Australian Reform Research Articles

Governance for health system collaboration: The case of the South-West Queensland Primary Care Alliance, Queensland, Australia.

Background: Internationally, as countries orientate health systems to embrace an integrated, person-centered approach it demands a fundamental shift in the way health services are funded, managed and delivered. Requisite to meeting these challenges given the involvement of multiple organisations, and therefore varying governance arrangements, is strengthening of shared governance with clear and transparent accountability mechanisms, across the health system where initiatives to better integrate care are being implemented. Governance models to achieve this have been attempted in several countries. The best fit for the Australian system is likely to be the Alliance contracting approach.
 The Alliancing concept was derived from the construction industry, where different organisations work collaboratively to ensure achievement of common goal, to complete a project successfully, on time and within budget. They help one another and, where relevant, share resources. Alliance governance is the set of rules which govern an Alliance. At their core, they are centered around governance that ensures the building of collaboration and a ‘whole of system’ approach to service planning and delivery. This is different and challenging and calls on members to focus primarily on their community rather their individual circumstances / organisations.
 Target audience: Policy makers, health system executives, funders, researchers.
 Alliance Partners: Western Queensland Primary Health Network, South West Hospital & Health Services, Health Workforce Queensland, Charleville & Western Areas Aboriginal & Torres Strait Islander Community Health, Royal Flying Doctor Service, private general practices, and CheckUP.
 What we did: Thematic analysis of a previous SW partnership project, against evidence-based health governance elements for integrated care, to distil learning for the SW Primary Care 5-year plan and conducted a rapid review to identify further evidence base for the alliance governance model in health. This evidence was incorporated into a stakeholder workshop to advise implementation.
 Results/impact: Using an evidence-based governance framework for integrated care, the South-West Primary Care Alliance was developed. An Alliance Charter, outlining the rules of engagement and commitments, has been passed. A governance framework agreed and an implementation plan adopted.
 Learning for international audience: More recent Australian reform documents identify the importance of a regional approach in bringing together all sources of health funding into one coordinated local service delivery approach. In particular, the ongoing difficulty in aligning Australia’s fragmented Commonwealth and State health systems, mean that for our health system this is the most critical reform step. This is more ambitious than co-commissioning or bilateral project-focused funding. It includes all relevant service delivery organisations making formal governance commitments to work together over time in addressing key areas of service gap or duplication.
 Next steps: Three work programs have been identified by the Alliance Leadership Team for implementation 2023-2025. The first of these, workforce, has an implementation plan set for 2023. As part of the implementation the barriers and critical success factors to implementing and sustaining this model of care will be investigated.

Protecting the Press from Search and Seizure: Comparative Lessons for the Australian Reform Agenda

Protecting the Press from Search and Seizure: Comparative Lessons for the Australian Reform Agenda

Seeding ePortfolio into Initial Teacher Education Curriculum in Australia: To Kill Multiple Birds with One Stone

The paper is stemmed from the Australian policy reforms between 2014 and 2015 in a concerted attempt to uplift Initial Teacher Education program quality and accreditation, enhance pre-service teacher’s class-readiness and equip them with essential competencies required of the teaching profession. It is coupled with the novel, emerging challenges of the Covid-19 pandemic, international border closure and the global shift from face-to-face learning to virtual and/or blended learning mode since March 2020. Drawing on a descriptive case study (Chetty, 2013; Yin, 1994) on the Education Double Degree in an Australian institution, the paper unpacks the ways in which the unit leader of the Education Double Degree in an Australian institution innovated four Education units in response to these above-mentioned challenges. Central to this curriculum innovation is seeding ePortfolio via Mahara and Google Site tools into program and curriculum redesign. The paper showcases the road used to remap the program and curriculum; it deploys an integrative learning approach as a conceptual framework to personalise the virtual learning space where student engagement with the course knowledge, skills and values is promoted and where students’ metacognition and deep learning are genuinely incubated. Insights from this paper are relevant and, therefore, applicable to curriculum, innovation, technology in education and an emerging ePortfolio pedagogy. It additionally puts forward significant implications for Initial Teacher Education reforms beyond Australia.

