Janus-like Policymakers and Health Managers Urgently Required

Abstract

The inspiration for this editorial comes from the contribution by Gorman. His article suggests that the senior governors of the health system need to be Janus-like in facing government requirements for limiting health demand and reducing costs in the face of desired autonomy and individualism of health providers in delivering patient care. Janus, from Roman mythology, 'is the god of gates, doors, doorways, beginnings and endings', and is depicted as having two faces, looking in opposite directions, looking into the future and the past. This description of Janus includes being patron of 'concrete and abstract beginnings of the world, the human life, new historical ages and economical enterprises'. Importantly, to the theme of this editorial, Janus was frequently utilised 'to symbolise change and transitions such as the progression of past to future, of one condition to the other, of one vision to the future' ... and was 'representative of the middle ground'. In light of the current Australian political context, Janus brings all the qualities required of those charged with developing health policy and of health managers required to implement that policy and to manage the new structures of health service delivery. For those readers not intimate with the current Australian political context, we have seen the recent return at the national level of a re-elected first-term government, which after a period of a few weeks of uncertainty, was able to form a minority government with the support of independents and minor parties. It was this re-elected government that, in its first term, initiated the National Health Reforms and went to the election promising to implement a strategy of health reform.