Australian Policy Makers Research Articles

Artificial intelligence (AI) to enhance breast cancer screening: protocol for population-based cohort study of cancer detection

IntroductionArtificial intelligence (AI) algorithms for interpreting mammograms have the potential to improve the effectiveness of population breast cancer screening programmes if they can detect cancers, including interval cancers, without contributing...

OP199 From Pilot Studies To System-Wide Innovation: Challenges And Opportunities For Clinical Decision Support Systems (CDSS) Implementation In Australia

IntroductionThe clinical data is increasing at a considerably higher rate than the capacity of the healthcare system and clinicians to manage this data. Digital tools such as clinical decision support systems (CDSS) provide opportunities for evidence-based patient care by intelligently filtering and presenting the information required for clinical decision making at the point of care. Despite the success of pilot projects, CDSS have had limited implementation in broader health systems. We aimed to identify challenges faced by policymakers for CDSS implementation and to provide policy recommendations.MethodsWe conducted eleven semi-structured interviews with Australian policymakers from state and national committees involved in digital health activities. The data were analyzed using reflexive thematic analysis to identify policy priorities.ResultsOur findings indicate that fragmentation of care processes and structures in the digital health ecosystem is one of the main impediments to delivering coordinated care using CDSS. Five themes for policy action were identified: (i) establishing a shared conceptual framework for user-centered design of CDSS that is aligned with stakeholders’ priorities, (ii) maintaining the right balance between the customization and standardization of systems, (iii) developing mutually agreed semantic interoperability standards at the local, state and national level, allowing generation and exchange of information across the health system without changing its context and meaning, (iv) reorienting organizational structures to build capacity to foster change, and (v) developing collaborative care models to avoid conflicting interests between stakeholders.ConclusionsFindings highlight the importance of developing system-wide guidance to establish a clear vision for CDSS implementation and alignment of organizational processes across all levels of health care. There is a need to build a shared policy framework for modelling the innovative activities such as CDSS implementation across the digital health landscape which minimizes the operational and strategic fragmentation of different organizations.

Approaches to quality assurance in school-based career development: policymaker perspectives from Australia

ABSTRACT In this article we explore Australian policymaker perspectives on the quality assurance of career development (CD) programmes in schools. We found that Australian policymakers are concerned about the quality of CD provision in schools and have a wide range of approaches that they deploy to ensure and assure quality at the school level. Quality assurance within the country is focused on the qualifications and professionalism of the people delivering career development programmes rather than on systemic or organisational quality. We also found that the range of quality assurance tools that are deployed by such policymakers varies across the different Australian jurisdictions and is influenced by geography, the size of the jurisdiction and the level of priority given to career guidance.

The how and why of producing policy relevant research: perspectives of Australian childhood obesity prevention researchers and policy makers

BackgroundUnderstanding why research is conducted may help address the under-utilisation of research. This study examined the reasons for childhood obesity prevention knowledge production in New South Wales (NSW), Australia, and the factors influencing research choices from the perspective of the researchers and health policy agencies contributing to the research.MethodsA literature search of SCOPUS and ISI Web of Knowledge (affiliation and key word searches) was conducted to compile a database of NSW childhood obesity research outputs, published between 2000 and 2015 (n = 543). Descriptive statistics were used to quantify outputs by research type, differentiating measurement, descriptive, and intervention research, systematic reviews and other publications. Interviews were conducted with a sample of researchers drawn from the database (n = 13) and decision makers from health policy agencies who funded and contributed to childhood obesity research in NSW (n = 15). Researcher interviews examined views about societal impacts, why and under what circumstances the research was conducted. Decision-maker interviews examined policy agency research investment and how research was used in decision making. Content analysis and a thematic approach was used to analyse the interview transcripts.ResultsThe research in this case was conducted for mix of reasons including those traditionally associated with academic inquiry, as well as intentions to influence policy and practice. Differences in funding mechanisms, administrative and employment arrangements, and ‘who’ initiated the research, created differing incentives and perspectives for knowledge production. Factors associated with the characteristics and experience of the individuals involved also influenced goals, as did the type of research conducted. Policy agencies played a role in directing research to address policy needs.ConclusionsThe findings of this study confirm that researchers are strongly influenced by their working environment. Funding schemes and other incentives to support policy relevant knowledge production are important. Contextual factors such as policy priorities, policy-driven research funding and the embedded nature or strong connections between some researchers and the policy agencies involved, are likely to have influenced the extent to which policy goals were reported in this study.