We Have Plenty of Water, Don’t We? Social Norms, Practices, and Contentions in a Drought-Ridden Country

Climate and land use change pose global challenges to water policy and management. This article furthers calls for integrated research conceptualizing water management as a holistic, interdependent system that may benefit from sociological research. To better understand how socioenvironmental change affects lifestyle expectations and experiences, interviews with in-migrants (relocated to inland Australia from metropolitan cities), industry and government informants are thematically analyzed. Results show in-migrants engage in adaptive water management and conservation strategies to enhance water security, yet call for council provision of water management education to minimize vulnerability. Industry informants perceive few water supply or pollution issues, favoring technological solutions to support unfettered growth and water amenities, while de-prioritizing environmental sustainability goals. Government priorities reflect drought narratives in Australian water policy reform and show concern about meeting consumer water supply and preserving water quality. With predictions of greater weather severity, including flooding, and in-migrants’ difficulty managing heavy rainfall, national legislation and policy modifications are necessary. Specifically, normalizing climate variability in policy and social identities is desirable. Finally, practices prioritizing water scarcity and trading management over environmental protection indicate a need to surpass environmental commodification by depoliticizing water management.

The unequal burden of retirement reform: Evidence from Australia

AbstractAs governments try to contain rising expenditure on retirement pensions by increasing eligibility ages, there are concerns that such reforms disproportionately affect poorer households. Using detailed longitudinal data, I examine this trade‐off in the context of an Australian reform that increased women’s pension‐eligibility age from 60 to 65. While this reform significantly reduced government spending on women at affected ages, the negative effects on household incomes were concentrated among poorer households. These unequal impacts meant that the reform temporarily increased relative poverty rates among affected women by around four percentage points and inequality measures by 6% to 19%.

Re-examining female labor supply responses to the 1994 Australian pension reform

Many governments are aiming to extend working lives by raising the age at which people can claim retirement pensions. This makes it vital to understand how these policies affect retirement decisions. In this paper, I revisit the labor supply effects of a major Australian reform that increased women’s pension age from 60 to 65. Atalay and Barrett (2015) studied these effects using repeated household surveys and a differences-in-differences design in which male cohorts form the comparison group. They estimate that the reform increased female labor force participation by 12 percentage points. Using earlier data, I show that the parallel-trends assumption did not hold before the reform because of a strong female-specific trend in participation rates across the relevant cohorts. Accounting for this trend, the estimated effect on female participation falls by two-thirds and becomes statistically insignificant at conventional levels. This highlights the importance of carefully assessing and controlling for trends across cohorts when evaluating pension reforms, which are typically phased in across cohorts.

Regulating Financial Advisers in the UK: Lessons for Australia

Prompted by the 2008 Global Financial Crisis, the Australian government introduced?the Future of Financial Advice reforms in 2013. It aimed to improve the quality of financial advice by virtue of a best interests duty and a ban on conflicted remuneration,?inter alia. Despite the reforms, public trust in financial advisers remains unacceptably low. Adviser misconduct, driven by conflicted self-interest, remains prevalent. By contrast, there is relatively greater trust in financial advisers in the United Kingdom (‘UK’). This article focuses on how the UK regulates financial advisers, where the best interests duty and suitability rule also apply. The analysis that follows is confined to the legislative text. The UK regulatory regime offers directions and possibilities for further Australian reforms.

Efficiency of the teaching-industry linkage in the Australian vocational education and training

The vocational education and training (VET) sector plays a crucial role in Australia’s education system. Associated closely between the VET provision and industry, VET training quality is continually at the heart of debates in the process of implementing the Australian VET reform agenda. In response of key themes of this reform process, investigating the training efficiency of VET through the linked efficiency between teaching and industry responsiveness is imperative. The paper aims to address this objective by using the dynamic network data envelopment analysis in a balanced panel data for 2008–2012. This advanced model allows to assess simultaneously the efficiency of two nodes, teaching and industry responsiveness, and the overall dynamic training efficiency of VET based on fields of education in a network structure. We found that the overall training efficiency of VET is, on average, 0.835 while the mean divisional efficiencies of the teaching efficiency and industry responsiveness are 0.763 and 0.908, respectively. Sensitivity analysis is conducted to examine dynamic changes of the efficiency of the teaching and industry linkage following various period weights. Policy implications are drawn for the Australian VET sector.

