Ed Harding

Ed Harding

Keeping health on the policy agenda in an election year

8 May 2024

Keeping health on the policy agenda in an election year

Health is a long-term issue in a short-term world, so how can health advocates make the most of an unprecedented year of elections?

As noted by many commentators, 2024 will be marked by an unusually large number of elections. These will occur in prominent countries such as the United States and India, as well as across the European Union. People in a total of 64 countries will be going to the polls, representing no less than 49% of the global population. For those seeking to change health systems for the better, this presents many challenges as well as opportunities.

But what can health policy advocates do to be prepared for and make the most of such an environment?

 

Getting political candidates on board with the issue

Advocates ultimately need to engage decision-makers, and elections bring a whole new cohort of candidates looking for public support. The opportunity to sign up to a simple policy pledge may be an attractive proposition to any candidate, if they feel it will boost their visibility in the public eye. And as it is a public commitment, this can later provide advocates with a great foundation on which to build a longer-term relationship if the candidate is successfully elected.

As they survey the list of potential candidates to approach, health advocates may do well to show flexibility in how they communicate their core mission to different politicians. For example, the same vision to improve patients’ lives could frame its arguments though different lenses such as inequality, citizens’ rights, greater efficiency and value from public spend, and new horizons in life sciences and digital services.

As the famous refrain goes, ‘all politics is local’, and many countries maintain local ballots for national deputies (or, if via some other system, may offer local weighting of some kind). In these cases, candidates will likely be most tempted by arguments, statistics and patient stories that are locally relevant.

Health advocates ultimately need to engage decision-makers, and elections bring a whole new cohort of candidates looking for public support.

 

Watch out for health policy getting too political

The English language makes a distinction between ‘policy’ (the strategy or action a government adopts, i.e. how a government leads) and ‘politics’ (the ceaseless, partisan struggle of political ideas and those who propound them), but not all languages do. During an election year, issues around health policy can become fodder for increasingly politicised and polarised debate. Health advocates should consider the risks of engaging in campaigning and advocacy work during this time, and will need to keep any eye on both electoral and charity law (which may specify what is and isn’t acceptable political engagement). Regardless of whether an advocacy group is independent or a charity, public perceptions of partisan behaviour will be heightened, and this scrutiny will also undoubtedly unfold on social media.

Despite these risks, the benefits of engaging with political candidates may well be worth it. For a rare moment, health advocates have a chance to pitch their case for change over a full government term of 4–5 years, allowing a more realistic cycle of investment and return on key improvements – which might include better patient outcomes, tackling health service backlogs, and possibly even cost savings.

 

The importance of maintaining good relationships

Of course, elections also bring the risk of losing long-standing political champions for a given health-related cause, as they either lose their seat or take the natural moment to step down from the demands of public office. While this is always disappointing, it may be wise for advocates to maintain the relationship; former politicians often enjoy a strong network of contacts, with the benefit of more time and freedom to pursue passion projects. The more they identify with a cause, the more likely they may be to offer constructive advice or to help plan a political strategy.

Post-election, many administrations will ‘swear in’ key officials, a process whereby a new minister or senior figure is scrutinised by a panel of lawmakers. For example, a panel of MEPs will be grilling the EU’s new Health Commissioner some time in 2024, after the European Parliament elections in June. If an elected official is willing to test the incoming minister/figure on a particular health policy issue, it may leave a lasting impression on the new official for the remainder of their term at the top.

 

Keeping health on the policy agenda in an election year

Placed in a room with a candidate for one minute, could you articulate your central asks, what this will require from decision-makers, and what the benefit to society will be?

Focusing on the fundamentals

Elections or no elections, uncertainty defines the modern political climate, and this will likely not be changing anytime soon. More cynical commentators may argue that, in fact, short termism and the revolving door of decision-making afflicts governments at all stages of the political cycle. I’m not so sure, but even so, there are some fundamental tactics that may work equally well in election years and beyond.

As obvious as it sounds, health advocates must know exactly what they are asking for. It may seem clear to you and your colleagues, but placed in a room with a candidate for one minute, could you articulate your central asks, what this will require from decision-makers, and what the benefit to society will be?

It also pays not to neglect relationships with non-elected decision-makers and influencers, such as civil servants or leading expert commentators, who will likely endure in their positions regardless of the election result, and to whom politicians of any background – especially new ones – may look for guidance. In fact, the period before an election often places restrictions on civil servants, which may free up their time to look at new issues, including new policy work.

Most importantly, elections remind of us the emotional as well as logical basis for society and its organisation. To that end, all health advocates must be ready to tell powerful stories that resonate and include the real-world experiences of patients, families and communities. In addition, a successful policy platform usually requires an alliance built on a diverse range of interests and sectors, armed with excellent, evidence-based arguments that withstand scrutiny.

Whatever the take, change usually requires both the short and long haul. But if you’re passionate about better healthcare for all, chances are you knew that already!

 

The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.
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