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

Results

What are informal relations?

While this research was conducted with an established definition for informal relations (noted above), subjects were given the chance to reflect on their own description of the formal and the informal elements of their intergovernmental work. Answers generally conformed with the proposed definition: informal relations are those interactions which happen around formal relations. However, subjects were given the chance to note the differences between what they considered the formal and informal elements. If informal relations occurred around formal relations, what are formal relations?

Generally speaking, formal relations involved documentation. In formal relations, “…there tends to be agendas. There tends to be common briefing notes prepared for the meetings, there are records of decisions, all those kinds of things…” This was the case whether the meeting took place over the phone or in person. It also existed at different levels: so long as there was some form of documentation, the interaction was considered formal. Thus, multilateral meetings would typically be formal whether they involved mid-level officials or ministers. Even bilateral interactions could be considered formal. One participant noted, for instance, that “Certainly, people have to be fairly cognizant of the fact that anything that’s written over email is a record that would be publicly available. So I think to a certain extent people would regard that as fairly formal.”

The difference between formal and informal becomes interesting when we consider how it might affect communication. If two officials in different jurisdictions were having a phone conversation, how might that be different from an email conversation? The answer may be in the role the official plays: “[On formal relations] It’s when you’re actually representing your province…”. Other interview subjects also noted the distinction between speaking their personal opinion and representing the position of their government. The fact of having a record of the conversation put the conversation into the realm of formal and (presumably) more cautious relations, since speaking off the cuff in a formal setting could cause problems for that official. In other words, in formal settings officials were more likely to be careful about representing only their government’s position.

This is not to suggest that officially scheduled interactions are purely formal. As several officials (and scholars, see Knight 1992) argued, informal relations frequently accompanied formal relations. As an example, discussions in hallways between formal meeting sessions were often noted as an important form of informal relations. As another example, this kind of informal work could also happen prior to officially scheduled teleconferences: “Of course, there’s more informal discussions, bilateral discussions that happen in between those meetings… there’s also the more informal discussions that take place between the co-chair officials in those jurisdictions, and there historically have been bi-weekly calls to discuss any topics of interest that have come to our tables.” The relationship between informal and formal was reciprocal. While formal relations create the framework for much of the subsequent informal work, informal relations were considered necessary to keep the formal work moving. One official even went so far as to describe the formal work as being predicted by prior informal discussions: “A good IGR meeting is almost like a play. If you’re an official and you’ve done your job, you can watch the whole script unfold.”

This brings us to the more direct issue of how officials characterized informal relations. Many described the importance of relationship building almost synonymously with informal relations: “…relationship building comes first, and a large part of that is informal relationships.” However, relationships were not considered an end in and of themselves. Inevitably, officials mentioned the use of relationships in terms of communication. Broadly, when asked to describe informal relations, officials turned to the importance of information sharing and communication: “It’s also getting information. That’s the most important thing. And being remembered on information links.”; “…it was that kind of trying to keep the lines of communication open, to be as transparent as possible with your colleagues across the country, so there were no surprises…”; “So it’s that thing of having your back, being able to share information and best-practices and material.”; “…trying to suss out jurisdictional interest.”

According to the health officials interviewed, informal relations consist of the development of personal relationships with other officials which led to informal conversations and information sharing. This process occurs both in and around the formal process of IGR, which is to say the written agendas, briefing notes, records of decision, and so on. At this point we are forced to return to Dupré’s concept of ‘trust ties’ which, as noted above, have been observed in some literature as being analogous with informal relations. But while trust ties are important (see below), they do not in and of themselves constitute informal relations. Trust is a factor which impacts informal relations, which leads one to wonder what other factors have impacts. As such, interview participants were given the chance to comment on this issue. Several factors were mentioned, many of which were related. Perhaps unsurprisingly, those factors which positively affected informal relations were ones that enabled open communication between parties.

Trust

Trust was mentioned as a major factor by several participants. Commented one provincial official: “The currency of the work is trust.” This element worked both ways. Where trust was present, it enabled good informal relations. In fact, trust was often mentioned as a necessary element of informal (but not formal) relations. If individual officials do not trust one another, their informal interactions will likely be limited. Consequently, an inhibitor to informal relations was breach of trust. As one official commented “Breach of trust is a big one. A lot of the good relationships are based on trust… If that’s not reciprocated, and I find myself in a meeting where the other jurisdiction says something completely different than what was agreed on, then that’s a real problem.” Trust was important because of its link to communication. An official trusted another to provide them with good information, trusted them to relay a message accurately, trusted them to back up their position in a formal meeting, trusted them not to repeat certain things, and so on. Trust matters in informal relations because without it, officials are forced to interact only in more formal settings, which makes their job considerably more difficult.

Closely related to the issue of trust was the importance of face-to-face meetings, which many officials mentioned as fostering good informal relations: “there’s a huge difference between the people you work with, who you’ve met in person, and you’ve seen their crazy hair, or found out about the orienteering thing they were going on in Spain, or whatever it might be”. In an era of fiscal restraint, the opportunities for face-to-face meetings were limited, which certain officials lamented: “You know, it’s a challenge, especially when a lot of the meetings are virtual. It’s kind of how you do business these days, but it does make it a little harder to form relationships with people when it’s just on the phone and you can’t put a name to a face, that kind of thing.”

Honesty and openness

In a closely related vein, honest and open communication was mentioned as being crucial for successful informal relations. The responses of government officials on this issue almost always tied honesty to trust: “…you trust that people can feel comfortable to give you information, and feel comfortable asking you for information.”. However, there was a difference in how external stakeholders approached the issue of openness. One stakeholder mentioned that even to be taken seriously by government officials, it was important to “…be consistent in your messages”. Another argued that from their perspective, everyone being open was a necessary condition for their engagement in the process: “I also value in a group of people I’m working with people who can speak plainly and clearly about what there issues are and why they’re there, so that if there are perspectives, investments, or biases, those are easy to discern.”

Personality

The issue of personality was mentioned by a number of participants as contributing to informal relations both positively and negatively. In general, officials and stakeholders noted that certain types of people are attracted to IG work, and that those people are effective relationship-builders. Virtually all officials noted that personality conflicts were quite rare, and for the most part “people are pretty reasonable”. They also noted the effects of the ‘wrong’ personality, however, and most officials of long experience were able to think of specific examples. In those cases, the officials in question “thought they were larger than the job”, were “not team players”, and were inflexible: “The problem that we were facing was that IGR, in order to achieve an outcome, you have to be flexible and to know when to lower your expectations to get to the common denominator, otherwise you are not really doing business.” The consensus seemed to be that those officials tended to move on to other portfolios before too long, and their behaviour was considered aberrant. With personality as with trust and honesty, the issue seems to revolve around communication. The ‘right’ personality is one that engages with others in a way that allows for a productive exchange and good communication.

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.