and Availability of Services
• Social Inclusion and Social Support
• Social Participation
• Political Participation
• Recreation, Arts and Leisure
• Transport
• Information

• ROLES
• Strengthen Community Capacity
• Plan
• Advocate
• Provide Services

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Key Planning challenges

• Governance
• Breadth need to respond to full gamut of
  community issues
• Community engagement and accountability
• Community planning
• Stewardship of resources
• Processes
• Community Consultation
• Timelines- aligning the planning cycles
• Legislative compliance vs other drivers

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Integration

• Aligning different values and paradigms
• eg urban development and design goals
• with environmental sustainability
• .with ..road engineering priorities ..
• withfinancial planning
• withaccess and equity goals
• .all to support social model of health
  planning.
• Understanding the barriers to integration and
  collaboration within Council, community and other
  levels of government.

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• Evaluation
• Developing processes and tools for evaluation
• Difficulty of measuring outcomes - long term and
  short term impacts
• Skills and resources for using evidence based
  research, health impact assessment
• Resources
• Financial, staffing and skills capacity
• Cost Shifting Increased responsibilities with no
  increase in resources
• Efficient use of resources for planning processes

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Some Traps.

• Using the Hammer Legislating for planning at the
  local level
• A tendency for State Govt. to use the
  legislative push to require planning for specific
  goals.
• Risks level of commitment, quality and
  exacerbates cost shift to local government.
• Response?
• State and Local Government agree on a clear
  hierarchy of legislated strategic plans - LGA,
  MPHP and the MSS.
• A consistent application of this by State
  Government Departments.

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Overdosing on Strategic Planning

• Overlaying many strategic planning processes in
  one community with potential for
• confusion of purpose and goals
• duplication of efforts and resources
• community consultation fatigue or
• scepticism
• contradictory directions

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Responses?

• Align principles, values and goals through the
  Council Plan Healthy Public Policy.
• Council Plan with the MPHP and MSS can provide
  the key framework, data and consultation input
  for other plans.
• MPHP being identified as an overarching plan for
  health and wellbeing goals.
• Identify common processes and timing.

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• Homogenising the plans
• Efforts to align and integrate too much
  resulting in over simplification.
• Best Practice planning in specialised areas
  jeopardised.
• Responses?
• Clarify/reach explicit agreement on the unique
  and specialised role for each strategic plan
  while aligning with the broader principles, goals
  etc.
• Design the Councils Planning Map.

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Great ideas but no action

• Avoiding the rhetoric on the shelf.
• Breadth of the MPHP and long term nature of the
  goals can lead to an over generalised plan.
• Responses?
• Balance strategic capacity of MPHP to raise
  awareness and lever resources, with capacity to
  deliver.
• Implementation Plans - cross-referenced in
  related plans-linked to MPHP.

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The myth of rational planning

• Expecting rational, tidy planning
• and implementation with disappointment and sense
• of failure if things dont go as planned.
• Responses
• Understanding the dynamics we cant control it
  all
• Ongoing processes for learning and review
• Systems to respond when opportunity knocks

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Evaluation

• Evaluation undertaken as performance reviews
  of outputs rather than analysis of impact and
  outcome.
• Long term nature of health outcomes.
• Responses?
• Pooling Council and other resources for
  evaluation of integrated strategies.
• Developing common evaluation processes and
  indicators of progress.
• Partnerships with research bodies.

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To Conclude

• Local Government is engaged in a complex and
  varied range of planning processes.
• Moves for more legislated plans by State
  Government would further confuse and strain the
  system.
• Opportunities for simplifying planning with
  agreement on
• the hierarchy of plans
• the unique role each plays and how they link.

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• MPHP is being identified as an overarching
  strategic plan complementing the MSS.
• Use planning energy and resources more
  effectively to achieve better health outcomes
  through joined up -
• Health Promotion planning
• Community engagement
• Local action
• Evaluation