Reducing the Generosity and Increasing the Conditionality of Welfare Benefits for People with Disability: “Turning the Supertanker” or “Squeezing the Balloon”?*

AbstractWe compare outcomes of disability benefit applicants before and after a major Australian reform of disability benefits, with two groups of applicants who fulfilled the same medical impairment criteria accepted or rejected based only on application date. The reform reduced the generosity and increased the conditionality of welfare payments by shifting partially disabled claimants from disability benefits to unemployment benefits. This led to increases in the probability not only of switching out of unemployment benefits on to alternative benefits, but also of exiting welfare altogether. However, because those who exited had a higher probability of subsequently returning to welfare, the reform had no impact on the proportion receiving welfare 12 or 24 months later.

Are Broad-Based Vouchers an Effective Way to Support Life-Long Learning? Evidence from an Australian Reform

Increasing mature-age access to education and training in a way that is responsive to changing labour market needs is a key policy challenge. In this paper we examine the impacts of a unique reform in the Australian state of Victoria that aimed to meet this challenge by introducing a broad-based voucher for those 25 and older. In effect, the reform uncapped public course-level funding and linked it to individual student choice instead of centralised funding allocations. Using national administrative enrolment data and difference-in-differences estimation, exploiting the continuation of existing centralised funding models in other states, we find that the voucher increased mature-age vocational education and training participation and improved the alignment of course enrolments with measures of prevailing skill needs, including enrolments of disadvantaged groups. Our study provides first evidence on the use of broad-based vouchers in vocational education and training to expand access to mature-age learning in a demand-responsive way. These results provide support for policies that put student choice at the centre of efforts to lift mature-age access to training, which is especially important for countries, such as the United States, that have traditionally funded vocational education and training through centralised allocations.

Living Waters, Law First: Nyikina and Mangala water governance in the Kimberley, Western Australia

ABSTRACT The ‘Living Waters, Law First’ water governance framework centres Living Waters, First Law and the health/well-being of people and Country. The framework is based on a groundwater policy position developed by the Walalakoo Aboriginal Corporation (WAC), the Nyikina and Mangala peoples’ native title corporation, in the West Kimberley, Western Australia in 2018. This article celebrates Traditional Owner’s pragmatic decolonising strategies. It explores the emerging conceptual challenges to the status quo by comparing the Living Waters, First Law framework to Australia’s settler state water governance framework, represented by the National Water Initiative. Bacchi’s ‘what is the problem represented to be’ approach is used to interrogate the underlying assumptions and logics (2009). We find that there are incommensurable differences with First Law and the Australian water reform agenda. Yet, our analysis also suggests ‘bridges’ in relation to sustainability, benefits and responsibilities could promote dialogues towards decolonial water futures.

MASS EDUCATION AND UNIVERSITY REFORM IN LATE TWENTIETH CENTURY AUSTRALIA

ABSTRACT This article examines the 1988 Dawkins reforms to Australian higher education and the creation of a unified national system. The article is based on two propositions. The first is that as historians we should examine educational reforms in a changing society not only for what they propose, but with a look backwards to understand their place within a longer history of educational reform. The second – with a side-glance to the British higher education reforms of the early 1990s as a counterpoint – is the extent to which the 1988 Australian higher education reforms should be seen as neoliberal or, as Quicke, McCulloch and Openshaw argue, should we as historians look for nuance within the complex philosophical forces at play?

