Civil society groups representing
health professionals have the longest history of organized involvement
in health policy. They also enjoy the strongest legal and institutional
links with health systems. Nursing, medical, dental and other
practitioner groups significantly influence health systems, through
a mix of:
- formal stakeholder participation
- technical input
- political pressure
- industrial action
- bilateral lobbying.
The more skilled of the health
workers have used their market scarcity to exact concessions
that sometimes directly conflict with or reverse public policy
(Equinet,
1998).
Sometimes, powerful professional
associations and councils advance specific professional interests
in conflict with wider health systems or client interests. This
triggers both state and civil society intervention to bring consumer
and ethical issues into the public domain (Bennett
et al., 1995). Equally, where dealings between the state
and professional groups are not transparent, consumer lobbies
have grown up to safeguard client interests in reforming health
systems.
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