Open Banking and Open Data in Australia: Global Context, Innovation and Consumer Protection

‘Open Banking’ is a digital finance innovation built upon customer data sharing between incumbent financial institutions and third party financial service providers. Open Banking is reshaping the banking sector through extending the reach and convenience of traditional banking services by opening up and leveraging consumer data. This disruption is both challenging and changing the nature of established banks and banking. This article provides a brief global survey of Open Banking regulatory developments as context for Australia’s new Consumer Data Right (CDR) regime. Spearheaded by the Open Banking movement, the CDR is the first step Australian policymakers have taken towards realizing the potential of open data capitalism. Australia is a jurisdiction, like the EU, that is increasing taking data protection and control seriously. We argue that emerging Australian Open Banking arrangements are both a measured response to digital financial developments, and another front in Australia’s ongoing commitment to uphold online consumer protection and empowerment.

Norm erosion and Australia's challenge to the rules-based order

ABSTRACT Australian foreign policy makers increasingly place an emphasis on the importance of rules and norms. These foreign policy statements reflect concerns about China's growing assertiveness combined with the belief that a ‘thick’ anarchy is safer for middle powers. Yet while Australia has been fixated with how China poses a threat to the international order, at times, Australia has actively challenged that order itself. Such was the case when the Prime Minister gave an address on ‘negative globalism’ at the Lowy Institute in October 2019. This article advances a theoretically grounded framework for understanding how these performative challenges arise and come to cause norm erosion. The framework draws together three elements: the rule or norm in question; representational strategies; and domestic audiences. The article illustrates this framework using the example of the Prime Minister's Lowy Institute address.

Creating a market for IQOS: analysis of Philip Morris’ strategy to introduce heated tobacco products to the Australian consumer market

BackgroundPhilip Morris International has made efforts to expand the sale of its heated tobacco product, IQOS, into new domestic markets globally. In Australia, where heated tobacco products are prohibited, the...

Scaling up population health interventions from decision to sustainability \u2013 a window of opportunity? A qualitative view from policy-makers

BackgroundWhile known efficacious preventive health interventions exist, the current capacity to scale up these interventions is limited. In recent years, much attention has focussed on developing frameworks and methods for scale-up yet, in practice, the pathway for scale-up is seldom linear and may be highly dependent on contextual circumstances. Few studies have examined the process of scaling up from decision to implementation nor examined the sustainability of scaled-up interventions. This study explores decision-makers’ perceptions from real-world scaled-up case studies to examine how scale-up decisions were made and describe enablers of successful scale-up and sustainability.MethodsThis qualitative study included 29 interviews conducted with purposively sampled key Australian policy-makers, practitioners and researchers experienced in scale-up. Semi-structured interview questions obtained information regarding case studies of scaled-up interventions. The Framework Analysis method was used as the primary method of analysis of the interview data to inductively generate common and divergent themes within qualitative data across cases.ResultsA total of 31 case studies of public health interventions were described by interview respondents based on their experiences. According to the interviewees’ perceptions, decisions to scale up commonly occurred either opportunistically, when funding became available, or when a deliberate decision was made and funding allocated. The latter scenario was more common when the intervention aligned with specific political or strategic goals. Decisions to scale up were driven by a variety of key actors such as politicians, senior policy-makers and practitioners in the health system. Drivers of a successful scale-up process included good governance, clear leadership, and adequate resourcing and expertise. Establishing accountability structures and appropriate engagement mechanisms to encourage the uptake of interventions were also key enablers. Sustainability was influenced by evidence of impact as well as good acceptability among the general or target population.ConclusionsMuch like Kingdon’s Multiple Streams Theory of ‘policy windows’, there is a conceptually similar ‘window for scale-up’, driven by a complex interplay of factors such as political need, strategic context, funding and key actors. Researchers and policy-makers need to consider scalability from the outset and prepare for when the window for scale-up opens. Decision-makers need to provide longer term funding for scale-up to facilitate longer term sustainability and build on the resources already invested for the scale-up process.

