Consumer representatives provide a consumer perspective to balance the views of health professionals and other stakeholders. They do not speak for all consumers.

Consumer representatives draw on the work of their consumer network, share information and are expected to keep them informed of their work. However, they usually do not have the authority to speak formally on behalf of their nominating organisation (e.g. In the case of CHF, only the Chair and CEO have this authority).

If you have any doubts, clarify your position with your nominating consumer organisation.

It is important to understand the circumstances in which you were appointed before you can assess your obligations. You should clarify whether your appointment is:

• In your own right, for example as a board member
• As a consumer representative nominated by a consumer organisation.

If you were nominated by a consumer organisation you may wish to ask them:

• Are you expected to carry forward the policies of the organisation?
• What do they expect of you?
• How will they keep you informed about their work and provide you with support?

Consumer representatives may be expected to fill a number of roles and perform different tasks.

Your nominating organisation will expect a number of things from you, the committee you are on may have expectations of you, and you will have expectations of yourself and of the committee.

Often consumer organisations expect their consumer representatives to regularly report and to consult with them and others in the consumer movement. The organisation should inform you of your obligations to them.

Consumer representatives do not usually make public statements on behalf of their nominating organisation or in relation to their committee work. Always be cautious if asked to make a public statement such as a media interview, speech or to write for a journal or other publication.

Sometimes committee members have a limited understanding of the role of consumer representatives. Committee members may believe that the consumer representative represents minority groups, women or even the entire community. Consequently consumer representatives are placed in an unenviable situation where they are asked to speak on behalf of these groups.

Consumer representatives must keep in mind that they are nominated by consumers to provide a consumer perspective. Try not to get into the position of speaking on behalf of other groups not represented on the committee. Your role will be to flag with the committee that the views and needs of these groups should be sought and included in the decision making process.

Committees will expect consumer representatives to be committed to attending meetings. This includes:

• Attending all meetings where possible
• Preparing for the meeting including reading meeting papers
• Participating and contributing to the meeting

There are a number of things you should expect as a committee member. They include being:

• Treated as an equal member of the committee;
• Heard, listened to, and understood by the rest of the committee;
• Able to ask for clarification and more information, especially if jargon is used;
• Given all relevant information and an agenda for the meeting with enough time to read, understand and consult consumer groups and other consumers before the meeting. The information should be provided in a format that can be readily utilised by consumer representatives, taking into consideration any special requirements the consumer representative may have;
• Able to ensure that the committee procedures allow you to return to your support network and consult with consumers, including guidance and advice around confidentiality requirements;
• Entitled to disagree with the rest of the committee and have this recorded.

Make sure you know as much as you can about the committee. Committees may vary in:

• Scope of their activity 
  Some committees are extremely broad in their scope, for example, the National Health and Medical Research Council; while others have a very narrow focus, for example, the Asthma Working Group of the National Health and Medical Research Council.
• Purpose
  Committees are established for many different purposes, for example, to advise on policy; review a particular program; plan a survey; control pricing; prepare material; or to hear complaints or appeals.
• Authority
  Committees can have advisory authority only; power to recommend but not to decide; and authority to regulate or control or to set standards. Their area of authority, or jurisdiction, will also vary from national coverage, to the state or territory level, or to local areas.
• Method of operation
  Committees may have regular and ongoing meetings or exist until a task is completed. Venues for meetings may vary from face-to-face meetings to teleconferences or video conferencing.

The same person may always chair meetings, or members may rotate 

CHF assists with sourcing consumer representation in two ways. In a select number of cases we run a selection and nomination process (nominating consumer representatives to a limited number of high level national committees and those related to funded priority areas). Where we cannot assist in this way, we advertise consumer representative opportunities to our national network, with applications going directly to the committee organisers (CHF does not play a role in the selection or nomination). 

In both cases, we first ensure that consumer representation is supported by the payment of a sitting fee and the coverage of travel expenses (when appropriate) to make it possible for the consumer representatives to contribute.  As the consumer advocates are drawn from our networks and are not paid members of the CHF secretariat, the committee organisers need to agree to support their participation in line with best practice ie. coverage of expenses/travel costs and payment of an appropriate sitting fee.

The CHF position is that consumer representatives are not honoraries who come from an academic or professional position. Consumers frequently forego their paid employment in order to prepare for and attend meetings or have to make other arrangements for ongoing commitments.  CHF expects consumer representatives to be committed to their work and does not put its consumer representatives in positions where they will be financially disadvantaged by their desire to improve health care.

CHF does not set a level for sitting fees as work and time requirements vary.  When asked for guidance CHF refers committee organisers to the middle range (category 2- on page 6) set by the Remuneration Tribunal for offices not-specified (available online at PTO 2022 - Compilation No. 4.pdf (remtribunal.gov.au) - updated August 28 2022).  This is around $430 per day (5 hours) . Meetings of less than 5 hours attract a proportion of this fee (2/5 or 3/5). Sitting fees should be paid for teleconferences as the consumer representative is still required to set time aside to prepare and attend the meeting.

In conjunction with your nominating organisation, establish any long-term goals you hope to achieve. By doing this, you will actively pursue the consumer agenda.

Try not to achieve too much too soon. If your committee is not used to having consumers represented, simply broadening the understanding of policy makers is probably an appropriate and realistic goal.

Long-term goals may also include resolving a difficult issue or problem, developing a new program, or formulating new legislation.

Remember that lasting change often comes in small incremental steps. Many consumer battles were won over years of patient lobbying and representation. Have a clear, long-term agenda which is realistic. Unrealistic goals will only lead to frustration.

It may be helpful prior to your first meeting to check on access eg. stairs, security procedures and parking. You should also ensure that the Committee Secretariat has noted any dietary or other reasonable adjustment requirements.

Talk with consumers and other consumer representatives within your network to provide you with consumer views on various issues. Listen carefully to what everyone has to say, ask questions, clarify issues and principles. Your job is to understand a range of consumer viewpoints, and to try to present this diversity of issues. Keeping in touch with your networks will ensure you gain an informed view of the consumers' perspective. Look for the principles and interests in common among the people or groups you are representing. If you cannot reach a consensus you can use material such as the Australian Charter of Healthcare Rights to express consumers' needs and a broad perspective on a range of issues.

