4 Public Policy and Administration Simulation
Only one simulation is proposed for public policy and administration: the lobbying and advocacy simulation. The goal of the lobbying and advocacy simulation is to give students a chance to exercise or experience for the first time the skills required in lobbying and advocacy and to familiarise them with the political issues and processes of a particular country. As with several other simulations, students may also be required to complete the worksheets 1–8 to analyse the performance. This is particularly useful to keep students engaged. A short introduction to the uses and background to the worksheets is best given at the start of the class during which students will use a particular worksheet to analyse what occurs. This will allow students to take notes adequately during the simulation, thereby also keeping them engaged.
Students playing the role of a special interest group or lobbying firm have several options in representing the request of their citizens. The first of these is sending a letter. Letters are the easiest and most obvious method of lobbying, but they are not always the most effective. When sending a letter, it is important to use the correct address and greeting. The letter should be typed on the organisation’s stationery. Personal letters hold a lot more weight than form letters. The letter should be brief and focused, and it should specify what action is being requested. The letter should also be factual and accurate, and all the facts in the letter should be checked to ensure that they are correct and that conclusions are supported. The letter closes with thanks. The tone of the letter is very important, but it is hard to judge: it is best to be neither negative, condescending, threatening, nor intimidating.
Another option for a lobbyist or a special interest group is to make a submission. Submissions include information on the group or organisation being represented, as well as contact details, the topic or issue that the submission is about. A submission should also make clear why it is being made in the first place, what the concern is, how the group is connected to the issue, and what the expertise or experience on the issue is. It should also include the specific actions that need to be taken, and the reasons why this action should be taken. This section is the right place to give the facts and make the main points in the argument. It is important to be as brief and accurate as possible. Some reasons for which the actions requested are desirable to the decision-makers may include how they will improve quality of life, make a contribution to the welfare of the community, save money or be in the interests of the minister or secretary’s support base and constituents.
Table 4.1 lists what is required of students.
Table 4.1: Requirements, Lobbying Simulation
Group |
Concerns |
Oral and Written requirements |
| Citizens/Interest group | Issue to be raised by existing interest group or association | one page letter or three page submission; presentation to minister and public servants; answers to questions |
| Public Servants | how the requested change fits in with existing policy; potential application problems; costs; priority among other ongoing concerns; recommendations; any problems from similar proposals in the past | questions after presentation; one page memorandum to minister/secretary |
| Minister’s/Secretary’s office | political implications for party, cabinet, minister, constituencies; priority within cabinet compared to other ongoing concerns | questions during presentation; oral presentation of decision; one page memorandum outlining decision |
It is sometimes useful to outline briefly what would happen if no action is taken, but it is important not to sound threatening to the decision-makers. It is also a good idea to offer further information or face-to-face meetings on request.
When at the meeting, the lobbyist should keep the argument short and simple. Going in, it is important to be clear about why s/he is even there, and what it is s/he hopes to accomplish during the meeting. The lobbyist should have the facts straight, should be on time, polite, patient, and always be polite. Nothing should provoke the lobbyist into being rude. It is a good idea to make the issue personal for the decision-maker.
One of the most effective approaches in lobbying is to do the work for the decision-maker. A lobbyist should become a resource for that person or group. The lobbyist should leave a one-page fact sheet with contact details. Before the lobbyist leaves, s/he should thank the decision-maker again for taking the meeting. The lobbyist should also follow-up on the meeting and builds the relationship as much as possible. And the lobbyist should whenever possible provide opportunities for positive publicity – a photo opportunity, event or occasion.
It is now possible to turn to the role of the public servants and the minister or secretary’s team. The public servants or political aides have a number of options. In terms of the questions which they may ask, there are three types: asking for more evidence, asking questions of clarification, asking linking or expanding questions, and asking hypothetical, cause and effect or summary questions.
