When does health advocacy become activism?

This post looks at the fine line between health advocacy and activism, and the consequences for those who cross it!

We are a passionate lot, aren’t we? We work in healthcare because we want to make a difference!  But what should we do when frustrated by the change inertia we encounter so often?

I plead guilty as charged… your honour!   I confess that at times this has got the better of me, and my change advocacy has spilled over into activism.

So I am left asking myself, can a person working in a healthcare organisation be both a change advocate and an activist at the same time — or are these essentially incompatible?  Institutions often take a dim view of activism; activists are unpredictable and not amenable to institutional controls.

Having worked extensively with rural communities at times of crisis it is hard not to be moved by their fear and anxiety as they see essential health services closing down around them.  When the rural GP practice closes the local pharmacy is at immediate risk.  Long-term elderly residents in the aged care annex of the local rural hospital are told that they may need to be relocated due to inadequate access to medical care.  For rural people in this position they see the very fabric of their way of life being torn away.  Many times I have been frustrated and disappointed by the indifference shown by those in positions of authority with the means to mobilise resources to look after their most vulnerable communities.  

So, what to do when we find ourselves in this situation?  Sure, it is acceptable and indeed expected that we advocate in-house for those who are vulnerable, and there can be no criticism.  However, when confronted by apparent institutional apathy how should we respond?  Institutions sometimes feel compelled to ‘spin the truth’ in the misguided belief that these false assurances are in the best interest of the public.  I don’t agree!  The public needs to know the reality, even if it is challenging for them. We owe this to the communities we serve!

At a recent PHN Commissioning Showcase a colleague confided that he had on one occasion taken a Hospital CEO to task for what he perceived to be gross negligence compromising patient safety.  It had the desired effect with the hospital mobilising to address the risk.  But afterwards he wondered what impact it would have on relationships longer term.  There are always consequences!

So, once again there is no simple answer.  Perhaps there are times when our advocacy should be ‘muscular’ but it is sensible to do this judiciously.  Take my advice, I’m not using it!

Thought starters:

1. Do you have people you consider to be activists working in your healthcare organisation?
2. Does the activist “voice” have a place in health service commissioning ?
3. How might we harness the passion of activists to improve health service commissioning?
4. What is your organisation’s position on staff who undertake a degree of activism in their personal time?