I'm a recent member of the list, and just wanted to say that I found the
"theologian"/"deal-maker" idea very useful. What is really useless is the
adversarial situation we sometimes slip into when we care too much,
exaggerating the negative of an alternative position, or person.
In response to a broader question on the list last week, the recent
anti-poverty law introduced in Quebec, as well as the social economy work
going on there may be the advanced edge in Canada on more structural
responses to determinants of health. Québec's interest in determinants of
health may also explain part of its difficulties with Federal-Provincial
negotiations on "health" care. I'd love to hear more about these
developments in Québec, from a determinants of health perspective, if
anyone on the list is familiar with them.
Joy Woolfrey,
Halifax, Nova Scotia
.........................................
At 08:45 AM 12/11/2002 -0500, you wrote:
>Recent exchanges on this listserve highlight a major issue in future action
>on social determinants of health - the balance
>between the "theologians" and the "deal-makers" in promoting action on
>social determinants.
>
>Most systems have, within them, people who are the "theologians" of the
>system - people who speak out (often bravely) for the integrity and purity
>of the system. They are often the system's most profound thinkers, often
>involved not in preserving its status quo but in "thinking it through" to
>its finest conclusions.
>
>Every system needs theologians. Without them the moral compass of the system
>goes awry or disappears altogether. Any system is well advised to cherish
>its theologians, even when they make us uncomfortable. Much as we enrich our
>dialogue around social determinants with evidence-based insights, at its
>core the "movement" is rightly an ethical and moral one. Every system also
>has deal-makers - folks skilled at negotiating the system's way into other
>systems, who translate good ideas into good action. Their deal-making is
>driven at is best by a principled sense of the ideals served by the
>deal-making.
>
>But theologian and deal-maker can have damaging sides. The theologian can
>stand for such rigid ideological purity that there is no chance that their
>ideas would be put into practice. They also run the risk of acting as grand
>inquisitors, finding and punishing heretics rather than cherishing
>diversity. Deal-makers, on the other hand, can be dangerous if "clinching
>the deal" is all that matters. They can lose sight of why deals ought to be
>made in the first place, and they can forget that sometimes, compromise to
>get a deal isn't worth it, because core principles would be obliterated.
>
>A healthy system needs both theologians and its deal-makers - and a group in
>between who understand theology and deal-making. The dialogue between
>theologians and deal-makers is essential, but uncomfortable and fractious at
>times. And that is what I see happening through this listserve. There are
>some people on it who are deal-makers - they want to know what tools others
>have used to clinch a deal - to embed an idea in the real, messy world.
>Hersh Sehdev put it well in a recent post when he said, "Sure a national
>strategy on social determinants would have been useful however meanwhile we
>continue to work bottom up and see where we reach".
>
>There are also people on the listserve with a theological bent. Dennis
>Raphael, for instance, highlights what is a theological issue when he cites
>Ontario's Heart Health programs, and the danger they pose when they stifle
>action on the underlying determinants of heart health.
>
>I am delighted that the Krimgolds, Sehdevs, Raphaels and Plasketts are part
>of this listserve. I am one little guy in one little town, but my own
>thinking - and my own actions - have already been changed by both the
>deal-makers and the theologians on this listserve. When the listserve ceases
>to be a rich dialogue between the messy pragmatists and the neat idealists,
>it will
>be time for me to leave (or to write another too-long missive).
>
>John Butler
>Markham Ontario
>
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J. Woolfrey Consulting,
10 Umlahs Drive,
Halifax,
N.S. B3P 2G6
Tel/Fax: 902-475-3343
Policy Research International,
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Ottawa, ON K1L 84B
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