The questions which ask for more evidence include questions such as: How do you know that? What data is that claim based on? What do other sources say that support your argument? Where did you find the view you just expressed? What evidence would you give to someone who doubted your interpretation? The questions which clarify the issues or requests include questions such as: Can you put that another way? What’s a good example of what you are talking about? What do you mean by that? Can you explain the term you just used? Could you give an illustration of your point? Could you give another example of your point? Linking or extending questions include such questions as: Is there any connection between what you’ve just said and what X said before? How does your comment fit in with X’s earlier comment? How does your observation relate to what was decided previously? Does your idea challenge or support what seems to be saying? Doing? How does the change you want add to what has already been done? Hypothetical, cause and effect, or summary questions include such questions as: What are the one or two most important ideas that emerged from this discussion? What remains unresolved or contentious about this request? What do you understand better as a result of today’s discussion? What needs to be discussed again? What key word or concept best captures our discussion today?
When the time comes for the public servants to respond to the lobbyists’ efforts, they will usually provide either a written response or a verbal one. If writing, then the public servants should include certain content. According to a former politician, when bureaucrats are asked for something, all other things being equal, they say no. Public servants should use the correct greeting in their response. The letter should be typed. The content of the letter should be brief and focused. It should be addressed to the politicians or decision-makers and offer 2 or 3 options or make 2 or 3 recommendations. The letter or memorandum should be specific about the request made by the lobbyists. Public servants should check all the facts in the submission, and correct them or offer alternatives as necessary. Their memorandum should address costs, both actual expenditure and trade-offs, i.e. what will not be done if the request is granted. It should address how the requested change fits in with existing policy, and any potential application problems. It should also discuss what the priority of the request is in the context of other ongoing concerns and other recommendations made by the public servants. It should also discuss any problems or outcomes from similar proposals in the past. The tone should be neutral.
The minister or secretary’s letter replying to the lobbyist’s request should, all other things being equal, say yes. The letter should use the correct greeting. The letter should be personal, and the minister or secretary should not reply with a form letter. The letter should be brief and focused, and it should be clear and specific about what the minister will or will not do. The letter should thank the citizens for their concern. The tone of the letter should not be negative, condescending, threatening, or intimidating. The letter should address the reasons for the decision. In making the decision, the minister or secretary should consider the political implications for the party, the cabinet, the minister or secretary him or herself, and for the various constituencies. It should also consider the priority within cabinet compared to other concerns.
The simulation unfolds as can be seen from Table 4.2, which provides a sample class schedule.
Table 4.2: Sample Schedule, Lobbying Simulation
| Week 2 | Intro to health policy, UK; Team formation | Resources, UK health: government website, UN sources |
| Week 3-4 | Lobbying | |
| Week 5 | Intro to health policy, US Team formation | |
| Week 5-6 | Lobbying | |
| Week 7 | Intro to environmental policy, UK; Team formation | Resources, UK Environment: government website, UN sources |
| Week 7-8 | Lobbying | |
| Week 9 | Intro to environmental policy, US; Team formation | Resources, US Environment: Congressional Research Service, government website, UN sources |
| Week 10-11 | Lobbying |
Below are examples drawn from student work, both letters and memoranda, and used with their permission, on the understanding that they would remain anonymous.
Resource 4:1: Sample Announcement, Lobbying Simulation
Impotence Consultation – Dobson Announces Final Decision
Published date:
7 May 1999
From 1 July, GPs will be able to prescribe specified impotence treatments on the NHS for men with certain medical conditions, Frank Dobson, Secretary of State for Health, announced today.
Mr. Dobson said:
We have completed a public consultation to help us find a sensible balance between treating men with the distressing condition of impotence, and protecting the resources of the NHS to deal with other patients, for example those with cancer, heart disease and mental health problems. Today’s decision means slightly more money than currently will be spent on treating more men for impotence.
I received 861 responses within the consultation period. Three quarters of the responses supported the idea that the prescribing of Viagra by GPs should be restricted – indeed some 10% thought that it should be banned altogether. Over half thought that all prescribing of impotence treatments should be restricted or banned.
