Evidence and information for health policy: a decade of change

Over the past decade or so, there has been increasing demand for greater clarity about the major causes of disease and injury, how these differentially affect populations, and how they are changing. In part, this demand has been motivated by resource constraints and a realisation that better health is possible with more informed allocation of resources. At the same time, there has been a change in the way population health and its determinants are quantified, with a much closer integration of the quantitative population sciences (such as epidemiology, demography and health economics) to strengthen and broaden the evidence base for healthcare policy.

A decade of downsizing: Understanding the contours of change in Australia, 1990-99

his paper seeks to map a decade of organizational downsizing in Australia utilizing a comprehensive longitudinal data set of 4153 firms. Aggregate downsizing measures conceal extensive change within organizations. We seek to assess these processes by comparing a conventional downsizing measure with more specific occupational downsizing measures. The results show the contours of change in Australia over the 1990s; indicate that there are distinctive and contrasting trends; and raise significant issues for future theoretical and empirical research.

Predestination and freedom in Milton's 'Paradise lost'

John Milton's epic poem Paradise Lost (1667) offers a highly creative seventeenth-century reconstruction of the doctrine of predestination, a reconstruction which both anticipates modern theological developments and sheds important light on the history of predestinarian thought. Moving beyond the framework of post-Reformation controversies, the poem emphasises both the freedom and the universality of electing grace, and the eternally decisive role of human freedom in salvation. The poem erases the distinction between an eternal election of some human beings and an eternal rejection of others, portraying reprobation instead as the temporal self-condemnation of those who wilfully reject their own election and so exclude themselves from salvation. While election is grounded in the gracious will of God, reprobation is thus grounded in the fluid sphere of human decision. Highlighting this sphere of human decision, the poem depicts the freedom of human beings to actualise the future as itself the object of divine predestination. While presenting its own unique vision of predestination, Paradise Lost thus moves towards the influential and distinctively modern formulations of later thinkers like Schleiermacher and Barth.

Government relations, government regulations: jumping through the hoops

Over the last decade, telehealth in Australia has been primarily facilitated and driven by government funding. The government now has a major policy initiative in online health. However, in pursuing the broad initiative there is a danger that some of the smaller components can get lost, and this is probably what has happened to telehealth. There appear to be a number of steps required if telehealth in Australia is to keep up the pace of development that occurred in the 1990s, as we move into what is now being called the era of e-health, involving broadband Internet health service delivery. This area is changing extremely rapidly and is increasingly migrating away from the public sector in Australia, where most of the developmental work has occurred, and into the private sector. Many of the issues that require consideration within the domain of e-health in Australia are also relevant to other countries. E-health will significantly change the way that health-care is practised in future, and it is clear that it is the human factors that are more difficult to overcome, rather than the technological ones.