Public health consultation

Consulting on new development proposals

The Public Health Consultation: A Guide for Developers (416KB) provides a framework for use when engaging with communities.

The Guide provides advice on:

  • public health issues that may be of relevance to communities
  • information related to the engagement of stakeholder groups who could be included in these consultation processes
  • ensuring the potential negative impacts from proposals are mitigated and that positive health impacts can be achieved

The guide is intended to be a broad framework for community engagement and consultation. 

The consultation process will allow a proponent to answer:

  • What effects (both real and perceived) will this proposal have on public health in this community?
  • What risks does it present and how can they be minimised?
  • What opportunities does it present to improve public health? (i.e. improving the health of the population and reducing inequality).

Public health consultation resources

Scoping tools

Steps to consider for public health consultation

The responsibility for consultation about public health issues rests with the proponent. To provide for good consultation outcomes the proponent should be prepared to invest time and financial resources into the planning requirements. Risk may be introduced if the process is not well planned and implemented. For example, the results may be biased if special interest groups dominate, or there is lack of equity in who is involved in the process. Other sectors such as the environment may be adversely impacted. A lack of trust or disrespect from the community may result and further consultation may be required which will extend timelines and increase cost.
 
To provide for appropriate consideration of public health, the following steps should be addressed during consultative processes:
 
Step 1 - Identifying
The proponent should review the issues associated with the proposal against the range of public health categories and determinants provided. This will include consideration of possible benefits that may arise from implementation of the proposal as well as potential risks. At this stage it would be appropriate to determine if a Health Risk Assessment is required.
 
The proponent should prepare documentation for stakeholders on the proposal including potential public health issues that should be discussed during consultation.
 
Step 2 - Profiling
The proponent should try to identify and understand all stakeholder groups associated with the proposal. As part of this process, the proponent should specifically look at sub-groups such as those listed below, which are often not included in consultation programs.
  • Children
  • Youth (aged 13 – 18)
  • Older people
  • People with disabilities
  • People with mental health problems
  • People with long-term illnesses
  • Indigenous people
  • Other ethnic and cultural communities
  • Unemployed
  • Women’s groups
  • Men’s groups
  • Migrants
  • Fly in/fly out workers.

The type of information that might be useful for proponents to collect and analyse includes statistical information available through existing sources in addition to information gathered about the community relevant to the proposal:

  • community population and demographic information – available from local councils, non-government agencies and other representative bodies, state government agencies and the Australian Bureau of Statistics;
  • state-wide statistical information from the Analysis and Performance Reporting Directorate within the Department of Health or the Australian Institute of Health and Welfare (external site)
  • identification of sub-groups or segments within the community:
    • identification of sub-groups or segments within the community who may be particularly affected by the proposal, based on the issues and the demographics
    • identification of organisations that represent these sub-groups or segments, and whatever information they might have.
Step 3 - Contacting
It is possible that some of the groups within a community who may be affected by a proposal may not come forward and volunteer to be a part of the consultative process. A scan of the list of sub-groups above shows that barriers to involvement may exist.
 
Therefore it may be necessary to put more effort into seeking people out, and finding a way of including their views in the consultative process. This suggests that a targeted and direct consultation process may be required. Potential points to consider include:
  • consider using an independent expert, or an objective third party to mediate, interpret or facilitate.
  • be clear about the level of consultation (refer to the IAP2 spectrum) and find methods that are appropriate to the level of consultation being offered, and the resources available.
  • ensure that good information about the proposal is widely disseminated as a first step
  • consult with key agencies and peak bodies that provide services to relevant groups and sub-groups that may be particularly affected by the proposal.
  • tap into existing groups to assist with the consultation:
    • Youth Advisory Councils, Aboriginal Communities, Service Organisations.
    • Utilise specific interest sectors such as government agencies, non government organisations and universities
    • Undertake an initiated feedback process through established peak bodies, using their networks
Find the resources to meet people on their terms - in places that suit them, at times that suit them and using methods that suit them. Be flexible with the consultation to fit with the circumstances of the people being consulted.
 
