Public policy is concerned with both intentions and practices, with politics and public administration. Much has been written about how we might think systematically about changing our world through policy, but there is also much to be learned from the experience of those involved in the practice of policy. Practitioners are less likely to reflect systematically on their experience, but we can learn a lot from this biography of an Australian policy pioneer, Cecil Cook, who worked in WA, the Northern Territory and the federal sphere from the 1920s into the 1970s. In reading this account of his work, I could see three particular lessons for policy people.
The first was about how much health policy should focus on medical treatment and how much on the social determinants of health. Cook was trained in tropical medicine, and when offered the position of Chief Medical Officer in the Northern Territory, insisted on combining it with the position of Chief Protector of Aborigines, on the basis that ‘protection is a province of health’, and in his work, demonstrated that he saw the health of the Aboriginal people and reflecting not simply medical treatment, but also education, employment, housing, hygiene and the management of the self, showing an understanding of the social determinants of health long before the term was used.
This linked to his broader perception of the policy task in relation to Aboriginal Australians, focusing on the ‘big picture’: not ‘what welfare measures should we apply to this needy social category ?’ but ‘what is to be the place of Aboriginal society in an Australia that was becoming (in Diamond’s terms) WEIRD: Western, Educated, Industrialised, Rich andDemocratic, and are our present policies going to deliver this outcome ?’. This did not endear him to his seniors, bureaucratic and political, who preferred to think in terms of process, with smaller questions and clearly-demarcated boundaries, rather than policy outcomes. For instance, when gold was discovered in the Warumungu Aboriginal Reserve near Tennant Creek, the consensus in government circles was that the gold-bearing area should be excised from the reserve to allow white prospectors to exploit it, with an area of land of no interest to the whites being added to the reserve in compensation. Cook argued that no decision could be made until the overall policy objective had been clarified: what was an Aboriginal reserve for, and how might ‘the mineral, pastoral and other wealth contained in [Aboriginal] reserves’ be used to contribute to Aboriginal people becoming full members of the Australian community ?
And this is related to the way we think about policy: how much should we see it as the authoritative choice of objectives, and how much as the collective negotiation of process ? Cook wanted this question to be resolved by the Minister, fully cognisant of the nature of the choice, determining the government’s objectives. He argued that the aim should be for ‘the aboriginal … to be lifted to the white standard of citizenship like the Maori of New Zealand’. The problem, as he saw it, was that the Commonwealth did not have a definite policy but that
Aboriginal protection has never been based on logical principles but has evolved as a sequence of expedients resorted to by Governments usually under pressure from sometimes one and sometimes another organisation interested in Aboriginal welfare.
Here, Cook was faithfully following the textbook account of policy as authoritative instrumental choice: ministers determine the objective, public servants give frank and fearless advice about how best to get there, but follow whatever course the ministers chose. But in practice, ministers seemed to be less concerned with the likely outcome of policy than with questions of process: the organisational structure, how it was done elsewhere, and keeping the show running smoothly. The sort of questions that Cook was raising were not of much interest to federal Ministers for the Interior, and there were eight of these in seven years in
Cook’s time. The mining area was excised from the reserve without Cook’s arguments even being put to the minister. In any case, ministers were likely to find him prickly: John McEwen, in his first ministerial post, determined to replace Cook because some of his reports were ‘couched in the most intemperate language’, showing that he did not have ‘those attributes which are essential’ in a departmental head.
This suggests that while the authoritative instrumental account of policy has its uses, it is not the best operational code, and experienced policy workers learn to be able to talk the language of authoritative decision when necessary, while seeing the policy task as more about ‘making sense together’ (Hoppe 1999) – drawing different participants into a shared focus and mutually-supportive responses. The reader may wonder whether Cook’s medical training made it harder for him to make this distinction: for him, there was a right answer, and it was his job to make clear what that right answer was. This seemed to be less of a problem in his later work with the NHMRC, where he was dealing with other professionals, and the work was more about how to deal with the plethora of good answers to different questions.
This book is a biography, not a policy text, but there is a lot that practitioners in, and observers of, the policy process can learn from it – about the long, stuttering prehistory of Commonwealth policy making on Aboriginal matters, about the early recognition of the social determinants of health, and above all, about the significance of commitment, and the tension felt by the committed professional confronting the organisational complexity and ambiguity of governing. Strongly recommended.