COVID-19: The need for an Australian economic pandemic response plan

ObjectivesPandemics pressure national governments to respond swiftly. Mitigation efforts created an imbalance between population health, capacity of the healthcare system and economic prosperity. Each pandemic arising from a new virus is unknown territory for policy makers, and there is considerable uncertainty of the appropriateness of responses and outcomes. MethodsA qualitative approach was used to review mixed sources of data including Australian reports, official government publications, and COVID-19 data to discern robust future responses. Publicly available epidemiological and economic data were utilised to provide insight into the impact of the pandemic on Australia's healthcare system and economy. ResultsPolicies implemented by the Australian Government to mitigate the spread of COVID-19 impacted the healthcare sector and economy. This paper incorporates lessons learned to inform optimal economic preparedness. The rationale for an economic response plan concomitant with the health pandemic plan is explored to guide Australian Government policy makers in ensuring holistic and robust solutions for future pandemics. ConclusionsIn future, an Australian Economic Pandemic Response Plan will aid in health and economic system preparedness, whilst a strong Australian economy and strategic planning will ensure resilience to future pandemics.

Governing Community-Based Natural Resource Management in Australia: International Implications

Community-based natural resource management (CBNRM) has grown in stature as a key component of many national natural resource and rural development governance systems. Despite their growth, the integrity of CBNRM governance systems has rarely been analysed in a national context. To enhance dialogue about how best to design and deploy such systems nationally, this paper analyses the Australian system in detail. The Australian system was selected because the nation has a globally recognised and strong history of CBNRM approaches. We first contextualise the international emergence of national CBRM governance systems before analysing the Australian system. We find that a theoretically informed approach recognising regions as the anchors in brokering multi-scale CBNRM was applied between 2000 and 2007. Subsequent policy, while strengthening indigenous roles, has tended to weaken regional brokering, Commonwealth–state cooperation and research collaboration. Our findings and consequent emerging lessons can inform Australian policy makers and other nations looking to establish (or to reform existing) CBNRM governance systems. Equally, the research approach taken represents the application of an emerging new theoretical framework for analysing complex governance systems.

Prudential Regulation in Australia and the Banking Royal Commission: A Missed Opportunity for Reform?

The global financial crisis (GFC) revealed fundamental regulatory weaknesses in many of the world’s leading financial jurisdictions. In particular, there was a lack of attention to risks of a systemic nature. Post-GFC regulatory reforms in many of these jurisdictions have sought to address this problem through the introduction of regulation that emphasises the systemic nature of financial risk as well as changes to regulatory structures to give effect to post-GFC regulatory approaches. These considerations have not had as big an impact in Australia as it escaped the worst effects of the GFC. Instead, Australian policy-makers and regulators have tended to focus more on market conduct and consumer protection matters as evidenced during the recent Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry. This article argues that the secondary status of systemic financial stability as a regulatory concern in Australia following the GFC undermines the centrality of systemic financial stability as a regulatory goal. The article proposes a number of reforms that have been introduced in jurisdictions such as the UK to give effect to global best practice following the GFC and which have as their key aim the maintenance of systemic financial stability as a primary goal.

A sustained tantrum: how the Joint Chiefs of Staff shaped the ANZUS treaty

ABSTRACT Unsurprisingly, most of the literature on the origins of the ANZUS alliance examines why the treaty came into existence in 1951, emphasising the role of John Foster Dulles, President Truman’s Special Representative, Dean Acheson, the Secretary of State, and Percy Spender, the Australian Foreign Minister. This paper takes a different approach. It focuses on the policy priorities of the Joint Chiefs of Staff (JCS) and argues that the JCS played an important, underappreciated role shaping the text and therefore the nature of the ANZUS treaty. Their coordinated intransigence within the interagency process—described by Acheson as a ‘sustained tantrum’—limited the geographic scope of ANZUS to the Pacific area and prevented Australian policymakers from gaining access to non-Pacific bodies such as NATO. Most importantly, the JCS limited the institutionalised depth of the treaty by preventing the Australian government from gaining access to the Pentagon’s global strategic planning. The policy priorities of the JCS in 1951, and their success at influencing the ANZUS agreement to reflect these priorities, holds enduring significance for the US-Australia alliance, which is simultaneously dominated by the two countries’ militaries yet hampered by underdeveloped mechanisms for policy formulation and institutionalised military cooperation.

