Advocacy is a verb everyone uses, and often misuses.

After more than two decades in the advocacy business, I’ve seen it done well, and also executed very poorly.

Sometimes I reckon advocacy can be overcomplicated, or perhaps overthought is a better term.

In its most common use, advocacy means building support for, and awareness of, issues.

This can be done to influence policies and spending, or to bring about change.

Advocacy is primarily used to improve understanding and knowledge.

This can be of a profession like physiotherapy, or about policy solutions, or identifying gaps and failures that should be addressed.

I divide advocacy into four ‘outcomes’.

You want something done

This is the most common form, otherwise known as campaigning. APA examples might include aged care reform, investing in multidisciplinary primary care models, telehealth and so on.

Here, you’re lobbying for decision-makers to implement reform or change, and advocacy becomes a campaign where you marshal your own members, other stakeholders and the public.

The campaign to introduce a national disability scheme is the best example from recent times.

The initial advocacy was to get the scheme agreed to by Parliament.

To do this, advocates used public support, media, and overseas examples to show why it was needed, and how successful similar schemes have operated. Having succeeded in establishing the National Disability Insurance Scheme, we’ve now seen dozens of small advocacy campaigns on specific regulations, operational matters and funding packages.

Maintain the status quo

Everything is working just fine, so please don’t start messing with things.

For instance, there’s a lot of advocacy going on around the Medicare Benefits Schedule review, and I bet certain medical craft groups are in this category, saying leave things as they are.

Don’t do anything

This is different from the status quo position as it involves marshalling support to prevent legislation or regulations.

This type of advocacy involves defending what currently exists.

One example is parallel book import rules. In 2016, the Productivity Commission recommended the government lift the ban, which would potentially make books cheaper, but also destroy the local industry.

The Australian Society of Authors joined with other stakeholders to defend Australian authors and the local industry.

This is a textbook (no pun intended) example of advocacy: they used petitions, brought in famous authors, cited economic data, and lobbied the opposition and backbenchers in the Senate to block legislation.

This campaign had several key ingredients for success: having high-profile writers (nationally and internationally), a dose of nationalism (cheap imports from overseas), and evidence of job losses.

Raising profile and awareness

At Mental Health Australia, we campaigned on unmet need. ‘Fix Mental Health’ was the mantra.

The specifics of funding and service delivery were more of an ‘internal’ matter.

The public campaign reinforced the concept that the mental health system was not delivering to those in need, and therefore more government investment was needed.

To these four categories I add a most important rider—have realistic expectations.

Some advocacy goals are ‘low-hanging fruit’ that might be more easily achieved, others are longer term or more strategic.

In certain instances, advocacy is like young Oliver Twist holding the bowl out saying, ‘Please, sir, I want some more’.

The problem is that unless you define ‘more’, you might end up with another ladle of gruel, and not the substantial investments you want.

Always recognise whether you’re seeking something broad, like raising an issue or profile, or a very specific outcome, like a funded deliverable or legislation.

There are common elements to all advocacy agendas, such as a strategic plan that includes:

• objectives, goals or targets


• a clear and understandable narrative that explains the ‘ask’


• credible evidence—data, facts, infographics, research and case studies


• easily accessible information that can be disseminated/ presented expediently


• target audiences and how to reach them


• opportunities, contexts, and events to capitalise on


• stakeholders and supporters (if part of joint advocacy)


• risk assessment that covers possible opposition, resistance, and obstacles


• evaluation tools.

Measuring wins

The most common frustration with advocacy is that too often we measure advocacy ‘wins’ by what’s in the media.

Media coverage is only one indicator of advocacy output. Many organisations in the health sector are in the media, but this isn’t necessarily an indication of ‘success’.

In a previous role, I spent years advocating for a tax on sugar-sweetened beverages.

This campaign was about ‘positioning’ and building consensus with allies and the public.

The evidence from the UK, Mexico and some US states was available, so too the economic argument and support across a range of health organisations.

A sugar tax is well covered in the media, and the issue has a ‘profile’. Yet nothing has changed. We haven’t gotten anywhere.

Although it might take years before a tax on sugar-sweetened beverages is introduced in Australia, I call this campaign a success. 

It set the agenda, raised the issue with decision-makers, gained media attention and engaged health stakeholders.

The ‘win’ will likely eventuate, so the advocacy building blocks have value (even though it can be frustrating when change is so slow).

Other approaches to advocacy are less visible but equally effective.   

It may be having a representative on a committee or taskforce, it may be a submission quoted in a Senate report, or an MP who promotes your issues in the caucus.

‘Silent’ wins could be the president or CEO talking with ministers and MPs, or senior department decision-makers.

These are not immediate outcomes, or even ‘wins’ we can readily categorise, but they are the foundations of raising profile and awareness.

Advocacy can also be about  not doing something, such as being in the media for negative reasons, or picking the wrong fight with governments, or asking for a policy or proposition that clearly isn’t credible.

APA and advocacy

Advocacy in the health sector is usually aimed at governments, departments and funders, and the media.

The APA pursues advocacy for myriad reasons. Like other member-based associations, we advocate to bring about improvements in the delivery, funding, and provision of (physiotherapy) services for the betterment of both patients and practitioners.

This means raising awareness of physiotherapy as a profession.

To do this, the APA has to address multiple ‘audiences’: APA members and the physiotherapy profession, the health sector (allied health, medical practitioners, non-government organisations), decision-makers (governments, departments, Primary Health Networks, private health insurers and other funders), the general public, the media, and most importantly the clients, patients and users of physiotherapy services.

Advocacy is the long game

The APA has so many issues  we  advocate on, such as aged care and MBS allied health item numbers, telehealth, workforce, women’s health and birth trauma, pain management, preventive health, Aboriginal and Torres Strait Islander health and cultural safety, rural and remote health, disability and the NDIS, sport and exercise, to name a few.

Then there are more complex issues, such as engagement with PHNs, funding models, and the role of physiotherapy in primary care.

Some of these may become evident in the coming months and years, while other issues may take longer to achieve.

What is evident is that the APA has achieved a lot in policy advocacy, and  the ‘build’ over the next few years is based on the tremendous work already in place across a range of areas.

Simon Tatz has extensive experience in the health sectors in Australia, including as the director of public health for the Australian Medical Association and director of communications for Mental Health Australia, and has held a senior advisory role to senior federal parliamentarians, ministers and shadow ministers.