Abstract
BackgroundSystems for planning are a critical component of the infrastructure for public health. Both in Australia and internationally there is growing interest in how planning processes might best be strengthened to improve health outcomes for communities. In Australia the delivery of public health varies across states, and mandated municipal public health planning is being introduced or considered in a number of jurisdictions. In 1988 the Victorian State government enacted legislation that made it mandatory for each local government to produce a Municipal Public Health Plan, offering us a 20-year experience to consider.ResultsIn-depth interviews were undertaken with those involved in public health planning at the local government level, as part of a larger study on local public health infrastructure and capacity. From these interviews four significant themes emerge. Firstly, there is general agreement that the Victorian framework of mandatory public health planning has led to improvements in systems for planning. However, there is some debate about the degree of that improvement. Secondly, there is considerable variation in the way in which councils approach planning and the priority they attach to the process. Thirdly, there is concern that the focus is on producing a plan rather than on implementing the plan. Finally, some tension over priorities is evident. Those responsible for developing Municipal Public Health Plans express frustration over the difficulty of having issues they believe are important addressed through the MPHP process.ConclusionThere are criticisms of Victoria's system for public health planning at the local government level. Some of these issues may be specific to the arrangement in Victoria, others are problems encountered in public health planning generally. In Victoria where the delivery structure for public health is diverse, a system of mandatory planning has created a minimum standard. The implementation of the framework was slow and factors in the broader political environment had a significant impact. Work done in recent years to support the process appears to have led to improvements. There are lessons for other states as they embark upon mandated public health plans.
Highlights
Systems for planning are a critical component of the infrastructure for public health
Of particular interest are the questions: has the Victorian framework improved planning processes and outcomes; what has been the extent of any improvement; and what are the challenges that remain? Underpinning these questions is the broader issue regarding the degree to which problems, where identified, are specific to this Victorian framework for planning or are general problems encountered in public health planning, irrespective of the manner in which it is organised
Analysis of the interview transcripts provided a great deal of information about the planning process from which four significant, and interrelated, themes emerge: agreement that the legislation has improved systems for planning but debate about the extent of that improvement; significant variation in the way in which councils approach planning, their level of sophistication and the priority they attach to the process; concern that the focus is primarily on the process itself rather than on outcomes; and some tension over priorities, with frustration expressed by those responsible for developing municipal public health plan (MPHP) that areas they believed should have priority are either not included in plans or where they are included they may be relegated in importance when State and Federal government prioritise other activities
Summary
Systems for planning are a critical component of the infrastructure for public health. Both in Australia and internationally there is growing interest in how planning processes might best be strengthened to improve health outcomes for communities. Strengthening public health infrastructure and capacity is an issue attracting increasing national and international interest (see for example [1,2,3,4] and [5]). One component of this work has been a focus on how to improve planning processes at the community level (see for example [6,7] and [8]). A central concern is how planning processes might be strengthened to improve outcomes in the public's health
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