DESerting clients? A Study Investigating Evidence-based Measures Supporting the Long-term Employment of Neurodiverse Australians

Employment outcomes for Australians with disability are weak and worsening. Aiming to assist in better understanding and redressing this troubling policy issue, this investigative research aims to (a) determine as to whether or not a significant relationship exists between disability type (i.e., physical or psychiatric) and long-term employment; and (b) identify evidence-based measures that might assist to improve the long-term employment of neurodiverse disability employment services (DES) clients. Addressing the first of these aims, an IBM SPSS-based chi-square analysis was conducted utilizing disability employment data sourced from the Australian Government. Targeting the second aim, a literature search was conducted utilizing Google Scholar, and thematic analysis was, then, applied on the results of this enquiry. Results of the chi-square analysis reveal that a DES client’s disability type appears to be associated with whether or not they attain long-term employment. From the 79 possibly relevant articles obtained from the Google Scholar enquiry, 13 were deemed relevant after applying the inclusion criteria. Thematic analysis constructed themes of resourcing, personalized support and education. In addition to offering a good practice employment guide based upon these themes, the study concludes by challenging Australian policymakers to consider the kinds of DES provider results that might not warrant reward.

Does risk management committee gender diversity matter? A financial distress perspective

PurposeUsing 2010 corporate governance principles and recommendations (CGPR) as a natural setting, the purpose of this paper is to investigate the relationship between risk management committee (RMC) gender diversity and a firm’s likelihood of financial distress. Empirical evidence regarding whether CGPR (2010) enhances RMC gender diversity (RMCGD) is also provided.Design/methodology/approachData were collected from the annual reports of the top 300 Australian Stock Exchange (ASX) listed companies from 2007 to 2014. To control for potential endogeneity, the association between (RMCGD) and a firm’s likelihood of financial distress was investigated using an instrumental variable approach (panel 2SLS regression). The relationship between CGPR (2010) and RMCGD was explored using panel regression analysis with firm fixed effects.FindingsRMCGD was found to be associated with a lower probability of financial distress, suggesting that women are better at monitoring and reducing firms’ excessive risk-taking behaviours, which, in turn, decreases firms’ risk of financial distress. The results also indicate that CGPR (2010) is quite effective in enhancing committee gender diversity. In the additional analysis, the results show that RMCGD moderates the negative relationship between risk and likelihood of financial distress. Importantly, the proportion of women with financial experience on RMCs is more effective in reducing the likelihood of financial distress compared to the proportion of men with financial experience on RMCs. These results highlight the benefits of having a gender diverse RMC.Research limitations/implicationsThe results were based on the top 300 ASX-listed companies; thus, restricting generalisability. In addition, this study only focussed on listed firms, non-listed firms may add additional insights to the literature.Practical implicationsThe results provide new and useful empirical evidence about RMCGD for Australian policymakers. This paper suggests that, in the short-term at least, RMCGD should be encouraged by regulators. Regulators could also recommend that the firms with a non-diverse RMC include women with financial experience on their RMC.Originality/valueGiven that prior studies have indicated that gender diversity is closely related to risk, this study contributes to the previous literature by investigating RMCGD and its effect on the likelihood of financial distress. It is expected that the role of RMC member would be to protect the firm from ultimate failure (likelihood of financial distress), especially during a financial crisis.

Mandated superannuation contributions and the structure of the financial sector in Australia

Australian workers must contribute a proportion of their wage to superannuation. The mandated contribution rate has risen from 3% in 1992, to 9.5% today, and is scheduled to reach 12% by 2025. We use a financial computable general equilibrium (FCGE) model to simulate an increase in the contribution rate. We find that raising the contribution rate has consequences for traditional financial intermediaries, and for financial structure more generally. This is of interest to Australian policy makers currently concerned with the size and role of Australia’s banks, and the leverage of the household sector.

Perspectives of Australian policy-makers on the potential benefits and risks of technologically enhanced communicable disease surveillance \u2013 a modified Delphi survey

BackgroundEvent-based social media monitoring and pathogen whole genome sequencing (WGS) will enhance communicable disease surveillance research and systems. If linked electronically and scanned systematically, the information provided by these technologies could be mined to uncover new epidemiological patterns and associations much faster than traditional public health approaches. The benefits of earlier outbreak detection are significant, but implementation could be opposed in the absence of a social licence or if ethical and legal concerns are not addressed.MethodsA three-phase mixed-method Delphi survey with Australian policy-makers, health practitioners and lawyers (n = 44) was conducted to explore areas of consensus and disagreement over (1) key policy and practical issues raised by the introduction of novel communicable disease surveillance programmes; and (2) the most significant and likely risks from using social media content and WGS technologies in epidemiological research and outbreak investigations.ResultsPanellists agreed that the integration of social media monitoring and WGS technologies into communicable disease surveillance systems raised significant issues, including impacts on personal privacy, medicolegal risks and the potential for unintended consequences. Notably, their concerns focused on how these technologies should be used, rather than how the data was collected. Panellists held that social media users should expect their posts to be monitored in the interests of public health, but using those platforms to contact identified individuals was controversial. The conditions of appropriate use of pathogen WGS in epidemiological research and investigations was also contentious. Key differences amongst participants included the necessity for consent before testing and data-linkage, thresholds for action, and the legal and ethical importance of harms to individuals and commercial entities. The erosion of public trust was seen as the most significant risk from the systematic use of these technologies.ConclusionsEnhancing communicable disease surveillance with social-media monitoring and pathogen WGS may cause controversy. The challenge is to determine and then codify how these technologies should be used such that the balance between individual risk and community benefit is widely accepted. Participants agreed that clear guidelines for appropriate use that address legal and ethical concerns need to be developed in consultation with relevant experts and the broader Australian public.

