Almost Like a Play’: Discretion and the Health Care Innovation Working Group Emmet Collins

Respect

Somewhat separate from the other factors was the issue of respect. This was particularly the case between governmental officials, who often noted the importance of respecting the position of other IGR officials. In cases of significant disagreement between the positions of governments, it was important to maintain a sense of separating the individual from the position and respecting their need to represent their government. “You don’t have bad relationships, even if you do not agree or do not have the same priorities as another colleague of yours, you still act with respect, and you understand where they are coming from.” This manifests itself in the recognition that IG officials are peers, regardless of whether they represent a small or large province. It also meant respecting the limits of communication: “Actually, you might not respect the person if that person is telling you everything. Because you are also playing the role of the bureaucrat who’s representing a province. So there’s a certain line that you don’t cross.”

The role of respect was treated somewhat differently in the perspective of external stakeholders. As their position was somewhat unprecedented, they often had to demonstrate their abilities in order to get respect: “I think you have to be informed, you’ve got to do your homework.” However, in the later years of the HCIWG’s work, some stakeholders mentioned that they were not being adequately consulted, and that the work was “was a fait accompli, it had already gone through all levels, so at that point, that’s not real engagement. So that doesn’t foster a good relationship.” Another stakeholder was more blunt, arguing that the failure to implement the suggestions of the first round of work (more on this below) effectively constituted disrespect.