If you are consulting with representatives of particular organisations or groups, allow time for them to canvass views from their constituencies.

Use a diversity of methods to increase exposure and optimise engagement with difficult-to-reach sub-groups. Don’t rely on one method.

The question of whether or not stakeholder groups should be resourced to participate in consultation deserves discussion. It is not recommended that individuals are paid for participation. However, there are two different types of resourcing: resourcing to remove barriers to participation, and resourcing to provide incentives.
 
Resourcing to remove barriers to participation includes payment for travel, parking, child care costs, and refreshments and should be considered. This would be particularly relevant if the time commitment involved is likely to be frequent over an extended period of time. Resourcing as incentives includes gifts and sitting fees. While this is not recommended, it is left to the discretion of the proposal proponent.
 
If specific groups are hard to access, it may be useful to identify groups or associations who can represent those interests. Look at other examples of similar proposals to provide links to representative bodies or speak to others who have worked with a specific community to see how they identified representative groups or individuals.

Be aware that people may choose not to get involved for a range of reasons such as consultation fatigue or a sense of powerlessness. Consultation fatigue is where people feel over-consulted. Consider whether representative bodies exist who could be asked for input on their behalf.

In addition, be specific about the purpose of the consultation and the opportunity that is being offered to influence the proposal, so people can determine whether or not they wish to become involved.

 Lessons learned*
  • Make sure sufficient resources are made available - time and money
  • Develop and implement a systematic process
  • Don’t consult if decisions have already been made
  • Be aware of the importance of transparency and objectivity
  • Provide an educative process to assist people with context so they can provide feedback – enables broader feedback than front of mind responses
  • Don’t assume that one process is appropriate for all circumstances
  • Cater for special needs


 
Step 4 - Discussing
In this step, the proponent seeks input from stakeholders about the relevance of public health issues in relation to this proposal, a two-pronged approach is proposed:
  • make the public health factors and consequences of decisions easy to understand and consider; and
  • provide a non-threatening and accessible means of discussing these factors.
The consultation framework (PDF 75KB) has been developed as a tool to broach public health issues with community members and groups. It has been designed to leave it open to the people being consulted to consider the range of public health issues that may relate to that proposal.
 
Not all public health issues will be relevant for every proposal, and relevance will be determined through the consultation process. The issues discussed during this stage build on the initial identification of issues by the proponent.
 
It is important that individual and community fears about development are acknowledged and respected. People may be uncomfortable with change or be concerned that the new development may result in adverse outcomes for themselves or their families. A broad discussion which allows those concerns to be expressed and acknowledged may lead to a discussion about possible outcomes that would address those concerns.
 
The discussion that takes place around the  consultation framework (PDF 75KB) allows people to identify the things that they want to address. It is envisaged that the framework could be used both in one-to-one and group discussions.

After consultation using the framework, the proponent will be able to determine the types of effects on public health the proposal may have on community sub-groups:

  • positive
  • negative
  • neutral
  • unknown.
The proponent will also be able to assess whether the proposal is likely to affect any of these subgroups more than others (i.e.: a disproportionate effect), or whether there will be broad effects across the community.
Step 5 - Planning
While proponents will do a preliminary identification of potentially relevant public health issues, the affected community should determine which factors or issues are important from its perspective. The framework provides a way of broaching the issues with community members, and allows input to come from the community. Using the framework as a basis for discussion, community members can be invited to talk about what sort of outcomes they would like the proposal to achieve, specific to each of the public health issues they have identified as relevant.

The discussions can be recorded in a table format similar to the public health consultation table (PDF 81KB).

 
Step 6 - Incorporating
Through the consultation process, the proponent will build a good understanding of:
  • the public health issues associated with the proposal
  • what types of effects these issues would generate if the proposal proceeds
  • what options exist to mitigate the effects.
Mitigation of effects can be shown to have outcomes that:
Mitigation Outcome 
 Eliminate the potential effect  nil effect
 Minimise the potential effect   minimal effect
 Minimise the effect through offsets  minimal or nil effect
 Improve the outcome  net gain
 
It will be important for mitigation to be considered in a manner that provides equitable consideration of the environmental, social and economic elements to ensure that minimum standards for each are met. Where there is the potential for trade-offs to occur, these should only occur above this minimum standard, and should be dealt with through agreement with stakeholders.