To remind yourself of your role as a consumer representative, you need to constantly ask yourself:

• What are the views of consumers?
• What are the needs of consumers?
• How can the views of consumers be captured?
• What does my experience as a consumer contribute to an understanding and identification of issues?
• How will consumers be affected by this committee's decisions?

If you need to, examine the agenda with your nominating organisation or other consumer groups. Determine which issues concern consumers and are relevant to them. 

It is sometimes impossible to prepare well for all agenda items. If this is the case, prepare three or four items which are pertinent to consumers and do not worry too much about the other agenda items.

Make contact with the Committee Chair to introduce yourself, obtain background information on the committee and what they expect from your position on the committee.

When you join the committee, find out when agenda items are required, and in what form. A formal committee will require items in writing, while a more informal committee may accept items verbally. 
Committees which send out agenda papers in advance often have a deadline for putting items on the agenda. Find out these protocols so you can contribute effectively. The Committee Chair or Secretariat can advise you on these protocols.

Check to see whether significant decisions or comments were correctly recorded in the minutes. If you want an important decision or comment recorded or changed, ask for an amendment at the next meeting or email the Secretariat any changes, if this is the committees' procedure. Even if meetings are six months apart, don't let it pass.

Check to see what action was recorded at the meeting, and remind yourself whether you agreed to follow-up any matter, or obtain any information, particularly any input or issues from consumers.

Preparation is crucial when attending meetings. Make sure you read all meeting papers carefully. Seek out additional information if anything is not clear. The Secretariat or Committee Chair may be able to clarify any concerns you have and provide you with additional information.

Set your goals for the meeting

Set short term goals for each meeting. These short term goals may be steps towards your long term goals.

Your short term goals may include ensuring that:

• A certain point is understood, and agreed
• A certain question is included in a planned survey
• A certain issue is raised
• An issue is clarified or
• An item in the minutes is corrected.

Tackle any achievable goals early on because this will give you experience and confidence.

It's a good idea to write down your short term goals as this will help you to refer back to them and use them as a guide to evaluate your achievements.

Melanie, your contact person at the Consumer Coalition, calls you to confirm that you are their new consumer representative on the Medications Access Committee (MAC), after the previous representative moved interstate. She tells you the next meeting is in two weeks, and that Lucy, at the Secretariat for the MAC, will contact you to discuss the meeting. She provides you with Lucy's contact details. 

Melanie asks if you have any questions. You have a number of questions; in relation to your role and its scope, the support you will receive from the Consumer Coalition and how you keep in touch with them. 

• You hold off from asking your questions until another day, as you don't want to appear as though you don't know what you're doing. 
• You ask Melanie your questions while you've got her on the phone.

Later on, you worry that Lucy at the Secretariat will call you and you won't have enough information about your role to speak to her knowledgeably; especially if she asks about such things as your reporting relationship with the Consumer Coalition. You decide that it would be better to call Melanie back, knowing that you need to go into this representational role fully informed, or it will reflect badly on you and the Consumer Coalition. 

• Melanie answers the phone.

You ask Melanie about the scope of your role on the Committee - whether you are there to speak for the Consumer Coalition, or as an individual. Melanie explains that you have been nominated as a 'consumer representative' by the Consumer Coalition to provide a consumer perspective on access to medications; but you are not expected to speak on behalf of all consumers, nor formally for the Consumer Coalition (only the Director and Chair can do that). 

Melanie explains that the Consumer Coalition has resources available that will help you in your work. She recommends that you have a look at the Position Statements on their website, as those will give you more information about the Consumer Coalition's views and positions on certain issues.

You ask Melanie if you should call her after the meeting. She says that you are welcome to report whichever way is best for you. She suggests it is helpful if you send an email report after each meeting with a summary of key discussion points, and any issues you think she should know about. That way, Melanie can share your report within the Consumer Coalition network and let you know of helpful information. This will help to keep other consumers aware of your work and the issues that are being worked on. 

She asks you to highlight any issues or comments that are confidential and should not be shared beyond the Consumer Coalition secretariat. She also encourages you visit the Consumers Health Forum of Australia website, and explains that on the website you will be able to access forums with other consumer representatives. She reminds you to attend one of the Consumer Coalition's upcoming Peer Network meetings.

Melanie offers to put you in contact with the Consumer Coalition's previous representative on the Medications Access Committee, Rick, to talk to him about the work of the Committee. You are glad you persisted with your questions, and already feel more informed.

• You decide to call Rick.

You read through the Terms of Reference and previous Minutes, to get an overview of what the Committee has been working on. Then you look through the Agenda - which now makes more sense, having read the background papers. 

When you read through the papers, you see there is no mention of sitting fees. You know the Consumer Coalition only nominates to committees that pay sitting fees but you feel awkward about asking. 

• You phone the Secretariat to ask about the sitting fees.
• You phone the Consumer Coalition for advice about committee sitting fees. 
• You hold off asking until the meeting. 

You make a few initial notes on the Agenda, and then have a look at the Position Statements on the Consumer Coalition's website. A few of them relate to Agenda items, and you read through them. You write down your short-term goals for the meeting. You also review the Consumer Health Forum Consumer Representative Guidelines and the e-learning module to refresh yourself on the tips for being a consumer representative. 

The day before the meeting you gather your meeting papers and the phone number for the Secretariat, in case you need it. 

You arrive outside the venue fifteen minutes before the meeting is due to start. Through the glass sliding doors you can see people entering and leaving the building with their electronic passes. The security guard checks in guests nearby. You're glad you arrived early, as this is a sign-in process you were unaware of. 

The Security Guard signs you in, hands you a guest pass, and points you towards the lift. 

End

Rick is pleased that you rang, and is keen to share his stories about the Committee. He gives you a useful overview of the issues and history of the Committee.

Then he begins to talk about some of the Committee members. He warns you about a member named John, who he believes is only interested in pushing his own agenda. You mentally make a note to avoid getting involved in Rick's personal politics with John. 

Although you are expecting the Secretariat to make first contact, you decide to call her first, as you are about to go away for a few days. 

• You phone the Secretariat.
• You email the Secretariat.

You send Lucy an email introducing yourself, and asking if she can provide copies of the previous Minutes, Terms of Reference and Membership List for the Committee. 

