An introduction to the horizontal coordination of public policies: Usefulness, facilitating factors, obstacles, and current challenges

This briefing note is intended for all managers in the health and social services sectors, as well as for public health actors who would like to see this type of approach established within their government so that health can be better taken into account in all policies. Those who are called upon to manage programs, projects or public policies involving multiple sectors with a determinant impact on population health will find here an overview of the usefulness of the horizontal (intersectoral) approach as compared with traditional approaches. This document presents the challenges and benefits specific to the horizontal approach, along with a summary of current thinking on the subject. It also includes examples of common practices tied to this approach. This approach should make it possible to better integrate health into all policies and to develop and implement healthy public policies. Managers familiar with horizontal approaches will find here an up-to-date review of current developments, as well as some avenues for reflection on their own management of horizontal approaches.

What constitutes the horizontal approach?

Firstly, it should be acknowledged that the question, “Have you ever collaborated with other government departments, the private sector, or the general population within the context of work on a public policy?” would be answered in the affirmative by a significant number of civil servants.

Everyone has, either at the initial or at a later stage, with varying decisional roles, been involved with public policies where some form of the horizontal approach was put into practice. The horizontal approach to public policy refers to a case where “anyone or any organization, when reflecting on a situation, formally considers who else has an interest in this situation and tries to associate that organization or that person with development in this area in an effort to promote the general interest” [translation] (Bourgault & Lapierre, 2000, p. 16). In other words, the horizontal approach refers to “any joint activity by two or more agencies that is intended to increase public value by their working together rather than separately” (Bardach, 1998) including “the processes and structures of public policy decision making and management” (Emerson, Nabatchi, & Balogh, 2012). In referring to coordination, management or governance, some use the descriptive terms horizontal, cross-cutting, whole-of-government, joined-up government, corporate, or intersectoral. While each term has a nuanced meaning, each mechanism is associated with a certain scope of ambition and with certain way of working tied to cooperative work.

The horizontal approach is distinguished from, but often complements, silo management. While silo management relies on vertical mechanisms established by organizations and adhered to by the actors involved, horizontal management relies on mechanisms that are jointly developed by participating actors and modified according to how the situation progresses. Silo management is centred around a classic pre-established organizational structure, with the aim being to carry out actions within a traditional field (health, agriculture, labour, etc.), whereas the horizontal approach is centred around a fluid structure, with the aim being to carry out actions within a non-traditional field, one that is either located at the border between the participants’ traditional fields of action, or that reflects the interdependence of these fields. This approach is practised within a single department, within or across levels of government, between national administrations, or to form associations between the private, non-profit and public sectors.

The horizontal approach has support in several countries. For example, the European Commission and Brazil are developing a training program focused on intersectoral coordination, and several reports on sustainable development point out the need for horizontal collaboration (Berger & Gjoksi, 2009); in Argentina, the Cabinet of Ministers commissioned a study on the challenges of public policy coordination (Jefatura, 2010); in Finland, the Prime Minister's Office has made this approach a strategic priority (Prime Minister's Office, 2011); and in Canada, the vision statement of the Clerk of the Privy Council, Blueprint 2020, supports the whole-of-government approach (Clerk of the Privy Council, 2013). The horizontal approach cannot, in 2014, be described as merely a fad. The Canadian federal government has been supporting this type of management for several years: a working group of deputy ministers was set up in 1996, a database of horizontal initiatives has existed since 2008, and guidance on the governance of horizontal initiatives is available (Centre of Excellence for Evaluation (CEE), 2012).

In brief

The horizontal approach:

• Is a method of working that involves several organizations;
• Is characterized by a collaborative culture;
• Seeks to promote the interests of all the actors involved and of the public, or to promote coherent government action;
• Requires the management of border zones between actors and between organizations.