This title is directed primarily towards health care professionals outside of the United States. This introductory text explores Australian health policy through a novel, problem-orientated approach. It shows the problem-solving techniques that are used when developing policy and demonstrates the skills of analysis and decision making. Introductory chapters explain the problem-orientated approach to health policy development and introduce the policy making process. These are followed by case studies that explore developments in Australian health policy in priority and topical areas. Chapters illustrate how policy-makers respond to perennial and emerging policy problems and demonstrate problem-solving approaches to the conception, development and implementation of health policy. Of particular concern are areas which are in transition or are highly contested. A team of prominent and expert contributors gives an overview of key issues, analyse the policy responses that have occurred and propose directions for the future. Topics covered span governance, values and specific service areas within major established areas of health policy of national concern as well as emerging problems and developments that have occurred in response to well-known cases.Takes a novel, problem-oriented approach to analysing health policy in Australia, which fits well with how policy is often created in practice.Combines a conceptual framework with a rich selection of pertinent and topical case studies by prominent researchers and policy practitioners to put policy analysis in context and give insights from practical experience.Topics have been chosen to appeal to students from a wide range of health backgrounds and include issues in nursing, management, rehabilitation, health information, and technology.Includes questions for discussion in each chapter.A companion Evolve website for Instructors contains chapter-by-chapter notes on review questions, suggestions for tutorial exercises, assignment topics and examination questions.

lgrsnf/64502.pdf

Simon Barraclough, Heather Gardner Ma

Churchill Livingstone Australia

Elsevier Australia

Marrickville, N.S.W, Australia, 2008

Marrickville, N.S.W, 2007

Australia, Australia

1, US, 2007

Includes bibliographical references and index.