The Political Economy of Australian Regulatory Reform

The problem of regulatory accumulation has increasingly been recognized as a policy problem in its own right. Governments have then devised and implemented regulatory reform policies that directly seek to ameliorate the burdens of regulatory accumulation (e.g. red tape reduction targets). In this paper we examine regulatory reform approaches in Australia through the lens of policy innovation. Our contributions are twofold. We first examine the evolutionary discovery process of regulatory reform policies in Australia (at the federal, intergovernmental and state levels). This demonstrates a process of policy innovation in regulatory mechanisms and measurements. We then analyse a new measurement of regulatory burden based on text analytics, RegData: Australia (see Al-Ubaydli and McLaughlin 2017; McLaughlin et al 2019). RegData: Australia uses textual analysis to count “restrictiveness clauses” in regulation — such as “must”, “cannot” and “shall” — thereby developing a new database (RDAU1.0). We place this “restrictiveness clauses” measurement within the context of regulatory policy innovation, and examine the potential for further innovation in regulatory reform mechanisms.

Australian water policy reform: lessons learned and potential transferability

ABSTRACTThis article sharpens consideration of aspects of policy transfer to address climate change and gives greater attention to the context that might support efficient adaptive resilience. Using the example of Australian reforms to water policy, we evaluate how different elements of policy proved more (less) successful in facilitating efficient adaptation to climate variability and thus expose elements that might be more (less) attractive as candidates for policy transfer. Overall, we find that Australian policy reforms in the water sector provide useful guidance in some instances and not others. Establishing caps on extraction, flexible water markets and individual carry over rights generally facilitated flexible and efficient adaptation, and could be transferred. Related policy concepts, like formulating clear water planning rules and entitlements, are worth considering for implementation elsewhere, even if the groundwork on governance is a prerequisite. We also note the importance of shaping drought responses from government in such a way as not to distort the incentives for individual adaptation, and there is some evidence of this working in the Australian setting. Achieving transferability of these policies, however, may be a challenge. Australian policies around ‘hard infrastructure’ investments have generally proved less desirable and ideally should not be considered as a roadmap. These relate specifically to: (1) extravagant augmentation of urban supply; (2) using infrastructure to supposedly improve irrigation efficiency for environmental water provision; and (3) governments’ infrastructure responses after flooding. None of these approaches is consistent with the aim of fostering adaptation to a more variable climatic future.Key policy insightsAustralian water policies that have focussed on capping water extractions, development of flexible markets and specifying rights to allow greater flexibility have generally worked well against a changing climate, and could be transferred.The development of clear planning rules and entitlements also proved important, although the conditions to favour transfer are difficult to engender.Policies dealing with hard physical infrastructure have proven problematic and their adoption elsewhere is discouraged, even if transfer is more amenable.Encouraging more individual adaptation to flooding is a particularly significant challenge, even in a country renowned for drought.

Contemporary consequences of the 1967 Referendum

The 1967 Australian Referendum and subsequent constitutional reform are widely considered a victory for Aboriginal and Torres Strait Islander people and an elevating moment in Australia’s history. However, this analysis reveals the Referendum was in some ways an anticlimax, enabling paternalistic policies and exploitation of the First Peoples of Australia.

The Effect of Job Search Requirements on Welfare Receipt

Many countries impose job search requirements on unemployment benefit recipients. Existing studies have evaluated only incremental changes to requirements. Australian reforms in 1995 saw groups of welfare recipients newly subjected to job search requirements, allowing us to produce the first causal estimates of the total effects of such requirements on welfare receipt. Using a quasi-experimental design and administrative data, we find large negative effects on welfare receipt for the mature-age partnered women targeted by the reforms. We also find large negative effects on welfare receipt of their partners, suggesting family labour supply decisions were considerably affected.

The Effect of Job Search Requirements on Welfare Receipt

Many countries impose job search requirements on unemployment benefit recipients. Existing studies have evaluated only incremental changes to requirements. Australian reforms in 1995 saw groups of welfare recipients newly subjected to job search requirements, allowing us to produce the first causal estimates of the total effects of such requirements on welfare receipt. Using a quasi-experimental design and administrative data, we find large negative effects on welfare receipt for the mature-age partnered women targeted by the reforms. We also find large negative effects on welfare receipt of their partners, suggesting family labour supply decisions were considerably affected.

