Opinion: Policy Graveyard- where policies go to dieLivingstone Hospital in the Eastern Cape. PHOTO: Black Star/Spotlight

Opinion: Policy Graveyard- where policies go to die

Comment & Analysis

Few would argue with an assertion of South Africa as being simultaneously policy rich and implementation poor.

If there is a policy graveyard located somewhere in the country it would be littered with well-written but otherwise poorly implemented policies. Moreover, it would not be unusual to find that most of these policies were buried without proper autopsies being conducted. Not knowing the causes of previous failures, makes it difficult to ensure future policy implementation successes.

In a recent article titled, How do we make an HIV and TB plan that has greater impact?, Marcus Low presents some reasons for our inability to implement policies in South Africa. While this article attempts to provide additional insights along the same lines, it also proposes actions, which if taken, could help to address the situation.

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Policy surfing

Policies often fail due to a phenomenon that can be referred to as policy surfing. It is characterised by continuous policy replacements due to a variety of factors such as a change in administration, change in leadership, funder requirements, lapsing of a time period, or a change in public sentiment. The next wave of policies is typically developed without properly reviewing the impact of the previous wave thereby foregoing the opportunity to learn and improve.

If there is a policy graveyard located somewhere in the country it would be littered with well-written but otherwise poorly implemented policies.

To illustrate this point, one just has to look at the policy evolution in the economic sector. In a very short space of time, we have moved from the Reconstruction and Development Plan (RDP) to Growth, Employment, and Redistribution (GEAR) to the Accelerated and Shared Growth Initiative for South Africa (AsgiSA) and now the National Development Plan (NDP). It is not clear whether any proper reviews were conducted before transitioning from one policy to the next.

This is not to say that policies should remain static, but rather they should not be changed for an arbitrary reason such as a change in administration.

Disconnect between policymakers and policy implementers

Centrally formulised policies are in many cases too generic to take into account differences experienced at various decentralised implementation levels.

A quick scan of the annual reports submitted by provincial departments will indicate that provinces achieve varying levels of success with the implementation of nationally formulated policies. This is reflective of a centrally formulated “one-size-fits-all” policy requiring further customisation that would take into account the conditions unique to each point of implementation.

The disconnect between policymaking and implementation also manifests when implementers are required to fund the implementation of policies developed elsewhere.

Policymakers are often blindsided by the quantum of available resources at the implementation level. This could lead to a situation where the plans are developed with a Rolls Royce in mind while the implementers only have resources to build a VW Beetle.

This is amplified in a scenario where you have different spheres of government each with its own mandate and budget. So, while the department of health formulates policies nationally, provincial departments have the leeway to decide how much money they allocate towards their health programmes. This has serious implications for the implementation of national policies at the provincial level and is often a source of frustration for policymakers.

This could lead to a situation where the plans are developed with a Rolls Royce in mind while the implementers only have resources to build a VW Beetle.

A separation in lines of accountability can also contribute to a disconnect between policymaking and implementation. Policymakers have a hard time getting their policies implemented when implementers fall outside of their lines of accountability. In the case of the department of health provincial departments develop their own service delivery plans with budgets for which they must account for to their provincial legislatures. They are only accountable to the national department where funds have been made available through conditional grants. This limits the extent to which the national department as policymaker can hold provincial departments as implementers, to account.

Credible implementation plans

Policies can be regarded as dead in the water for as long as they are not supported by credible implementation plans.

Realising the importance of credible implementation plans, the Department of Provincial and Local Government (now CoGTA) in 2006 embarked on a process of reviewing Integrated Development Plans (IDPs) with the view to establishing its credibility. Noticing that municipalities were performing poorly against planned objectives the department wanted to understand the reason behind this. Suspecting that the problem may be embedded with the plans themselves, the department started the process of reviewing the plans for credibility. Stemming from this, the department developed a tool referred to as “Credible IDP Evaluation Framework” for use by municipalities to promote credibility and therefore minimise implementation failures.

Policies can be regarded as dead in the water for as long as they are not supported by credible implementation plans.

It is not clear whether the National Department of Health has a similar Framework or processes in place, that would enhance the credibility of plans developed within its domain. What is clear, however, is that credibility is questionable when considering the findings of a recently conducted review of the National Strategic Plan (NSP) for the Prevention and Control of Non-Communicable Diseases (NCDs). One of the key findings of this report is that a significant portion of the expected outputs will not be achieved severely undermining the implementation of the Strategic Plan and therefore its achievability. This stems from the fact that many of the planned activities were not contributing to the intended outputs.

Costing

It is a standard practice in many jurisdictions around the world for government agencies to present the financial implications of new policies or legislation as part of the policymaking or legislative processes. The benefits of providing detailed costing alongside the policy objectives are that it compels the policymakers to think on a practical implementation level. It also requires them to be realistic in terms of what is executable given prevailing financial constraints. In a bi-directional manner, the costing process impacts the planning process in that plans are often adjusted or reprioritised to align with financial constraints.

It is not the standard practice in South Africa for policies to be costed and this could explain why so many policies fall by the wayside.

Ensuring implementable policies

While many of the causes for policy implementation failures cannot be addressed without tinkering with the structure of government in South Africa, there is some low-hanging fruit to be had with minimal intervention. It doesn’t take much to insist for policies to be accompanied by credible implementation plans. This includes developing frameworks that would help policymakers and planners to test their plans for credibility or adjusting existing frameworks to do the same.

For example, the District Health Planning and Monitoring Framework used in the development of District Health Plans can be adjusted easily to allow for the testing of the plan’s credibility.

Insisting that implementation plans are costed will be a major boost for its implementability. As Treasury is currently considering reengineering the budgeting process with the view to introducing zero-based budgeting, it presents an ideal opportunity to make this practice compulsory.

Ultimately, to ensure policy implementation the aim should be to have the policy coded into law. Unlike policy statements which are generally about values, principles, and high-level outcomes, acts of parliament assign authority, rights, and obligations. Acts of parliament are enforceable whereas policies are non-binding. Therefore, policies when enacted into law have a much higher chance of being executed.

“Think globally, act locally” is a popular principle that promotes a bottom-up approach to addressing societal challenges. It is thus critical for policymakers to constantly remind themselves that policies must find expression in local conditions each characterised by its own set of challenges and realities.

*Botha is an independent health economist.