A Recipe for Success: localism and bounded rationality in lobbying for radiation therapy services in North West Tasmania

Abstract

Objective: Describes where bounded rationality and localism are evident in the debate over the introduction of radiation therapy services in North West Tasmania and how this affected the delivery of the message from
each side.

Design: Semi-structured interviews with stakeholders and patients/family over an eight month period in 2016 are contrasted with viewpoints identified via document analysis.
Setting: North West Tasmania.

Main Outcome Measures: The mechanisms for policy change and the policy beliefs of each side are examined with the intention of understanding how bounded rationality and a sense of localism can combine to effect
policy change.

Results: In the instance of radiation therapy services in North West Tasmania, a policy debate was originally waged between medical professionals and policy makers opposed to a local service on one side and a handful of policy actors advocating for a local service on the other. Those in favour of a local radiation therapy service harnessed a sense of localism to project the perception of widespread community support for the proposal and secured funding commitments during the 2010 Federal Election campaign.

Conclusions: There is evidence of bounded rationality from both the stakeholder and patient groups, as well as a strong sentiment of localism expressed by patients and community advocates. Through understanding this particular case, health service managers can determine how to better time and target messages to the general public and to policy makers during periods of proposed changes to health services.