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90 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90
Belgium is no exception. Health professions, at different levels, have a strong role in
developing policies : this can be seen through the numerous executive and consultative
bodies (particularly within the Social insurance institution RIZIV/INAMI) in which
medical representatives sit along with government bodies and are allowed to wield
considerable influence on the policy process 194 : National Committee of Physicians and
Sickness Funds, Committee for Medical Evaluation and Control, Planning Commission ,
National Council for Hospital Facilities, etc. Belgium is clearly a country which provides
many opportunities to interest groups to influence or block a policy. Although this
could be sometimes considered as a hurdle to policy changes 195 , the Belgian situation is
clearly that of pluralism. This situation makes stakeholder analysis an important tool for
developing solutions in Belgium.
This chapter aims at assessing the political power side of the problem and the political
feasibility of policies for improving GPs’ attraction, recruitment and retention through a
stakeholders’ analysis. Stakeholders are defined as “persons or groups that have
interests in an issue, including those with some role in making a decision or its
execution” 192 . A stakeholders’ analysis can be defined as “an approach, a tool or set of
tools for generating knowledge about actors to understand their behavior, intentions,
interrelations and interests; and for assessing the influence and resources they bring to
bear on decision-making” 196 . This stakeholders’ analysis will help to understand the
interests and influence of individuals or groups both within and outside the organization
of general practice.
6.2 OBJECTIVES
This stakeholders analysis has four objectives:
• To describe stakeholders’ understanding of the challenges faced by
general practice in Belgium;
• To identify the policy options more likely to be supported aiming at
improving the GP’s career;
• To identify the criteria and factors making the stakeholders more likely
to support or oppose some policy options;
• To identify implementation details of the policy options more likely to
be supported.
6.3 METHOD OF THE STAKEHOLDER SURVEY
6.3.1 Design
This survey used a multi-criteria analysis (MCM) 197 , a tool to support decision among
different options and several criteria (see appendix 5.1.). It aims at combining
comparability between interviewees while accommodating each respondent’s
perspective. MCM has been used in the health sector for obesity prevention 198 or
selection of anti-psychotic drugs 199 .
Multi-criteria analysis has the following characteristics 197 :
• To identify alternative ways to solve a problem (GPs’ attraction,
retention and recruitment): policy options.
• To suggest criteria allowing the appraisal of those policies: policy
criteria.
• To score each option on each criteria.
• To weigh each criteria in order to reflect its relative importance.