Evaluating health policy capacity: Learning from international and Australian experience

Deborah H Gleeson,Deirdre O'Neill,David G Legge

doi:10.1186/1743-8462-6-3

Abstract

BackgroundThe health sector in Australia faces major challenges that include an ageing population, spiralling health care costs, continuing poor Aboriginal health, and emerging threats to public health. At the same time, the environment for policy-making is becoming increasingly complex. In this context, strong policy capacity – broadly understood as the capacity of government to make "intelligent choices" between policy options – is essential if governments and societies are to address the continuing and emerging problems effectively.ResultsThis paper explores the question: "What are the factors that contribute to policy capacity in the health sector?" In the absence of health sector-specific research on this topic, a review of Australian and international public sector policy capacity research was undertaken. Studies from the United Kingdom, Canada, New Zealand and Australia were analysed to identify common themes in the research findings. This paper discusses these policy capacity studies in relation to context, models and methods for policy capacity research, elements of policy capacity and recommendations for building capacity.ConclusionBased on this analysis, the paper discusses the organisational and individual factors that are likely to contribute to health policy capacity, highlights the need for further research in the health sector and points to some of the conceptual and methodological issues that need to be taken into consideration in such research.

Highlights

The health sector in Australia faces major challenges that include an ageing population, spiralling health care costs, continuing poor Aboriginal health, and emerging threats to public health
Canada The Canadian Government began to focus on rebuilding policy capacity in the mid-1990s, after two decades of "new public management" and public sector downsizing were perceived to have resulted in a decline of policy capacity [42,43]
Based on the findings of this review, some propositions about the organisational structures and processes, organisational cultures and individual competencies that are likely to contribute to health policy capacity were developed by the authors

Summary

Introduction

The health sector in Australia faces major challenges that include an ageing population, spiralling health care costs, continuing poor Aboriginal health, and emerging threats to public health. The context for health policy-making Health policy-makers in Australia face a broad range of entrenched (and in some cases, worsening) public health problems, as well as emerging issues that create challenges for the health system into the future. These include, inter alia: continuing poor Aboriginal health [1,2]; widening inequalities in health [3]; an ageing population [4]; increasing health care costs [5]; environmental destabilisation [6]; rising incidence of chronic disease [7]; and emerging threats to public health, such as new communicable diseases [8]. Many policy problems (such as social exclusion and health inequalities) cross jurisdictional and portfolio boundaries and require policy-makers and public sector organisations to work in new ways in order to be effective

Methods

Results

Discussion

Conclusion