Front Cover
Front Matter
Copyright
Dedications
CONTENTS
PREFACE
CONTRIBUTORS
REVIEWERS
ABBREVIATIONS
SECTION 1 : Health policy:an overview
CHAPTER 1 - A problem-oriented approach to health policy analysis
SEMANTICS: THE PROBLEM OF THE WORD ‘PROBLEM’
PROBLEM SOLVING AND POLICY ANALYSIS
PROBLEM DEFINITION
CATEGORIES OF HEALTH POLICY PROBLEMS
KINGDON ON PROBLEMS AND THE POLICY AGENDA
INTERROGATING THE PROBLEM:SOME ANALYTICAL QUESTIONS
How is the problem categorised and would a different category change howwe approach it?
Who is seeking to place the problem on the policy-making agenda?
What story or discourse about the policy is being presented?
Is the problem contested and what is the nature of the contestation?
What is the evidence for the existence and nature of the problem?
Is causality for the problem suggested and what are the complexities of theproblem?
How long has the problem been recognised and what previous steps havebeen taken to deal with it? What knowledge and experience about theproblem exists?
Is there a potential benefi t from comparative analysis of a problem?
Have efforts to deal with the problem caused, or are likely to cause, further ordifferent problems?
What are some possible solutions and how are choices limited?
What values are relevant to the problem and to possible solutions?
References
CHAPTER 2 - Health policy as a process
WHAT IS POLICY?
WHO IS INVOLVED OR IS POLICY POLITICAL?
Federalism and health
Political parties and the policy process
POLICY AS PROCESS: ARE MODELS USEFUL?
PLURALISM AND HEALTH
STRUCTURAL INTERESTS AND HEALTH
NEW PUBLIC SECTOR MANAGEMENT
CAN POLICY BE RATIONAL?
CONCLUSION
References
CHAPTER 3 - Institutional problems and health policy
REFORMING THE SYSTEM
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
Private health insurance
CONCLUSION
References
CHAPTER 4 - Population health, the health system and policy
TOWARDS EVIDENCE-BASED HEALTH POLICY:THE IMPORTANCE OF RESEARCH
COMMUNICABLE DISEASE
DATA FOR HEALTH
ACCOUNTABILITY AND COST EFFECTIVENESS
HEALTH EXPENDITURE
ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE
HOW DOES AUSTRALIA COMPARE?
THE HEALTH WORKFORCE
THE CORPORATISATION OF HEALTHCARE
CONCLUSION
References
CHAPTER 5 - Health Impact Assessment in a policy context
ANALYSIS OF HEALTH IMPACT ASSESSMENT
IDENTIFICATION OF THE PROBLEM
FRAMING THE PROBLEMS AND LINKS TO HIA
HIA as a solution to achieving healthy public policy
HIA as an extension of EIA
THE POLICY RESPONSES:THE IMPLICATIONS OF REPRESENTATIONS
HIA as a solution to achieving healthy public policy
HIA as an extension of EIA
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
References
SECTION 2 : Governance of thehealth system
CHAPTER 6 Federalism and health
IDENTIFYING THE PROBLEM
THE CURRENT DISTRIBUTION OF FEDERAL AND STATEGOVERNMENT RESPONSIBILITIES
POLICY RESPONSES: THE INSTITUTIONS OF FEDERALISM
The Constitution
High Court decisions
Federal–state councils
PROGRAM BOUNDARIES AND COORDINATION
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
Functional separation
Capitated fund holding
Jurisdictional realignment
Addressing perverse incentives
Strengths and weaknesses of functional separation options
Improved cooperative action
Joint governance
Better benefi t sharing
Clearer national policy and goal setting
Strengths and weaknesses of cooperative action options
CONCLUSION
References
Endnotes
CHAPTER 7 - The public service and health
PUBLIC SERVANTS AND THE PUBLIC INTEREST
SIZE AND STRUCTURE OF THE AUSTRALIAN PUBLIC SERVICE
PUBLIC SERVICE REFORM
The effects of reform
Effects of reform 1: political–bureaucratic relations
Effects of reform 2: privatisation and outsourcing
Effects of reform 3: the structure of the public service
LOOKING AHEAD
References
CHAPTER 8 -
Municipal public healthplanning policy in Victoria
THE POLICY CONTEXT
IDENTIFYING THE POLICY PROBLEM
THE POLICY RESPONSES
Environments for Health development strategy
Implementation
Impact of Environments for Health
Problems faced when developing Environments for Health
Factors affecting the success of Environments for Health
Ministerial support
Strong reference committee
Key champion – Director of Public Health
Strategic and entrepreneurial Local Government Partnerships Team
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
CONCLUSION
References
CHAPTER 9 -
The health workforce:innovation, substitutionand reform
IDENTIFYING THE HEALTH WORKFORCE PROBLEM
Health workforce as an arena of contest
Health workforce complexity and multi-professionalism
Indicators of health workforce problems
1. Continuing shortages despite a protracted period of growth
2. A projected signifi cant reduction in total workforce entrants: all industries
Sustainability of new entrant policies
Profession-centred workforce planning
New models of workforce planning
THE POLICY RESPONSE TO THE HEALTH WORKFORCE ‘CRISIS
The National Health Workforce Strategic Framework
The Productivity Commission: Australia’s health workforce
FUTURE POLICY DEVELOPMENT: WORKFORCE REFORM
References
CHAPTER 10 - Regulating complementary and alternative medicine practitioners
COMPLEMENTARY AND ALTERNATIVE MEDICINE DEFINED
AUSTRALIAN POLICY FRAMEWORK FORHEALTH WORKFORCE REGULATION
A LONGSTANDING PROBLEM: THE HISTORICAL BACKGROUNDTO POLICY DEVELOPMENTS FOR CAM
RECENT POLICY RESPONSES
Victorian review of Chinese medicine
Review of naturopathy and western herbal medicine
National positioning relating to complementary and alternative medicine
National approach to health workforce regulation
POLICY ANALYSIS
CONCLUSION AND FUTURE DIRECTIONS FOR POLICYDEVELOPMENT