That afternoon you receive an email reply. Lucy thanks you for getting in touch, and has attached the Terms of Reference, previous Minutes and the Membership list. You save each of these documents into a file on your computer. Lucy also explains that they can reimburse you for your travel expenses, by reimbursing parking fees or public transport fares; or providing taxi vouchers in advance. 

When you look at the documents she has sent you, you realise they are quite large; too large for your small home printer. You phone her and ask if she can post the documents to you as well, along with the taxi vouchers. Lucy agrees, and you give her your postal address. 

Lucy provides you with the street address and meeting time. You remember that one of your peer consumer representatives is required to maintain absolute confidentiality about the Committee work they do. You ask Lucy about this, knowing you are supposed to report to the Consumer Coalition after each meeting. Lucy explains that it is fine for you to report on the work of the Committee, provided the Consumer Coalition does not discuss this work outside of the organisation. She also explains that sometimes the Committee will ask members to keep certain items confidential, but that these will be clearly identified. 

A short time later, you receive an email from Lucy, thanking you for getting in touch. She confirms that she has put the previous Minutes, Terms of Reference, membership list and taxi vouchers in the post to send to you.

• You file the papers in a folder.

A few days later, the Committee papers and taxi vouchers arrive in the post. Lucy also sends a group email to all the Committee members, and attaches the meeting Agenda and related papers. In her email she welcomes and introduces you. You save the Agenda and other papers to your Committee file on your computer. Lucy says she will provide copies of the papers at the meeting. 

• You also save the email from Lucy, which you note has email addresses for each of the Committee members.

You decide to wait until the meeting to ask about sitting fees. At the meeting, it is then awkward to bring up; but you do find out that you will be paid an acceptable fee. 

• You begin preparing for the meeting.

When you phone the Consumer Coalition, Melanie confirms that a sitting fee should be paid. She explains that while professionals may undertake committee work as part of their professional life, it is an accepted practice for consumer representatives to be paid a sitting fee. This is because consumers frequently forego their paid employment in order to prepare for and attend committee meetings; or have to make other arrangements for ongoing commitments (such as carer responsibilities). Melanie says that the Consumer Coalition checks that a committee will pay consumer representative travel expenses and a sitting fee before nominating a consumer representative. She says that there is no set amount as sitting fees can vary depending on the committee workload and requirements. 

When you phone Lucy to ask, she confirms that you will be paid a sitting fee. You are comfortable with the amount, and she explains the process for claiming the fee. 

• You begin preparing for the meeting.

When you phone Lucy, she confirms that you will be paid a sitting fee. You are comfortable with the amount, and she explains the process for claiming the fee.

• You begin preparing for the meeting.

Lucy answers the phone, and you introduce yourself. She is pleased you rang, as she has some information to run through with you. 

She confirms the date and time of the next meeting, and gives you the street address for the meeting venue. You ask if she can send you through the previous Minutes, Terms of Reference and membership list for the Committee. Lucy offers to email them to you. 

Although you want her to email the documents so you can save them to a file on your computer; you only have a small home printer. You ask if she can also post a copy of them out. She asks if you have any questions. 

You ask her if there is any reimbursement for travel expenses, such as parking fees or public transport fares. She explains that the Committee can reimburse you for parking and public transport fares, or provide taxi vouchers in advance (you request some taxi vouchers for the first meeting). 

You remember that one of your peer consumer representatives is required to maintain absolute confidentiality about the Committee work they do. You ask Lucy about this, knowing you are supposed to report to the Consumer Coalition after each meeting. Lucy explains that it is fine for you to report on the work of the Committee, provided the Consumer Coalition does not discuss this work outside of the organisation. She also explains that sometimes the Committee will ask members to keep certain items confidential, but that these will be clearly identified. 

A short time later, you receive an email from Lucy, thanking you for getting in touch. She confirms that she has put the previous Minutes, Terms of Reference, membership list and taxi vouchers in the post to send to you; and she has also attached electronic copies of each of these. 

• You save the electronic documents into a file on your computer. 

A few days later, the Committee papers and taxi vouchers arrive in the post. Lucy also sends a group email to all the Committee members, and attaches the meeting Agenda and related papers. In her email she welcomes and introduces you. You save the Agenda and other papers to your Committee file on your computer. Lucy says she will provide copies of the papers at the meeting. 

• You also save the email from Lucy, which you note has email addresses for each of the Committee members.

The Medications Access Committee is a national committee that seeks to improve appropriate access to prescriptions and medications in Australia. It was established by the Minister for Health, and is Chaired by her advisor, Janet. 

Please note that the Medications Access Committee is a fictional committee. 

• Go back.

Membership of a committee is determined by the Terms of Reference. Two key members of the committee are the Committee Chair and the Secretariat. You should introduce yourself to both the Committee Chair and the Secretariat and familiarise yourself with their roles.

Ask at the meeting, before the commencement of the first agenda item, to have amendments to the previous meeting's minutes made. Don't let matters slip as it may become critical later whether a point was noted or not.

If you are unable to add items to the agenda before the meeting, use other business to have them put on the agenda for the next meeting. You may ask the Committee Chair if there can be a standing agenda item for consumer issues.

You enter the meeting room. A number of people are standing around the room. You see a woman who you think might be Lucy, the Secretariat. 

• You take a seat towards the middle of the meeting table.
• You introduce yourself to the Secretariat.

A motion is when an item of business or issue requiring a decision is introduced to be considered by the committee. If the motion is passed it will then become a resolution.

As a novice consumer representative you can use your inexperience to your advantage. No one expects you to know everything. Use the opportunity to ask questions such as:

• would you mind defining that term for me?
• I don't know the background to that decision - could you fill me in briefly?
• why didn't that plan work?
• what was the original intention?

Don't be afraid to ask questions, chances are other members of the committee may also need clarification on issues or additional information.

While a good Chairperson will keep the discussion as close as possible to the agenda items, any member of the committee can do this. It is okay to remind the committee of its objectives, especially if there is a tendency for members to wander off on tangents.

At times, it is necessary to have your dissent recorded in the minutes because you will not agree with every decision reached by the committee. Use your right to disagree sparingly, usually when decisions taken are not in the interests of consumers.

Keep your own notes of major decisions, and a summary of useful discussions. Remember to note who makes significant points; remind yourself of anything you have agreed to take action on; and jot down any ideas.

If you wish to make a point, make it strongly and then leave it. Don't worry if it is not picked up straight away. If someone else picks it up later, then your point was made twice, and you have discovered an ally on that issue. Be confident that your perspective is relevant and valid and represents the views of consumers.

