A movement is underway to democratise the modus operandi of our health departments in delivering services. The Trojan Horse being used for this purpose is an advisory body, bearing the august title of “Clinical Senate”, attached to state health departments. Queensland is soon to introduce its own Clinical Senate, similar to those already established in South Australia and Western Australia.
Each Senate provides a new forum to canvas the views of health care professionals in decision making and formulating policy direction. Its composition is inclusive, being broad enough to reflect the views of general practitioners, medical specialists, nurses, Indigenous health workers, and allied health professionals such as pharmacists, physiotherapists and social workers.
In Queensland, the clinical senators are expected to meet for a full day, up to six times a year, to address specific questions. Employing the charrette model of deliberations, they will create a consensus report to present to the Department of Health, which must then issue a formal reply within a fixed period.
The utility of Clinical Senates has yet to be evaluated, but an informal survey of individuals involved in the process yielded comments such as: “tokenism”, “not sure the system has delivered the goods”, “offers opportunities not yet realised” and “consultation occurs after decisions have been made”.
The word senate is derived from the Latin senex, meaning elder or old man — so senate literally means a body or council of elders. The Roman Senate provided counsel for the rulers and citizens of Ancient Rome. Ostensibly it too was an advisory body, but, historically, any gathering of ambitious men soon becomes infested with politics and powerful fiefdoms. Indeed, the Roman senators indulged in their share of coups d’état and political assassinations. One hopes that modern-day clinical senators are above such machinations. But in health care we are living in troubled times, marked by frustration and entropy. In these circumstances, anything is possible.
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