Outsourcing in the Australian health sector : the interplay of economics and politics

<b>Purpose &ndash;</b> The paper discusses the reasons and approaches used at three health organisations in introducing outsourcing. It specifically answers the question: why have managers of health organisations outsourced some functions in preference to others? <br /><br /><b>Design/methodology/approach &ndash;</b> This research employs a case study method making use of qualitative analysis. The health organisations were chosen first as representatives of their type, and secondly due to the nature of the outsourcing decisions made. The first health organisation operates in the rural sector; the second is a metropolitan network; and the third is a large metropolitan hospital, which, in contrast to the other two case study organisations, had made only one decision to outsource, producing the largest outsourcing contract in health in Australia. Furthermore, this situation was distinctive as the contract was terminated and re-issued to another private sector organisation. <br /><br /><b>Findings &ndash;</b> The reasons for outsourcing varied within and between health organisations. Although generally they were made on the bases of the characteristics of the labour market, employee skill levels and the nature of industrial relations, the perception of what was core, the level of internal management skills, the ability of internal teams to implement change and the relationship between management and staff. Even though cost savings and a downsized labour force resulted, generally these occurred even when services were not outsourced, through the use of other change processes, such as introducing new technology, changing structures and promoting workforce flexibility. The interplay of political reasons and economic effects was evident along with the political nature of the decision-making and processes used. The paper concludes that the power of managers was a moderating factor between the desire for outsourcing and whether outsourcing actually occurred. <br /><br /><b>Research limitations/implications &ndash;</b> Although this research was conducted solely within the health sector it has implications for other public sector bodies and the private sector. <br /><br /><b>Practical implications &ndash;</b> Managerial decision making can be enhanced with the exploration of the full complement of reasons for the outsourcing decision. <br /><br /><b>Originality/value &ndash;</b> The paper has value to both academics researching in the public sector and public sector managers. <br /><br />

Australia's Prime Ministers: Bob Hawke

In the run up to the Federal Election Trevor Chappell has been look at some of Australia&rsquo;s former Prime Ministers.<br /><br />Bob Hawke is Australia's longest serving Labor Prime Minister, he was at the helm from 1983 to 1991.<br /><br />Trevor Chappell spoke to Professor Geoff Robinson, a political historian and lecturer in Australian Studies and Politics at Deakin University about the Bob Hawke years.<br />

Australia's Prime Ministers : R. G. Menzies

In the run up to the Federal Election, The Overnights show is taking a look at some of Australia's former Prime Ministers. The second PM we discussed was Australia's longest serving Prime Minister Sir Robert Menzies.<br /><br />Often characterised as an extreme monarchist and British to the Bootstraps, Robert Menzies was responsible for many post-war socioeconomic developments and linked Australia more closely to South-East Asia and the USA to counter what was seen as the spread of Communism and the possible isolation of Australia.Michael Pavlich spoke to Geoff Robinson, a political historian and lecturer in Australian Studies and Politics at Deakin University.<br />

The politics of resistance to workplace cultural diversity education for health service providers : an Australian study

This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals, recruited from over 17 different organizational sites. Participants included cultural diversity educators, ethnic liaison officers, health service managers, nurses, health interpreters, allied health professionals, and community-based ethnic welfare organization personnel working in or with select metropolitan health services in Victoria, Australia. Analysis of the data revealed that workplace cultural diversity education in healthcare is a significant site of resistance and struggle. 'Resistance' was expressed in several forms including: the problematization of resources and staff availability to attend cultural diversity education forums; indifferent failure to recognize cultural imperatives in healthcare; deliberate refusal to recognize cultural imperatives in healthcare; selective recognition of cultural imperatives in healthcare ('facts sheets' only); and the angry rejection of cultural imperatives in healthcare. 'Struggle', in turn, largely involved cultural diversity educators having to constantly 'cajole and convince' (and even manipulate) staff to attend cultural diversity education forums and using a 'velvet glove and iron fist' approach to teaching staff who remained resolute in their resistance when participating in educational forums. An important implication of this study is that the politics of workplace cultural diversity education - and the 'politics of resistance' to such programs - need to be better recognized and understood if the status quo is to be successfully challenged and changed. The need for critical debate and further comparative research on the subject are also highlighted. <br />

Politics and technology : friends or enemies of the story?