Remember you have been nominated to provide a broad consumer perspetive. It is important to keep your own experiences separate from the experience of consumers in general.

The lunch break is an important opportunity to develop trust and to identify allies. Chat informally to other committee members and ask people to fill you in on details and background information.

You take a seat at the middle of the meeting table, where you will be able to see everyone and they will be able to see you. After a few moments, Lucy approaches you and introduces herself. You introduce yourself to her, and she points out Janet, the Chair. 

The other members begin to sit down and you make a deliberate effort to make eye contact, smile and say hello to the other members; and introduce yourself to the people who sit down either side of you. 

• Janet opens the meeting.

You introduce yourself to Lucy. She introduces you to a couple of other Committee members, and the Chair, Janet. You make small talk with the members you have just met while you are waiting for the meeting to begin. After a few moments, people begin to sit down, and you take a place at the middle of the table where you will be able to see everyone and they will be able to see you. 

You make a deliberate effort to make eye contact, smile and say hello to the other members, and introduce yourself to the people who sit down either side of you.

• Janet opens the meeting.

Janet thanks everyone for attending the Medications Access Committee, and introduces you as the new representative from the Consumer Coalition. She requests that each of the other members introduce themselves for your benefit. The other members include representatives from local and federal government departments, health peak bodies and medical associations. You also see that John, who works at the local university is there, and recall that Rick, the previous Consumer Coalition representative, warned you that he didn't get along with him. 

Janet asks for apologies, and then invites members to review the previous Minutes. After the Minutes are accepted by the Committee, she begins to move through the Action Items from the Minutes. She asks Derek, the representative from the Health Department to provide an update on the Online Medications Database. 

Derek reports that in the last month they have 'piloted the portal with a test group of consumers, and obtained feedback on its accessibility, navigation, presentation and delivery', and that they will be publishing within the next two weeks. The Chair asks if anyone has questions or comments, and a few people glance at you because he mentioned the word 'consumer'. Although you read about the Online Medications Database in the previous Minutes, Derek's jargon doesn't make sense to you. 

• You ask Derek for more information.
• You decide to stay quiet.

You ask Derek if he can provide more information, using your newness as an excuse. He explains that his Department is responsible for implementing the Online Medications Database, which has come about because people are increasingly turning to the Internet for information about medications. This Database will provide one website that people can access for correct and up-to-date information. 

You ask him to explain what work had taken place within the last month. He explains that they piloted (tested) the website with a group of consumers, to get their feedback on how easy it was to use and understand, and whether they liked the look of it. 

You're glad you asked, especially when you see a couple of other people nodding like they now understand it too. You ask Derek how many consumers he tested it with. He tells you there were 12 consumers in the group. 

This surprises you - you expected that for a national initiative there would have been a more rigorous consultation. You question whether there will be more consultation occurring. 

Derek tells you this is unlikely, and explains that there was an opportunity to discuss the process at the last Committee meeting. You know from having read the previous Minutes that there was no consumer representative at the last meeting, with Rick finishing up two meetings prior. 

• You decide not to press the issue.
• You politely pursue your position; and relay your concerns about the issue.

You decide to stay quiet, and the Chair continues to move through the Actions. However, you find you are still confused, and think that a) the committee shouldn't be using unnecessary jargon, and b) it's possible that there are also other people in the room who didn't understand what Derek was saying. You ask the Chair if you can go back to that item and ask for more information. 

• She obliges.

You decide not to press the issue further, as you are worried you will be viewed a nuisance. A week later though, when you have submitted your email report to Melanie at the Consumer Coalition, she writes back asking for more information on this issue; wanting to know with whom and how they tested the website. She asks you to follow this up again at the next meeting or out of session. 

• Go back.

You state that there wasn't a consumer representative at the last meeting. Derek concedes that the process was not ideal; but his Department had pressing time and budgetary restraints. 

You know that it is too late to change the outcome on this issue now, as the website will be up and running within the fortnight. You instead suggest that the Committee look at how it might incorporate consumer consultation into reviewing and evaluating the website; and ask them to commit to having a broader discussion about consumer consultation at a future meeting. 

Your idea is supported by the representative from the Health Peak, who suggests it be placed on the Agenda for the next meeting. You're pleased that another member has engaged in the discussion, and mentally note down her interest in this issue. She may be a useful ally in the future. Derek agrees to engage in a discussion about incorporating consumer consultation into a review of the website.

• This is noted in the Minutes. 

The Chair begins to move through the Agenda items. Occasionally, where you think it's important, you ask the speaking member to clarify a term or provide more explanation.

The Committee gets side-tracked on a debate about the ethics of an Electronic Prescription Tracking System, which was not on the Agenda. Members are discussing the benefits of consumers and pharmacists having access to their records; versus respecting consumer confidentiality. One of the members asks you what you think. You feel unprepared, having been put on the spot.

• You say you don't know.
• You say you would like to consult with the Consumer Coalition, and come back with a response out of session or at the next meeting.

The Committee begins discussing medication labelling, and in particular; reported problems around people taking incorrect dosages. You have been waiting for this Agenda item - this is an issue close to your heart, as one of your elderly relatives took an incorrect dosage and was sent to hospital because the writing on the label of his medication was too small for him to read. You are aware that this is a common issue raised by health consumers. 

Janet says it would be interesting to get a formal consumer perspective on this issue. But before you get to have your say, one of the other Committee members, Jack, complains 'but we're all consumers'. He talks about an experience he had where he received medication that was incorrectly labelled. You see a couple of Committee members roll their eyes at each other, and others ignore him. You feel it is an important issue, and want to support some of Jack's points. 

• You tell the Committee about your relative's experience. 
• You brings Jack's story back to some of the broader issues that have been raised by consumers on this topic.

You state that you think the Consumer Coalition would be interested in contributing to the discussion; and that you would like to consult with them out of session. 

The Chair notes this as an action that all members are to consult with their stakeholders and come prepared for a discussion on this topic at the next meeting. You recall that the Consumer Coalition has a Policy Statement on this. 

Lunch arrives, and the meeting is adjourned for ten minutes. You see John making himself a cup of coffee. 

• You heed Rick's warning and ignore John for now. 
• You decide to introduce yourself to John.