Mitigation should be considered in terms of whether the desired outcomes can be incorporated into the proposal, with the aim being to create a proposal that seeks to not disproportionately affect a particular group or widen health inequalities. Further, the aim is to try and reduce health inequalities through the process.

It may be that a proposal will produce public health impacts that cannot be mitigated or offset. The proponent should aim for the “best net” outcome.

Demonstrating the results of consultation within the proposal

The proponent should outline the process undertaken to consult with the community, and the way in which the proposal has incorporated community information and comment. Stakeholders and those consulted should be able to see that their input has had an integral role in the final shape of the proposal and its contents through:

  • documentation of consultation outcomes specifically linked to evidence of project provisions responding to the issues raised during consultations. This could be in table format, listing the issues raised through consultation, and how those issues have been dealt with in the final proposal. This sets up a paper trail which allows community members to see how their concerns have been addressed
  • documentation of the steps taken
  • demonstration that the consultation outcomes have been communicated to parties involved and interested in the process. This feedback loop is important and adds to the transparency.
  • inclusion of standards or targets set and agreed with the community, including details of monitoring systems and periodic reviews
  • evaluation of the consultation process itself and whether it has been effective
  • demonstration that offsets, if any, are accepted by the community and stakeholders
  • clear agreements/understanding outlined with supporting and dissenting views, and how much of each
  • demonstration that the final proposal matches the consultation promises made
  • justification of why some issues may not have been included
  • illustration of how the public health agreements will be delivered by the proponent through construction and operational phases, so that the agreements are maintained and followed through on for the long- term
  • inclusion of a public health statement as an attachment to the proposal to demonstrate alignment with sustainability considerations. The statement could follow these lines:
    • that consideration has been made of the potential public health effects of the proposal
    • that these potential effects have been explored in consultation with the following community members and stakeholders, as documented fully in the proposal (list)
    • that the public health issues raised through consultation have been considered in the final proposal (and are documented as such in the proposal) and
    • that the final proposal will have a nil/positive/negative net impact on health, wellbeing and health inequity.

Demonstrating that the proposal will lead to positive public health outcomes

Based on the agreements reached with the community, proponents will be able to demonstrate to stakeholders and regulators that public health is enhanced through the proposal, and adverse impacts minimised. It is important that the process to demonstrate the outcomes provides attention where appropriate to the:

  • use of quantitative data
  • use of easy to understand language
  • use of international research
  • use of case studies and examples to support the public health claims
  • use of evidence demonstrating effectiveness of proposed mitigations
 
Step 7 - Consolidating
One concern of communities is likely to be how the agreements with communities on proposal outcomes can be carried forward beyond the approval of a specific proposal. This involves consideration of:
  • development of feedback processes so that communities have confidence that their issues are continuing to have influence in the process.
  • a clear statement about how the agreed outcomes will be managed into the future. This may include a statement about timeframes for monitoring and review.
  • a commitment to convening a meeting with the community if any of the agreed outcomes cannot be implemented for unforeseen reasons or because of new considerations.
Proponents should include in their proposal documentation how both of these aspects will be managed.
 
At a point in the process, consultation on the proposal will finish and the proposal will be finalised and implemented following approval. The proponent should communicate the expected timeline at the start of the process to the community, how additional input from stakeholders will be dealt with and whether ongoing opportunities for community involvement in monitoring and review will be incorporated into the proposal once it proceeds.

Key principles of community engagement are to:

  • be open and transparent with information, and
  • allow people good opportunities to clarify and ask questions to ensure that they understand the proposal and its ramifications.
 
 
Last reviewed: 03-06-2022
Produced by

Environmental Health Directorate

Further information