It is fair to say that a lot of people thought that more men than I proposed should be eligible for NHS prescriptions for impotence. But I have to think of the impact on the NHS as a whole in deciding this. I have, however, decided to extend the list of eligible patients to include: men treated for prostate cancer -the original proposal referred only to men having their prostate removed; men treated for kidney failure, by transplantation and dialysis; men who have had polio; men with spina bifida; men with Parkinson’s disease and men with severe pelvic injury.
Therefore GPs will be able to write NHS prescriptions for impotence treatments (including Viagra) for the following groups of men:
Men treated for prostate cancer
Men suffering from spinal cord injury
Men treated for kidney failure
Men with diabetes
Men with Multiple Sclerosis
Men with single gene neurological disease
Men with spina bifida
Men who have had polio
Men with Parkinson’s disease
Men with severe pelvic injury
For other men who are caused severe distress by impotence, it is proposed that treatment should be available in exceptional circumstances only after a specialist assessment in a hospital.
Mr. Dobson continued:
I have also decided that GPs can prescribe impotence treatments to those men not included in the above categories but who were receiving drug treatment for impotence from their GP on 14 September 1998.
I propose to bring these changes into force from 1 July 1999, subject to Parliamentary approval.
Other men whose impotence is causing them severe distress will be able to be referred by their GP for treatment in the secondary sector. I have asked the NHS Executive’s Acting Medical Director to prepare guidance for the NHS on the arrangements for identifying and treating through secondary care services those other men whose condition is causing severe distress.
I have noted that there is general agreement to my proposal to issue guidance which will ask doctors to aim to prescribe no more than one treatment a week, which reflects research evidence on this point. As I said when I announced my proposals for consultation I shall review the operation of this policy after one year.
Notes for Editors
From 1 July 1999 any patient not suffering from one of the named conditions for Viagra and other drug treatments for impotence, and therefore not eligible for treatment on the NHS, would be able to receive a private prescription from their own GP. GPs will not be able to charge for writing the prescription.
The associated Health Service Circular is attached.
The changes will be laid as regulations subject to negative resolution.
With the exception of Sweden, Viagra is not generally available in European Union countries at the expense of their healthcare systems.
Schedule 11 to the NHS (General Medical Services) Regulations 1992 is a list of drugs which GPs may prescribe on the NHS only in specified circumstances, and/or for specified patient groups.
The criterion underpinning this decision has been notified to the European Commission to comply with the terms of the European Transparency Directive. The criterion set out in full is as follows: A medicinal product or a category of medicinal products may be excluded entirely from supply on NHS prescription. It may alternatively be excluded except in specified circumstances, or except in relation to specified conditions or categories of condition, or specified categories of patient.
A medicinal product or a category of them may be so excluded where the forecast aggregate cost to the NHS of allowing the product (or category of products) to be supplied on NHS prescription, or to be supplied more widely than the permitted exceptions, could not be justified having regard to all the relevant circumstances including in particular: the Secretary of State’s duties pursuant to the NHS Act 1977 and the priorities for expenditure of NHS resources.
Resource 4.2: Sample Letter of Reply, Lobbying Simulation
To:
Laurence Buckman
Chairman, British Medical Association’s GP Committee
BMA House, Tavistock Square,
London, UK,
WC1H 9JP
From:
Rt Hon Andy Burnham MP
Secretary of State for Health
Department of Health
Richmond House
79 Whitehall
London, UK
SW1A 2NS
Date: 14 October 2009
Response to Request for Funds to Ensure Efficient Delivery of H1N1 Vaccines to Vulnerable Populations
Thank-you for presenting your case to us and providing your concerns about the H1N1 pandemic. We share your deep concern for the growing swine flu pandemic and its potential impact on the economy. We know that general practitioners play a crucial role in combating the swine flu and we recognise the effort that will be made into putting the vaccination campaign into practice as well as the non-routine work that will need to be done.
