Strengths and limitations
We were unable to recruit all members of the EAG to take part in the study and those who did not participate may have had unique and valuable insights into the process. However, a consistent and rich case description was built through in-depth interviews supplemented with the analysis of internal and external documents. Inter- views took place almost two years after the EAG process and we acknowledge that participants’ accounts were inev- itably shaped by their position at the time of interview and changes subsequent to the EAG process. However, the timing of the study allowed us to discuss the fate of the EAG proposals and explore participants’ attitudes to the newly established National Clinical Care Programme. This programme is still in its infancy but incremental pro- gress has been made in certain priority areas, includ- ing the introduction of a national retinopathy screening programme in 2013.
Studies of the policy process are often criticised for providing a description rather than an explanation of what happened [48], and for the absence of theory to underpin analysis [37]. This is one of the first studies to examine the policy process within the Irish health sys- tem and contributes to both the theoretical and practical principles of policy formulation. This study goes be- yond description to explanation, illustrating how external events, such as an economic crisis, suppressed internal support from senior management, leaving the EAG po- werless to implement change. Although specific to diabe- tes, the study captured a number of commonly identified features of the policy-making process, including bargain- ing or ‘horse-trading’, and covert decision making [28,49].
In terms of practice, a number of policy tactics were iden- tified which could increase the chances of acceptance and approval of policy proposals within the health system. Retrospective analysis of success and failure in policy mak- ing creates a learning environment for those involved in the policy process [50].
Strengths and limitations
We were unable to recruit all members of the EAG to take part in the study and those who did not participate may have had unique and valuable insights into the process. However, a consistent and rich case description was built through in-depth interviews supplemented with the analysis of internal and external documents. Inter- views took place almost two years after the EAG process and we acknowledge that participants’ accounts were inev- itably shaped by their position at the time of interview and changes subsequent to the EAG process. However, the timing of the study allowed us to discuss the fate of the EAG proposals and explore participants’ attitudes to the newly established National Clinical Care Programme. This programme is still in its infancy but incremental pro- gress has been made in certain priority areas, includ- ing the introduction of a national retinopathy screening programme in 2013.
Studies of the policy process are often criticised for providing a description rather than an explanation of what happened [48], and for the absence of theory to underpin analysis [37]. This is one of the first studies to examine the policy process within the Irish health sys- tem and contributes to both the theoretical and practical principles of policy formulation. This study goes be- yond description to explanation, illustrating how external events, such as an economic crisis, suppressed internal support from senior management, leaving the EAG po- werless to implement change. Although specific to diabe- tes, the study captured a number of commonly identified features of the policy-making process, including bargain- ing or ‘horse-trading’, and covert decision making [28,49].
In terms of practice, a number of policy tactics were iden- tified which could increase the chances of acceptance and approval of policy proposals within the health system. Retrospective analysis of success and failure in policy mak- ing creates a learning environment for those involved in the policy process [50].
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