Integrated practice in the early years in Australia: The assumptions, omissions and contradictions of policy reform

The aim of this article is to examine current national early years’ policy reform, which emphasises the importance of service integration, national quality standards and a quality knowledge base for educators concerning the provision of early childhood education and care. Using Queensland, Australia, as an example, a policy discourse analysis identifies two problematics of implementing current national policy – the early childhood education and care problematic and the integration problematic. The article argues that speedy implementation of a national policy in order to meet national targets has unintended consequences for the knowledge base of educators and the possibility of collaboration within service provision. Although government commitment in this area is evident, these consequences and the current difficulties surrounding integration are the result of the lack of a specific integration strategy, and government investment focussed on the development of an integrated workforce.

Cost and outcomes associated with participating in the community fireguard program: experiences from the Black Saturday bushfires in Victoria, Australia

There is increasing recognition of the importance of shared responsibility between community and government in supporting community preparedness in disaster risk reduction programs. However, there is limited evidence to support decision making about how best to allocate resources. This paper presents an economic analysis of the Community Fireguard Program coordinated by the Country Fire Authority in Victoria, Australia. The economic analysis evaluates the costs and benefits of the Community Fireguard program (estimated in 2012 Australian dollars) to determine the efficiency of the program in terms of its outcomes of loss of life and property loss in the event of a bushfire. We take a societal perspective, including all costs and benefits regardless of who bears the costs, who receives the benefits or who provides the resources. The analysis uses data from a previous review of the program and estimates of costs and benefits over ten years, assuming each region faces a 10-year risk of major bushfire and the CFG group learnings would last ten years. Totalled over ten years, the cost per Fireguard Group for the program is $10,884, with a range of $2697-$19,071, and in the event of a major bushfire the predicted savings from reduced property loss is $732,747 and from reduced fatality $1.4 million. Even if the risk of major bushfire event in a region were one in 100 years, the estimated cost savings in a 100-year period is $217,116 per group. The value of the psychosocial impacts was not calculated, as quantitative data are currently not available.

Measuring community and service provider attitudes to child sexual abuse in remote indigenous communities in Western Australia

This study aimed to evaluate a scale to measure attitudes to child sexual abuse (CSA) in remote Australian Indigenous communities. The scale was developed to gauge attitudes that may be inhibiting the reporting of cases of CSA to police, as well as to evaluate whether interventions that focused on collaborative relationships between community members and police resulted in changes in attitudes. Participants included service providers living outside the community (58%), community members (living within the community; 9%), and service providers who were also community members (33%); 18% of participants identified as Indigenous. Principal components analysis revealed a nonintuitive six-factor solution that did not support the original four concepts. Four intuitive factors emerged from an abridged version of the scale: entrenched issues, personal understanding and knowledge, communication between community and government, and community action. The scale detected significant differences between community status and between Indigenous status groups on some factors.

Neoliberalism, economic restructuring and policy change: precarious housing and precarious employment in Australia

 Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable individuals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.

Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia

OBJECTIVE: To elicit medical leaders' views on reasons and remedies for the under-representation of women in medical leadership roles.

DESIGN: Qualitative study using semistructured interviews with medical practitioners who work in medical leadership roles. Interviews were transcribed verbatim and transcripts were analysed using thematic analysis.

SETTING: Public hospitals, private healthcare providers, professional colleges and associations and government organisations in Australia.

PARTICIPANTS: 30 medical practitioners who hold formal medical leadership roles.

RESULTS: Despite dramatic increases in the entry of women into medicine in Australia, there remains a gross under-representation of women in formal, high-level medical leadership positions. The male-dominated nature of medical leadership in Australia was widely recognised by interviewees. A small number of interviewees viewed gender disparities in leadership roles as a 'natural' result of women's childrearing responsibilities. However, most interviewees believed that preventable gender-related barriers were impeding women's ability to achieve and thrive in medical leadership roles. Interviewees identified a range of potential barriers across three broad domains-perceptions of capability, capacity and credibility. As a counter to these, interviewees pointed to a range of benefits of women adopting these roles, and proposed a range of interventions that would support more women entering formal medical leadership roles.

CONCLUSIONS: While women make up more than half of medical graduates in Australia today, significant barriers restrict their entry into formal medical leadership roles. These constraints have internalised, interpersonal and structural elements that can be addressed through a range of strategies for advancing the role of women in medical leadership. These findings have implications for individual medical practitioners and health services, as well as professional colleges and associations.

Ageing, chronic disease and injury: a study in western Victoria (Australia)

Background : An increasing burden of chronic disease and associated health service delivery is expected due to the ageing Australian population. Injuries also affect health and wellbeing and have a long-term impact on health service utilisation. There is a lack of comprehensive data on disease and injury in rural and regional areas of Australia. The aim of the Ageing, Chronic Disease and Injury study is to compile data from various sources to better describe the patterns of chronic disease and injury across western Victoria.

Design : Ecological study.

Methods : Information on demographics, socioeconomic indicators and lifestyle factors are obtained from health surveys and government departments. Data concerning chronic diseases and injuries will be sourced from various registers, health and emergency services, local community health centres and administrative databases and compiled to generate profiles for the study region and for sub-populations within the region.

Expected impact for public health: This information is vital to establish current and projected population needs to inform policy and improve targeted health services delivery, care transition needs and infrastructure development. This study provides a model that can be replicated in other geographical settings.

Mediatisation, marginalisation and disruption in Australian Indigenous affairs

This article considers how changing media practices of minority groups and political and media elites impact on demo-cratic participation in national debates. Taking as its case study the state-sponsored campaign to formally recognise In-digenous people in the Australian constitution, the article examines the interrelationships between political media and Indigenous participatory media—both of which we argue are undergoing seismic transformation. Discussion of constitutional reform has tended to focus on debates occurring in forums of influence such as party politics and news media that privilege the voices of only a few high-profile Indigenous media ‘stars’. Debate has progressed on the assumption that constitutional change needs to be settled by political elites and then explained and ‘sold’ to Indigenous and non-Indigenous Australians. Our research on the mediatisation of policymaking has found that in an increasingly media-saturated environment, political leaders and their policy bureaucrats attend to a narrow range of highly publicised voices. But the rapidly changing media environment has disrupted the media-driven Recognise campaign. Vigorous pub-lic discussion is increasingly taking place outside the mainstream institutions of media and politics, while social media campaigns emerge in rapid response to government decisions. Drawing on a long tradition in citizens’ media scholar-ship we argue that the vibrant, diverse and growing Indigenous media sphere in Australia has increased the accessibility of Indigenous voices challenging the scope and substance of the recognition debate. The article concludes on a cau-tionary note by considering some tensions in the promise of the changing media for Indigenous participation in the national policy conversation.