You tell them you don't know, and explain it wasn't an Agenda item. Janet, the Chair, nods in understanding, although a few people look disappointed. Janet suggests that it be included as a formal Agenda item for the next meeting. 

• Go back.

You walk up to John and introduce yourself. He seems pleased to meet you and says he thought you raised a valid point about consumer consultation. He explains that his university will be assisting Derek's department to develop the evaluation framework for the Online Medical Database. 

You are glad you didn't let Rick's personal politics get to you. You hope you may have another ally on this issue in John, and talk to him for a few minutes about the evaluation framework. 

• The meeting reconvenes. 

You decide to ignore John for now, just in case there was something to Rick's warning about him. However, John startles you by sitting down next to you and introducing himself. He says he thought you raised a valid point about consumer consultation, and explains that his university will be assisting Derek's department to develop the evaluation framework for the Online Medical Database. 

You regret letting Rick's personal politics get in your way. You hope you may have another ally on this issue in John, and talk to him for a few minutes about the evaluation framework. 

• The meeting reconvenes. 

You tell the Committee about your elderly relative's experience, and how he too required hospitalisation. The Chair thanks you and Jack for sharing but says 'I'm sure we all have personal stories but we need to focus on the evidence'. You remember from your consumer representative training that you were advised to 'leave your story at the door'. 

• Go back.

The Chair agrees and asks Lucy to note it down as an action.

There is only five minutes of the meeting left, and you note that there are still two Agenda items. You think one of them is particularly important and relevant to consumers - it relates to accessing prescriptions through General Practitioners. Janet suggests that the Committee skip the last two items and go straight to 'Other Business'.

You suggest that the additional Agenda items be placed early on the Agenda for the next meeting, and the other Committee members agree to this. Following 'Other Business', Janet thanks everyone for attending and closes the meeting. People begin to rise from their seats. Some leave the room immediately, while others move slowly and continue to chat.

You make a point of smiling and saying goodbye to the other members as you leave.

Write a report as soon as possible after the meeting. Include in it the details of issues important to consumers; the decisions made; and a list for follow-up action or information.

Feedback is an important part of representative work and you should work with your nominating organisation to decide what information they need and to seek their support and advice.

You may be required to: write a report after each meeting; write monthly updates for a newsletter; and/or give a report at meetings of the organisation. The Chair will be able to advise and assist you when confidentiality requirements restrict the information you can share.

Keep in touch with the Secretariat and other committee members, even if there is a long break between meetings.

Often some of the informal work of committees is done between meetings. It is important for consumer representatives to be aware of the informal discussions that are taking place amongst committee members.

Reflection and evaluation are important tools for effective representation. Here are some tips which may help you to evaluate the progress of the committee and your effectiveness:

• look for themes coming through the agenda
• look for interests of members on various issues
• look for interests in common
• items that were not discussed that you thought would be
• reflect on the role you have played, and on the roles played by others
• can you identify the results of your participation or how your participation was blocked.

Contact the Committee Chair to obtain feedback on your role within the committee. Be prepared to receive both positive and negative comments.

The following week you attend the Peer Network meeting that has been organised by the Consumer Coalition for its consumer representatives to meet each other and discuss their experiences. With a small group, you share your experience of your first meeting, without naming names or discussing the work of the Committee. They give you positive feedback on your actions at the meeting. You also admit that you don't like public speaking, and another consumer representative tells you she was able to access a public speaking workshop. You decide to talk to Melanie about training and professional development opportunities that you could access. 

A few days later, Lucy sends out the Agenda for the next Committee meeting; and you prepare yourself for the next meeting. 

End

On the way home, you review your notes and write a summary of the actions you received at the meeting, knowing that the Minutes might not be available for a while. You reflect on what you thought you did well, and what you might do differently next time; and how well you met your short-term goals. You find yourself already thinking about your short-term goals for the next meeting; and longer-term strategic goals for the Committee. 

That night, you start thinking about your report to Melanie at the Consumer Coalition.

• You would prefer to sit with the issues for a while longer before you write your report. 
• You take half an hour to write your report. 

You phone Lucy, the Secretariat, to resolve these confidentiality issues. You explain to her that although you know the report is confidential, it raises some important issues for consumers that you would like to discuss with the Consumer Coalition. You ask permission to share it with your contact person, Melanie. She says she will check with Janet, the Chair, and get back to you. 

When Lucy calls you back the following day, she explains that on this occasion, Janet has given permission for the Consumer Coalition to look at the draft report, provided they don't distribute or discuss it outside the organisation. 

You forward the draft report to Melanie, and inform her about the confidentiality clause. Melanie provides you with representative support, including providing you with information from the Consumer Coalition to take to the next meeting. 

• You make a note to provide this feedback at the next meeting.

You tell Melanie you are not able to share the report, due to the confidentiality clause. 

At the next Committee meeting, you provide some feedback on the draft report, although feel it is rather limited because the Consumer Coalition has not been able to review the report. 

You wish you had asked the Secretariat for permission to share the report with Melanie. 

• Go back.

Having finished your reporting to the Consumer Coalition, you would like to debrief with someone about your first experience as a consumer representative. The Consumer Coalition has a Peer Network meeting next week, which you are looking forward to. In the meantime you log onto the Consumers Health Forum of Australia website, and browse through the representatives' forum. 

There are other new consumer representatives who have posted about their first experiences, and you see that other people have discussed similar experiences, such as dealing with jargon from committee members. One member posts that she simply asked the Committee not to use jargon, which worked for her. You make a note to think about raising this if it happens again at the next meeting. 

Another consumer representative has asked for advice, saying that he felt he wasn't listened to when he shared his personal experience. Having experienced a similar situation, you log in and reply to his post; suggesting that he try de-personalising the issue so it reflects the broader experience of consumers, rather than only his own. You're pleased that in addition to learning new ideas, you already have some thoughts to share with other consumer representatives. 

• You review your actions from the meeting.

A few days later, you receive an email back from Melanie. She thanks you for participating in the meeting and reporting on the outcomes, and sends you a couple of journal articles from previous Consumer Coalition newsletters that relate to the Electronic Prescription Tracking System and medication labelling issues that you can provide alongside the relevant Position Statements. Melanie thanks you for using the Consumer Coalition's existing resources, such as the Position Statements, rather than speaking directly for the organisation. 