To support GPs, the Department of Health is providing a package of administrative cost-saving measures for the duration of the pandemic as well as £5.25 per vaccine dose. In addition to this, the government has launched other initiatives, such as the National Pandemic Flu Service, which will give the public access to anti-viral medications without having to see a GP, thus taking the pressure off frontline services (UK Government, 2012). This year, £109 billion went to the creation of new hospitals, 150 walk-in health care centres and 100 more GP practices in under-doctored areas for 2009–2010. This too will ease the pressure on the previously established GP surgeries.
The increase of H1N1 cases does not increase the vaccination costs. Our previously negotiated term of £5.25 per shot covers the mass inoculation program for all the target population, and we feel that this amount is sufficient. Consequently, at this time, we feel that it is necessary to decline your request for a funding increase to £8. The amount of £5.25 combines a per dose payment to cover additional staff costs and other expenses, as well as a package of measures to free up practicing time. We have already agreed to ease the burden of extra work by not making any changes to the Quality and Outcomes Framework in the 2010/2011 year. Doctors have been given leeway in setting their access targets, like guaranteeing appointments within 48 hours as well as advanced bookings, if they achieve high immunisation rates. We are also willing to extend the collection date on childhood immunisations to mid-February as we realise that a large amount of resources needs to be directed into preventing the swine flu, and as such will give all practice staff added flexibility.
If an urgent need arises to recruit additional temporary staff, the necessary legislative and practical arrangements are in place to do so. The NHS is able to double its critical care capacity to accommodate serious H1N1 cases. Based on collaborative monitoring of the situation, we will also continue to discuss emergency contractual arrangements should general practices experience unmanageable pressure during a second wave of the pandemic (UK Government, 2012).
The GPs promotion of vaccination uptake is part of the broader communication strategy to promote infection control practices and proper hygiene such as hand-washing, covering the nose and mouth when coughing or sneezing, and other hygienic routines.
The £ 5.25 package is fair compensation for the inoculations in balance with our resources to meet the spectrum of needs of all patients in the NHS system.
We are extremely confident that our GPs and their teams are properly equipped with the resources they need in order to run the swine flu vaccination programmer smoothly and efficiently. This arrangement has been made in unique circumstances and does not set a precedent for situations like this in the future.
Sincerely,
Rt. Hon Andy Burnham MP
Secretary of State for Health
http://www.dh.gov.uk/en/Publichealth/Flu/Swineflu/DH_105132 GP deal on swine flu vaccination
http://www.bma.org.uk/images/letterfluvacc_tcm41–190183.pdf BMA GPC H1N1 vaccination arrangements
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1240732817665?p=1240732817665
Other Applications
The lobbying simulation has been used successfully to examine issues in health care, higher education and the environment in such countries as the US, the UK and Canada. Potential applications include other domestic issues in those countries, as well as domestic issues in France, Germany, Italy, Japan, Australia, New Zealand, Ireland, Spain, Portugal, etc.
Additional resources
Potential guests include:
- – NGO’s (non-profits, if they can lobby legally),
- – Activists (environment, poverty, violence, peace, anti-nuclear),
- – Professional lobby groups (industry, financial).
Lobbying US:
- – Official website of the US government: http://www.usa.gov/.
- – Lobbying federal government of the US: http://lobbyingdisclosure.house.gov/.
Lobbying UK:
- – Official documents of UK government: https://www.gov.uk/government/publications?official_document_status=command_and_act_papers.
- – General information on the UK: https://www.cia.gov/library/publications/the-world-factbook/geos/uk.html.
- – Official policies of the UK government https://www.gov.uk/government/policies
- – Lobbying the UK Parliament: http://www.parliament.uk/get-involved/have-your-say/lobbying/.
Films:
- – Yes Minister,
- – Twelve Angry Men,
- – Conspiracy.