References
SECTION 3: Values in health policy
CHAPTER 11 - Conflicting values in health information policy
THE PROBLEM
THE ACCESS CARD POLICY DEVELOPMENTS
Population-based health identifi cation of Australians
SHARING HEALTH INFORMATION
The electronic health information infrastructure
The states and territories and the identifi er problem
Current policy on patient identifi ers
The key problems
Duplication and confl ict with parallel smart card developments
The predominance of the technological solution
The Access Card as a national identity card
Function creep
The costs of the project
Access
Ownership
The use of taxpayers’ money to fund the project
When is a health record not a health record?
Benefi ts and disbenefi ts: Access Card health information
The threshold question
Future policy directions
The status of the legislation
CONCLUDING OBSERVATIONS
References
CHAPTER 12 - The problem of trust in health policy
IN WHAT WAY IS TRUST A PROBLEM IN PUBLIC POLICY?
POLICY RESPONSES TO THE PROBLEM OF TRUST
Clinical governance
Communities’ experience of health institutions
FUTURE DIRECTIONS FOR HEALTH POLICY DEVELOPMENT
References
CHAPTER 13 - Dilemmas in end-of-life care: the Maria Korp case
IDENTIFYING THE PROBLEM
THE POLICY RESPONSES
Advance care planning
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
References
Endnotes
CHAPTER 14 - The problem of failing to provide culturally and linguistically appropriate healthcare
ABORIGINAL HEALTH
IDENTIFYING THE PROBLEM
Getting the problem on the policy agenda
The policy responses
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
Towards a new agenda
References
Endnotes
CHAPTER 15 -
Government, medical error,and problem defi nition
IDENTIFYING THE PROBLEM
A system problem
A fi nancial problem
A human problem
POLICY RESPONSES
Government advocates
Government reforms
Government funds
Government regulates
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
CONCLUSION
References
Endnotes
SECTION 4: Responding to perennialor emerging healthpolicy problems
CHAPTER 16 -
The ageing population: insearch of a policy
IDENTIFYING THE PROBLEM AND THEVARIABILITY OF STATISTICS
POLICY RESPONSES
The ‘crisis’ argument and the ‘burden’ of the ageing population
The expansion of private sector health delivery
Increasing taxation and reform
The ‘benefi ts’ argument
We don’t know anything for certain
Indications are negative
We can manage it easily: older people are an asset
FUTURE DIRECTIONS
Fiscal
Migration
Employment
Case study 1
Sweden: decentralised public sector health with some controlledprivatisation
Health reforms
Case study 2
Japan: multi-payer, government controlled and semi-privatised
Management strategies
LESSONS FOR AUSTRALIA
References
CHAPTER 17 - Reform of the pharmaceutical benefits scheme
A ‘WICKED’ PROBLEM
THE POLICY RESPONSE
Changes to the pricing of PBS-listed medicines
Price reductions
Price disclosure
Compensation arrangements for pharmacists and wholesalers
Streamlining authority approvals for some medicines
Access to medicines working group and stakeholder engagement
SOLUTIONS OR LONG-TERM PROBLEM?
Arrangements for pharmacists
Reference pricing
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
References
Endnote
CHAPTER 18 - Rethinking policy in mental health
IDENTIFYING THE PROBLEM
THE POLICY RESPONSES
The National Mental Health Plans
Changes under the National Mental Health (NMH) Strategy
State-funded mental health services
Private sector and primary care services
Consumer and carer participation
Service quality and accountability
Continuing problems despite the NMH Strategy
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
The Senate Committee on Mental Health
The National Action Plan on Mental Health 2006–2011
BEYOND NATIONAL MENTAL HEALTH POLICY?
References
CHAPTER 19 -
Accommodating newtechnology: robotics inprostate cancer surgery
A PERENNIAL AND AN EMERGING PROBLEM
THE ROBOT
PROSTATE CANCER
ANALYSIS OF THE PROBLEM
Outcomes
Cost
Access
CONCLUSION
References
CHAPTER 20 - Implementing post-injury rehabilitation policy
IDENTIFYING THE PROBLEM
THE POLICY CONTEXT
The salience of vocational goals within rehabilitation
The health benefi ts of employment
WORKERS COMPENSATION POLICY AND POST-INJURYRETURN-TO-WORK ACHIEVEMENTS
The 1985 Victorian WorkCare scheme
The problem of the ‘leaking bucket’
Replication of the weaknesses of the Victorian scheme in otherjurisdictions
Motor vehicle accident insurance and rehabilitation
Vocational achievement following work-related or transportaccidents
Research design for understanding post-injury vocationalachievements
Unrealised vocational potential following work or transportaccident injury
The recent return-to-work performance of the Victorian workerscompensation scheme
CONCLUSION
References
CHAPTER 21 - Achieving uniformity in food hygiene regulation
THE DEVELOPMENT OF NATIONAL FOOD STANDARDS
THE PROBLEM OF NON-UNIFORM FOOD HYGIENEREGULATION
THE POLICY RESPONSE
THE PROBLEMS OF UNIFORM APPLICATION ANDIMPLEMENTATION
FUTURE DIRECTIONS FOR POLICY DEVELOPMENT
CONCLUSION
References
CHAPTER 22 - Improving hygiene and childrens health in remote Indigenous communities
ABORIGINAL AND TORRES STRAIT ISLANDER POLICIES
Extreme levels of disadvantage
A historical perspective
Health, housing and environmental health policy
POOR CHILD GROWTH AND DEVELOPMENT
The high burden of infection and poor childhood growth
Family and community dysfunction
LOOKING TOWARDS THE FUTURE
Essential conditions
An ecological approach
Sectoral harmonisation
Enabling environments
References
GLOSSARY
INDEX