She also asks if the Consumer Coalition can have a copy of the confidential report that was provided to the Committee members for feedback. You are not sure what to do - having read the draft report, you think the Consumer Coalition would contribute some good feedback, and you think it's important that the Consumer Coalition have this opportunity. 

• You provide the report to Melanie.
• You do not provide the report to Melanie.
• You contact the Secretariat for assistance.

You discuss the report with the Consumer Coalition and raise the issues of concern. 

At the next meeting you raise with the Chair that you discussed the report, and the Chair expresses disappointment that the confidentiality of the report was not maintained. You wish you had checked with the Secretariat before you sent it to Melanie. 

• Go back.

You review and begin to progress your actions early, in order to ensure you will have time to complete them before the next meeting. The Secretariat sends a group email to the Committee with the Minutes, which you check to ensure you haven't forgotten any actions; and that your participation was reflected accurately. 

Looking at the Minutes, you consider the key themes coming through, the interests of members and the results of your participation. You are pleased that your participation had a tangible outcome - that you were able to encourage the Committee to agree to have a discussion about consumer consultation in relation to the review of the Online Medications Database and future projects. 

To make the most of every opportunity to engage with the Committee in a positive way, you use the reply-all option to thank the Secretariat for sending the Minutes, and reiterate your interest in the valuable work of the Committee. 

• You send the email to the Committee.

You write an email to Melanie to report on the meeting. In it, you provide an overview of the key discussion points and agreements, along with your comments. 

Following the Committee's request to come prepared for a discussion at the next meeting on an Electronic Prescription Tracking System, you include in your email that you will use the relevant Consumer Coalition Position Statement; and ask her if the Consumer Coalition has further information they would like to provide. 

In relation to the Committee's request to provide a briefing on medication labelling, you report that you will provide a copy of the Symposium Report and the relevant Consumer Coalition Position Statement, and again invite Melanie to contribute further information. 

At the meeting you were provided with a draft report on access to medications, which was circulated to members for feedback out of session, but which was marked confidential. 

• You note in your email that you were provided with a confidential report.

A few days later, you write an email to Melanie detailing the key points and decisions. You provide an overview of the key discussion points and agreements, along with your comments. 

Following the Committee's request to come prepared for a discussion at the next meeting on an Electronic Prescription Tracking System, you include in your email that you will use the relevant Consumer Coalition Position Statement; and ask her if the Consumer Coalition has further information they would like to provide. 

In relation to the Committee's request to provide a briefing on medication labelling, you report that you will provide a copy of the Symposium Report and the relevant Consumer Coalition Position Statement, and again invite Melanie to contribute further information. 

At the meeting you were provided with a draft report on access to medications, which was circulated to members for feedback out of session, but which was marked confidential. 

• You note in your email that you were provided with a confidential report. 

If you find discussion taking place on papers you have not seen, interrupt the discussion and ask for a copy of the papers being discussed. If an item is important, ask that it is deferred until you or others have had time to read the paper and consider the issues. Occasionally papers are circulated to some members of the committee, but not to all.

You need to receive the agenda papers in time to consult properly with your organisation and its constituents. This will vary according to the work of the committee, but you will usually need at least a week before the meeting to prepare properly.

Extensive agendas can lead to problems such as:

• The committee's efforts being directed to day-to-day or urgent issues
• The committee not having time to discuss all of the agenda items and broader or long-term issues
• The committee appearing to be very busy and productive, but actually avoids the hard work or achieve outcomes or
• The committee not facing the real issues.

It is necessary to assess which items are really worth spending time on, where the decisions have direct effects on consumers, both in your preparation, and in committee discussions.

Occasionally the committee will require you to give your opinion, or to vote on a motion, when you have not had time to consult with your constituency. If this happens:

• You can give an interim opinion (and state that it is such), pending consultation
• If you feel it is important, ask for time to consult. The item can then be deferred until the next meeting
• If you are unable to present the consumer view for a particular group of consumers, flag with the committee the need to undertake further consultation.

Consumer representatives can use the Australian Charter of Healthcare Rights, other consumer rights statements and consumer principles to explain the consumer perspective to the committee when they have not canvassed the views of consumers or if consumers are divided over an issue.

This may occur:

• On a committee that has not had consumer representation before. It may take time to gain acceptance and for some committee members to realise the importance and value of the consumer perspective
• When the committee is primarily made up of technical experts, often talking their own jargon. In this situation you will need to ask committee members to avoid using jargon and to explain or provide you with a list of acronyms.

If the facts are misrepresented, ask the person to verify these facts. You must be prepared to verify your own facts. You may wish to bring in an expert to put views on your behalf. Arrange this before the meeting with the whole committee if possible or at least with the Chairperson.

Existing research and data are often used to support an issue. The research can sometimes indicate only part of the story. If this is the case, it is useful if you can demonstrate the larger picture.

When a decision is reached, and everyone is committed to it, it is important to verify everyone's understanding of the agreement and if any action will result from the decision.

You can help to clarify issues by summing up or asking someone else to sum up the understanding of the agreement. The final agreement is recorded in the minutes.

If no minutes are recorded, you should write down your understanding of the decisions for further reference.

If you disagree with a major decision of the committee, ensure that this should be recorded in the minutes, or even stated in the final report. Always let your nominating organisation know if you disagree with a major decision.

If a decision has been made but not yet implemented, you may wish to follow it up at the next meeting.

Committees often deal with matters which must remain confidential within the committee. Sometimes a matter is confidential until a public announcement is made.

Confidentiality requirements, and how to deal with them without compromising the ability to consult effectively is an issue faced by many consumer representatives.

Clarify the issue of confidentiality early on. Not all issues and decisions arising in meetings are necessarily confidential. If a matter arises and you are unsure if it is confidential, discuss it at the meeting.

Confidential information is likely to become a problem for you where it routinely hinders your ability to consult appropriately or where it is used to stifle discussion or compromise the independence of representatives. You must seek advice from your nominating organisation if this is the case.

Confidentiality requirements of the committee do not release you from any reporting or consulting duties. Representatives may need to clear written reports with the committee's Chairperson before they are distributed to nominating organisations or other consumers.