Implementation of an augmented stepped mental health care service in Australian primary care: a mixed method study

ABSTRACT Objective: StepCare is an online, stepped mental healthcare service in general practice which identifies adults with common mental disorders, recommends evidence-based treatments and monitors symptoms and risk, with feedback to the patient and GP. Previous data suggested that StepCare was acceptable and feasible, assisting GPs to identify and manage patients’ depression and anxiety. Areas for improvement were recommended by GPs, practice staff and patients. StepCare was accordingly upgraded and a new implementation strategy was introduced, consistent with the Australian Government's reform agenda. This study aimed to evaluate the augmented StepCare and new implementation model. Methods: Two Primary Health Networks (PHNs) and 22 general practices took part. The StepCare team trained and supported PHN staff to implement the Service in their general practices. PHN staff, GPs, practice staff and patients rated the acceptability, feasibility and effectiveness of StepCare. New cases at screening and patients’ symptom change over 12 weeks were measured. Implementation facilitators and barriers were also investigated. Results: The majority of PHN staff, GPs, practice staff and patients rated StepCare as acceptable and feasible, GPs reported it assisted their identification and management of common mental health conditions and most patients indicated they would recommend it to a friend. 37% of patients reporting symptoms at screening were new cases. Patients’ depression symptoms reduced significantly by 12 weeks. Discussion: Augmented StepCare is able to identify new cases and produce clinical change within routine general practice. It also has the potential to be implemented by PHNs with assistance from the StepCare team.

Rethinking Trade Mark Exhaustion: Does Australia’s New Defence Offer a Way Forward?

Despite the strong economic case in favour of liberal trade mark exhaustion rules, both the parallel importation of legitimate goods, and the sale of second-hand goods, have come to be treated with a high degree of scepticism in legislatures and courts around the world. Given how restrictive most jurisdictions’ laws on trade mark exhaustion have become, it is important to consider whether there are other ways WTO Members could approach exhaustion and, if so, what a model for reform might look like. In this regard, it is highly instructive to look at recent developments in Australia. With the introduction of a new defence to infringement contained in section 122A of the Trade Marks Act of 1995, which came into effect on August 25, 2018, Australia now has the most liberal trade mark exhaustion regime of any major jurisdiction. In summary, the new defence applies if the parallel importer or reseller reasonably believed that the mark was originally applied to the goods by or with the consent of the owner, or a range of other parties, with “consent” being defined in exceptionally broad terms. In a reversal of the typical onus of proof, if an importer/reseller forms such a reasonable belief it will not be liable for infringement unless it persists in its conduct after information as to the lack of consent to application of the mark is brought to its attention. And, crucially, the defence does not in any way turn on whether the imported/resold goods have been altered, repackaged or relabelled, or if there are material quality differences between the imported/resold goods and those supplied locally by or under the licence of the mark owner. This paper provides context for the new Australian exhaustion laws, showing that Australia, over the course of the twentieth century, had recognised the benefits of facilitating the parallel importation of legitimate goods, but that since the mid-1990s an overly restrictive approach had come to be taken by the legislature and courts. It then examines the liberal new section 122A defence in detail, analysing its scope by reference to the more restrictive pre-2018 case law, and showing how it operates more favourably to importers and retailers than any other set of exhaustion rules in the world. It then uses the recent Australian reforms as a springboard for a broader reconsideration of whether trade mark exhaustion rules in other jurisdictions should be liberalised, showing that the Australian approach is underpinned by different ways of thinking about exhaustion—namely, as to the proper scope of registered owners’ rights, as to what sort of conduct by importers and owners we want to incentivise, and as to how risk should be allocated between such parties.

Large Response to Delayed Eligibility or a Pre-Existing Trend in Female Participation? Re-Examining an Australian Pension Reform

Atalay and Barrett (Review of Economics and Statistics 2015, 97(1): 71–87) study an Australian reform that increased women’s pension age from 60 to 65. Using repeated surveys and a differences-in-differences design in which males form the comparison group, they estimate that the reform increased female labor force participation by 12 percentage points. I successfully replicate this estimate but show, using earlier data, that the parallel-trends assumption did not hold before the reform because of a female-specific participation trend across cohorts. Accounting for this trend, the estimated effect on female participation falls by two-thirds and becomes statistically insignificant at conventional levels.