Sharing control: four strategic priorities for the public value pivot

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The public servant in charge of Victoria’s health and human services system has outlined her vision for delivering public value: it should be person-centred, and offer local solutions, early intervention and quality.

The social determinants of poor health — things like poor education, unemployment, poverty and social isolation — need to be considered and we are increasingly recognising the importance of prevention, says the Department of Health and Human Services secretary Kym Peake.

The future will see governments making a stronger effort to work with clients and the private and community sectors to design and deliver services, Peake told a Trans Tasman Business Circle event in Melbourne on Friday.

“This new way of working is a big change for government agencies. The public service needs to get better at building consensus and sharing control,” she argues.

Peake, who was appointed secretary of the super department in November, was asked what she wanted her term to be known for in five years’ time.

Nailing some at-scale examples of joined up working and moving the focus from tertiary services — such as emergency — to early services — like prevention — ranked high on the list. Being able to measure and understand the impact is a key part of that, too.

“And on a personal level if I walk into a department where it’s described universally as having a service orientation and openness to work with others, that we’re seen as being capable in co-design work, and we’re seen as having insights around what needs to come next, then I’ll feel pretty proud of where we’ve got to,” Peake added.

Four reform priorities

She outlined her four key reform priorities for DHHS:

• Person centred services and care — designing services and funding models around people and improving how we measure the experience and impact of our services, programs and investments for the people we serve;
• Local solutions — involving people and communities in the design and planning of services and aligning our efforts with community activities;
• Earlier and more connected support — getting in early to prevent or address problems before they become too big, and tailoring service responses so that they meet people’s needs; and
• Advancing quality, safety and innovation — keeping our eye on the quality and safety of health and community services and working with our partners to build evidence, share knowledge, scale effective practice and support clinical and practice development and change.

Shifting from a program focus

Asked how she thought the department was faring, Peake noted the shift from a program focus to one that encourages staff to bring common skills to a range of subject areas — a reform she discussed with The Mandarin earlier this year.

“While I think there was a very supportive culture across the department [from 2000 to 2008], it was still very program-oriented. One of the things I’ve been really pleased about in the last six months, in our strategic plan that will come out in a week or two’s time, is that we are having much deeper conversations about what are the cross-fertilising capabilities, what are the perspectives and expertise that can be brought from different parts of the department to help solve problems in other parts of the department.

Executives and middle management are supportive of the changes Peake is introducing, and have been “very generous” about reflecting on which approaches could be translatable across policy areas.

Identifying common clients

In the near to medium term, a lot of work will be done on discovering clients common to different parts of the business — many of whom are among the most disadvantaged in the state. The Health and Human Services portfolios were joined up again at the start of 2015 out of a recognition that they shared many clients, who were there for the same basic reasons.

“In the next 12 to 18 months I hope to see more of that then really translate into seeing the common clients being identified and understood and being a focus of our work more explicitly. And some of the techniques and methodologies being cross-fertilised more evidently across the department.”