‘Australia in this Matter is under Some Scrutiny’: Early Australian Initiatives to the Rhodesian Problem, 1961–64

Australia’s attitude towards the problem of Rhodesian independence in the early 1960s has been largely ignored by the literature on the subject. Not unnaturally, the focus of recent research and scholarship has been Australia’s response to Rhodesia’s Unilateral Declaration of Independence (UDI) in November 1965 and the absence of any appetite for sanctions against the white minority regime. This lack of enthusiasm is often interpreted as symptomatic of an abiding sympathy not only for ‘kith and kin’ but also for Rhodesia’s white supremacist policies, which are invariably conflated with Australia’s own racially discriminatory practices. While senior Australian policymakers were uncomfortable with the notion of alienating people with whom they shared traditional political, economic and sentimental ties, they showed no support for the perpetual domination of the African population by Europeans, and indeed, accepted both the desirability and inevitability of black majority government. With this in mind, they worked hard to contribute to a genuine solution to the Rhodesian problem in the early 1960s and were deeply critical of Britain for refusing to adopt positive action. Although Australian Prime Minister Robert Menzies continued to struggle with these competing forces, he too recognised the irresistible nature of black rule and acted accordingly.

Process implementation perspective on neoliberal regulation: a comparative analysis of national curricula and standards-based reforms in the USA and Australia

ABSTRACTThis comparative case study adopts a process implementation perspective on neoliberal regulation to explore developments in national curricula and standard-based reforms in the USA and Australia. Date sources include research reports, books, OECD data, and local survey data. The comparison of the dynamic of two countries reveals that whereas policymakers in the USA adopted a transforming regulatory strategy (targeting the ambiguity and conflict levels in local policy) to implement, Australian policymakers adopted a congruence regulatory strategy (ratifying ambiguity and conflict levels). As a result of this dynamic, the education system in the USA displays a relatively tighter structure, which is related to the tighter professional teaching culture. The analysis suggests that the effect of global ideas and policies adopted locally depends on policymakers’ regulatory strategy, and that local system change drastically only when policymakers adopt the neoliberal default preference for active transformative implementation. Hence, a specific implementation dynamic is a key factor in the global neoliberal agenda, and its presence or absence indicates convergence or divergence between countries adopting similar policies.

“Stop talking around projects and talk about solutions”: Positioning health within infrastructure policy to achieve the sustainable development goals

Purpose and settingInfrastructure is a global multi-trillion dollar market presenting many opportunities and risks for sustainable development. This article aims to foster better conceptualisation of the connections and tensions between infrastructure policy and public health in the light of the Sustainable Development Goals, especially ‘good health and wellbeing’ (number 3) and ‘industry, innovation and infrastructure’ (number 9), based on findings from interviews with a purposive sample of senior practicing Australian infrastructure policy makers. Principal findingsWe use an institutional framework to explore the ideas, actors, rules and mandates, and procedures underpinning the inclusion of health in infrastructure policy. Informants defined infrastructure as the construction and provision of services that facilitate economic, environmental and social outcomes. The tendency to default to infrastructure as essential for economic success has fundamental challenges for the SDGs, particularly the politically driven pursuit of ‘mega-project’ legacies, sector-specific siloed governance arrangements, and inadequate conceptualisations of costs and benefits. ConclusionsPublic health and infrastructure policy are mutually re-enforcing given they both concern the public interest with implications for all 17 SDGs. Positioning health and wellbeing as fundamental societal outcomes from infrastructure decisions would go a long way to helping achieve the SDGs.

Issues in Australian Foreign Policy

Issues in Australian Foreign Policy