Use these useful tips for dealing with confidentiality issues:

• Ask the Chair/Committee Secretariat for guidance on what material is confidential and what isn't
• If confidentiality is applied 'blanket' fashion, raise concerns that this makes it difficult/impossible for the consumer representative to fulfil the role expected
• Clear reports with the Chair
• Prepare a report that draws on information available in the public domain prior to commencing on the committee. This helps provide a base for consumer consultation on non-confidential material (that can then be used to inform the confidential work on the committee). Look for a way to distinguish between publicly available information and confidential material

Tip

The Confidentiality Fact Sheet may assist you with issues around confidentiality. Remember you can clarify any issues with the Committee Chair and Secretariat or your nominating organisation.

Consumer representatives are expected to act with integrity at all times and not compromise the interests of consumers. If you discover that you have a conflict of interest or that you may be perceived to have a conflict of interest, you must bring it to the attention of your nominating organisation and the Committee Chair.

An example of a conflict of interest is if you were on a committee to decide on the purchase of a particular item of equipment and one of the suppliers for this particular piece of equipment was a company where a member of your family was employed. Having an interest in one of the companies may influence your decision.

If it is a major conflict, it will make representation difficult. In extreme cases you and your nominating organisation may decide that you need to resign your position on the committee.

You may experience the unease of being the only person representing consumers on a committee. Government and industry typically have several representatives while there is often only one consumer representative.

You can address your isolation by keeping in regular contact with your nominating organisation and other consumer representatives in your network. Your presence often raises the level of awareness of those on the committee and may lead to the increase of consumer representation.

In comparison with most committee members, consumer representatives are poorly resourced. Both industry and government representatives often attend committee meetings as part of their jobs where expenses are paid and hours are allocated. Consumer representatives seldom have such luxuries.

In many cases consumer representatives take time out from their paid employment to attend meetings and rely on their employers to get time off. Sitting fees are not always paid.

Consumer representatives may have limited or no access to the internet, e-mail and faxes and have to do committee work at home. Networking is done in their own time and phone calls are usually made from home.

Consumer representatives are often out-of-pocket for routine committee work such as making phone calls. A fact sheet is available to provide to the Secretariat detailing suggested entitlements.

Try to find ways to have the committee pay for expenses such as:

• Having them ring you back when you call them
• Paying for the cost of your printing or ask to be sent hard copies of all the meeting documents
• Internet costs.

Tip

The fact sheet How committee secretariats can support consumer representatives may assist you with issues around lack of resources.

Occasionally there may be more than one consumer representative on a committee. It is preferable for representatives to plan together (caucus) before each meeting and reach a consensus position on issues to strengthen the consumer position.

If a consensus is not reached you may decide to refer to your nominating organisation for advice or focus on the Charter of Healthcare Rights to deal with the issue rather than presenting differing consumer views.

Although not all consumer representatives serve on company boards, increasingly they are filling this role. This may place you in the position of having to assume liability as a director. It is your responsibility to know your rights and liabilities when appointed as a director. You should seek specific training to understand and support the role.

In particular, you should check whether the company has the appropriate insurance to protect its directors. Make sure you are aware of your responsibilities and accountability.

There are some qualities which are important in ensuring that you are effective. It helps if you have ability to:

• remember to base your argument on the broader consumer experience, not your personal story
• analyse an issue, and determine its effects on consumers
• move away from a personal opinion to a viewpoint that takes account of the diversity of experiences and needs of consumers
• present an argument rationally and convincingly
• understand the consequences of decisions, in the short and long term
• negotiate and
• always speak with respect and sincerity.

There is no correct way to become an effective representative, much of it is learned from experience and networking. Seek out relevant information and workshops, and take every opportunity to network with other consumer representatives and your nominating organisation to improve your skills.

Remember your nominating organisation can provide you with support and resources to assist you in your role.

First impressions are crucial!

Aim to create a first (and lasting) impression as someone who is organised, open to ideas and confident of your own opinions. On the first day, arrive a little early so that there is time to meet all members, and to chat informally with them. Choose a seat where you can see, and be seen by, everyone at the table. Make your point clear and don't feel you need to talk at every opportunity.

Once you've established yourself on a committee you will feel comfortable in promoting consumer issues.

If you have decided to discuss a particular issue, or move a particular issue forward, you will need to prepare your strategy well. Preparation is the key to success

Think about:

• how you will introduce that point
• what facts/research you will need to support your issue
• when is the right time to raise a point to inform the discussion (inappropriate timing may cause you to lose the opportunity)
• who is likely to support you (you may wish to discuss your approach and form allies beforehand).

Sometimes it is useful to write a paper on an issue. Committee members may prefer to respond to written arguments. You may well find your paper forms the working document for the discussion.

Forming alliances with other committee members is a normal part of committee work; use these to your advantage. However, if standing alone is unavoidable, support your position with logical argument and evidence.

It is important to work out any potential allies. Some allies may support you on some issues, and not on others. Anyone on the committee is a potential ally depending on what issues are discussed.

Try sounding out issues with other committee members because this way you can decide if they are worth raising with the full committee.

Discuss issues and approaches with one or more others. You may seek out a caucus, or others may seek you out. If you feel you are compromising your own position by joining a caucus, decide to stand apart.

Consulting with consumer groups and your nominating organisation is crucial for ensuring effective representation. Through consultation you ensure that you are able to provide a broader perspective and not just providing a personal opinion. This will increase your credibility and ensure that you are effectively representing consumers.

It is especially important to talk with any other consumer representatives on the committee and on related committees, to see what their opinions are on a particular issue. Importantly, you share ideas on important issues, discuss why they are important, and what outcomes are desirable.

If you are on a committee which is part of a structure with many levels of sub-committees and working parties, it is extremely important to have a good network with other consumer representatives within the structure.

Ask your nominating organisation or the Committee Secretariat to supply you with a list of names of other consumer representatives and a chart of the committee structure.

If you are taking over from a consumer representative who has served on the committee then it is wise to get a briefing from them. Ask them about:

• what achievements and difficulties they had on the committee
• who were their friends and foes (remember they may not turn out to be your friends or foes). However, it is important for you to make up your own mind once you have experienced the committee.
• what issues are the most crucial for consumers
• is the Committee Chair supportive of having a consumer representative?
• the support available from the Committee Secretariat and
• the process for claiming reimbursements.

Reporting regularly to your nominating organisation ensures that consumer representatives are accountable and credible. This enables the nominating organisation to support you in your work as a consumer representative. They can give informed policy advice, and advise you to talk to other consumers in their networks. When reporting to your nominating organisation, it is important to remember issues around confidentiality of information.