Section 1. Health policy: an overview
Section 1. Health policy: an overview
Section 1. Health policy: an overview
Section 1. Health policy: an overview
Section 1. Health policy: an overview
Section 1. Health policy: an overview -- Section 2. Governance of the health system
Section 1. Health policy: an overview -- Section 2. Governance of the health system
Section 1. Health policy: an overview -- Section 2. Governance of the health system
Section 1. Health policy: an overview -- Section 2. Governance of the health system
Section 1. Health policy: an overview -- Section 2. Governance of the health system
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview -- Section 2. Governance of the health system -- Section 3. Values in health policy -- Section 4. Responding to perennial or emerging health policy problems
Section 1. Health policy: an overview-- Section 2. Governance of the health system-- Section 3. Values in health policy-- Section 4. Responding to perennial or emerging health policy problems

"Analysing Health Policy explores Australian health policy using a novel, problem-orientated approach. It shows the problem-solving techniques that are used when developing policy and demonstrates the skills of analysis and decision making. Introductory chapters explain the problem-orientated approach to health policy development and introduce the policy making process. Case studies then explore developments in health policy in both priority and topical areas. Chapters illustrate how policy-makers respond to perennial and emerging policy problems and demonstrate problem-solving approaches to the conception, development and implementation of health policy. Section 1 Health policy: an overview 1 A problem-oriented approach to health policy analysis 2 Health policy as a process 3 Institutional problems and health policy 4 Population health, the health system and policy 5 Health Impact Assessment in a policy context Section 2 Governance of the health system 6 Federalism and health 7 The public service and health 8 Municipal public health planning policy in Victoria 9 The health workforce: innovation, substitution and reform 10 Regulating complementary and alternative medicine practitioners Section 3 Values in health policy 11 Conflicting values in health information policy 12 The problem of trust in health policy 13 Dilemmas in end-of-life care: the Maria Korp case 14 The problem of failing to provide culturally and linguistically appropriate healthcare 15 Government, medical error, and problem definition Section 4 Responding to perennial or emerging health policy problems 16 The ageing population: in search of a polic y! 17 Reform of the pharmaceutical benefits scheme 18 Rethinking policy in mental health 19 Accommodating new technology: robotics in prostate cancer surgery 20 Implementing post-injury rehabilitation policy 21 Achieving uniformity in food hygiene regulation 22 Improving hygiene and children's health in remote Indigenous communities"--Provided by publisher

This work explores Australian health policy by using the longstanding analytical approach of identifying and describing policy problems and exploring realistic solutions. The diversity of health policy is reflected in the structure of the book, with covers the policy process, governance of the health system, values in policy making and responses to both perennial and emerging problems in Australian health policy. This book provides an analytical introduction to health policy, is a practical teaching text which introduces students to a conceptual approach to policy analysis, and is a rich source of pertinent, research-based, case studies. Analysing Health Policy is of direct relevance to students and practitioners engaged in the study or administration of health policy.

2025-01-04