DEBATE
                     POLICY FORMULATION:
                    COMMENTING ON PRICE
                                                                          Ben Fine
    Max Price's commentary (Transformation, 21) on the changing role of
 progressive policy groups in South Africa is most timely and welcome - as is his
 appeal for an open discussion on the issues involved. He raises the issue of how
 independent and critical intellectual participation is to be maintained even as
 individuals and organisations previously committed to oppositional stances to
 the apartheid regime are being drawn into advisory and policy roles for or in the
 current Government of National Unit (GNU). The significance of his
 contribution lies not only in its intrinsic interest wherever and whenever such
 dilemmas might be faced but because of their particularly sharp relevance for the
 South African transition. Those from whom independent critical commentary
might be expected, whether from academic or broader MDM (mass democratic
movement) origins, have become an endangered species as they have been
 swallowed up by government and as the Reconstruction and Development
Programme (RDP) and GNU have become ideological tokens of loyalty and
commonsense. Yet, as expectations and aspirations are being continuously
revised downwards and policy stances compromised, it is unfortunate that the
tradition of critical commentary should be most prominent on the conservative
and establishment side of the debates. Indeed, the uniqueness of the South
African situation is in whether critical progressive commentary will
meaningfully survive at all in the immediate future.
   With considerable sensitivity, Max Price recognises in his opening paragraph
that the experience in health is not unique nor is it liable to be representative. As
an academic who has been in a similar position in some respects in relation to
economic policy over the last ten years, I find this point particularly telling.
Paradoxically, then, his commentary is almost without substantive reference to
health at all. To use an old-fashioned vernacular, it is all about the form of the
dilemmas but neglects the content of what is involved. Thus, he deals with
funding sources and the control of the research agenda, consultancy versus
research, the potential aversion to participatory research, the requirements of
secrecy and against advocacy, the risk of poor quality undercutting by private
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 DEBATE                                                                         RNE
consultants, and a number of other issues. No doubt, each of these factors will
have a different weight in the dilemmas faced by progressives both within and
between each of the broad policy areas concerned. In addition, one crucial factor
seems to have been overlooked, namely the continuing inertia, power and
hierarchical structure of the government service - which has profound direct and
indirect effects on what and how research is commissioned, quite apart from how
policy implications are drawn and implemented.
   But my purpose in this short note is not to add to the list of the forms in which
progressives face the dilemma of both participating and being independent.
Rather, it is to insist on the debate being carried forward through being tied to
the specific and central substance of the corresponding policy issues. For
example, whilst I was researching for the section on health in the MERG (Macro
Economic Research Group) Report, it became clear that a central issue from an
economic perspective was how to control the burgeoning private health care
system, with its potential intensification of inequalities and inefficiencies and its
promotion of unnecessary curative at the expense of primary and preventative
care. The details need not detain us but surely the example illustrates how much
weaker is Max Price's commentary for not addressing the progressive's dilemma
in this context specific to health. The same must apply in other policy areas,
including economics. How can we express the dilemma without reference to the
unchallenged powers of private corporate capital, the Reserve Bank, and so on?
Indeed, it is precisely the capacity to hold onto such realities which is at the
greatest risk when critical gives way to constructive, constructive to compromise,
and compromise to capitulation - as the imperatives of politics and pragmatism
come to the fore.
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                                                   TRANSFORMATION 29 (1996)