Committee members will take on many different roles and tasks. It helps to know what committee duties typically need doing, and when. This ensures that you are a positive force within the committee. Keep in mind whenever you can to:

• bring the discussion back to the relevant issue
• initiate new discussion
• summarise major points
• think laterally when discussion is not getting anywhere
• blend various people's comments together
• connect two points
• diagnose a problem
• inspire others
• relieve tension, or create useful tension
• remain active even when the issue does not have consumer implications.

Play an active part in your committee work to increase the profile and value of consumer representation. Active participation includes:

• preparing for the meetings and actively discussing issues
• adding items on the agenda
• presenting papers for discussion.

Being a consumer representative can be hard work especially if you are the only consumer representative, or if you are on a committee who has not had a consumer representative before or your role is to give the appearance of consulting with consumers. It is worth reflecting on your role and your expectations for your committee work. Talk with your nominating organisation about your difficulties and frustrations. You may need to decide if it is time to ease yourself out and let a new representative take over.

If you feel that your appointment was a public relations exercise, you should try to change attitudes by demonstrating your ability as an effective committee member. Get advice from your nominating organisation if the problem persists.

Even while retaining a clear sense of the differences in positions, and an understanding that there are often real conflicts of interest, avoid projecting an 'us' and 'them' feeling.

If you are working with people on an ongoing committee, it is important to keep up a good working relationship. This is often more important for future decisions than the outcome of one particular negotiation. Talk to other members before and after meetings, think of them as colleagues, rather than as enemies you need to avoid.

Fight over the issues, do not fight because of personal animosity. You will gain respect from people if you present a strong, logical argument without holding any personal antipathy.

Put yourself in the other person's shoes discuss each other's perceptions. Ask questions so that you understand, and could explain, the other's point of view.

Ensure that everyone participates so they will have a commitment to the outcome.

Listening is an important tool as you may need to check that you understood the discussion. Try interpreting and reading back others' statements. Remember to ask questions if you are unsure of an issue, chances are others within the committee also need clarification.

By locking yourself into a position which you must defend, you will find changing your position difficult. Early on, try to articulate your interests or principles, rather than taking a position or stand.

Rather than expecting, and looking for, opposing interests, look for the shared interests. This is difficult when people have different perspectives, or are not open to opposing views. Reformat the debate in your language, your terms, and your definition of the problem. Ask questions to identify the other members' interests.

Don't state your solution first. Spend time analysing and discussing the problem, sorting out the common interests, and then put a solution, relating it to those interests. Try to work out joint solutions, so that it is not 'your' solution or 'their' solution, but everyone's solution.

Don't constantly refer to past behaviour or statements (unless it is useful to do so) focus on the present and the future.

There is no single correct answer. Brainstorming is a helpful way of looking for creative solutions. This is done either within your committee; or you can reach your own idea of a solution outside the committee meeting, using people from your nominating organisation.

Remember to use the 'rules' of brainstorming such as collecting and building on ideas, no matter how way out, don't evaluate them until later.

The costs of making any decision on the basis of who has the strongest will are very high, especially as the loser can feel resentful and bitter. If the committee members agree that decisions are made by taking the most votes, then move on whether you 'win' or 'lose'. Reflect and learn from your actions and consider alternative ways you may have been able to present your points or arguments for a successful outcome.

Ensure everyone is committed to the outcome

Once you and the other committee members have reached a decision, make sure everyone knows:

• what is going to happen next
• who is going to do what, and by when
• what resources are available
• what would be the consequences for not following through on agreements or tasks.

Once you settle in your role, you may find it useful to attend a course in negotiating, public speaking, assertiveness or communication skills.

Courses are often available at reasonable cost in adult continuing education centres. It is often useful to get a group together and arrange some training. Your nominating organisation may be able to support you or have some ideas on where good and affordable training is available.

Your committee may also offer training or professional development opportunities. Discuss your needs with the Committee Chair.

Often a committee will develop particular characteristics which are not conducive to effective committee work. Committee members may have tendencies to:

Groupthink

When a group is very cohesive, there is the risk of groupthink. This becomes a problem if the committee is agreeing to decisions that will adversely affect consumers. You may find that everyone is getting along so well that you or other committee members do not want conflict, so decisions are agreed to too readily.

Keep it in the back of your mind that groupthink can happen, especially when you are most enjoying committee meetings, because things are running so smoothly! Consciously assess each decision made by the committee. If you decide that decisions may adversely affect consumers then you must voice your concerns.

Work avoidance

Committee members often avoid working on the real issues when the committee is very busy with long agendas. Perhaps time is spent discussing problems which the committee has no scope to change or focusing on trivia and putting the hard issues at the end of the agenda. As with groupthink, this can happen when things seem to be going very well.

Remind committee members of the aims of the committee and its terms of reference. Suggest that the committee take time out to reassess its priorities.

Losing independence

Occasionally you may find that committee members are so enthusiastic about the work of the committee that you find yourself caught up in their enthusiasm. This is not necessarily a problem unless it clouds your consumer perspective and prevents you from voicing problems or concerns.

If you feel that you have lost focus, reassess the purpose of your appointment and your goals. If it becomes a real problem then you need to discuss this issue with your nominating organisation.

Putting people into certain roles

You may find that as a consumer representative you are placed in the role of complainant or opponent; or that the committee places a member in the role of leader and tries to get them to make the committee's decisions for them and to resolve any conflicts; or that one member is made into the committee's scapegoat.

Try to avoid this role stereotyping. It is useful at times to surprise others by agreeing with them and being positive. Beware of the tendency to get one person to do the committee's work and blaming this person if the committee doesn't achieve its objectives

If you notice role casting, point it out to the rest of the committee. Remind committee members that you all must work as a group. The final outcomes are as a group, not as individuals.

It is important to reflect on whether a committee is effective. This helps you to evaluate your own performance. Think about:

• why was this committee established?
• does it have any real power?
• what were its long-term goals?
• does it have adequate resources to carry out its work?
• are decisions followed up by action? If not, why not?
• is there anything you as a member can do? You could raise your feelings at the meeting or discuss your feelings with other members informally.

Consider action, such as preparing a definite proposal for discussion at the next meeting or suggesting the committee solve small achievable goals.