Taking its cue from the conference at which it was presented, this article considers both old stories and new ways, and addresses the question of the impact not only of new technology but also of politics upon 'the story'. Fundamental is the question of whether politics and technology might be considered friends or enemies of the story. Drawing on her long term experiences as an interviewer, the author interrogates particular oral history projects undertaken into children's play lore and play ways, to show how children's games and play time activities have been politicised. Locating her analysis in an international context of US legislation and British and Australian research, the author examines how play itself has become the plaything of both politicians and fear. She then examines the impact of high fidelity recording equipment and the universal accessibility of material located on the internet to address the question of technology as friend of the story, ultimately concluding that the story and the question will both go on.<br />

The Australian class structure and Australian politics 1931 - 40

This paper presents the results of an analysis of the class structure of interwar Australia based largely on the 1933 Commonwealth census. It reviews previous analyses by academics but although contemporary journalists and political strategists. It develops an estimate of the class composition of the electorate as distinct from the general population and attempts to define the class position of voters outside of the paid workforce. It considers the question of to what extent Labor needed non-working-class votes to secure an electoral majority and how the differing social composition of the Australian states impacted on electoral outcomes and Labor strategies. It employs the method of bounds to develop some preliminary conclusions about the electoral behaviour of different social groups and concludes with some observations on the divided nature of the Australian working class and the competing strategies that parties developed in their search for an electoral majority.<br />

Population ageing and the politics of demographic alarmism : implications for the nursing profession

<b>Objectives</b><br />This article provides a brief examination of the prejudices and politics framing current public debate on population ageing in Australia and the possible implications of this for the allocation of required health and social sector resources. The role and responsibility of nurses and professional nursing organisations to engage in and influence public policy debate concerning the health and social care of older people is highlighted.<br /><br /><b>Setting</b><br />Australia<br /><br /><b>Subjects</b><br />Australia's ageing population and succeeding generations over the next 40 years<br /><br /><b>Primary argument</b><br />According to the Australian government, population ageing in Australia is poised to cause unmanageable chaos for the nation's public services. The cost of meeting the future health and social care needs of older Australians is predicted to be unsustainable. Officials argue that government has a stringent responsibility to ration current and future resources in the health and social care sector, cautioning that if this is not done, the nation's public services will ultimately collapse under the strain of the ever increasing demands placed on these services by older people. This characterisation of population ageing and its consequences to the nation's social wellbeing may however be false and misleading and needs to be questioned.<br /><br /><b>Conclusion</b><br />The nursing profession has a fundamental role to play in ensuring responsible debate about population ageing and contributing to public policy agenda setting for the effective health and social care of Australia's ageing population.<br /><br />

Memory, photography, and the politics of abuse : the ambiguous nature of photography

Critical commentary on Australian artist Bill Henson&rsquo;s work including the series Untitled 1994-1995 which represented Australia at the Venice Biennale is frequently framed within the discourse of the &lsquo;white cube&rsquo;. Its contextualisation in predominantly art historical and formalist perspectives tends to operate as a mechanism that denies affective and embodied dimensions of meaning making. Much the same could be said of the work of Marian Drew who uses road kill in her photographic still life works. However, the &lsquo;distancing&rsquo; in these works is also achieved through historical allusion, which at the same time reactivates the fl ow of emotional empathy and desire. In this paper, I ask the question: &ldquo;What distinguishes the work of these two artists with media images of torture?&rdquo;<br /><br />My attempt to address this question will involve a narrative re-reading of selected works of Henson and Drew incorporating notions of affect, identification, memory and desire as processes which operate non-discursively, but which are inseparable from memory and lived experiences. This will permit a double exposure of the work of these artists. Within a psychoanalytical context, my re-reading will be used to extend an understanding of the now familiar press and Internet images of the torture of Iraqi prisoners.<br /><br />As a metaphor for desire and ideology, photography operates within manifest and latent registers. I will argue that certain forms of photographic practice may be understood in terms of a politics of abuse &mdash; instantiating an uneven differentiation of power between actants, the winning (forcefully or otherwise) of consent or complicity, the silencing of refusal of resistance and/or the incriminating of the &lsquo;victim&rsquo; &mdash; whilst at the same time upholding the claim of verisimilitude and aesthetic or ethical intent. Critical engagement with such practices is crucial to an understanding of the relationship between institutional discourses, trauma and abuse in contemporary society.<br />

Bare life in second life : Giorgio Agamben's politics in performance

This paper describes and analyzes the necessary misreadings of Giorgio Agamben&rsquo;s account of &lsquo;bare life&rsquo; in a recent performance in Melbourne, Australia. The &lsquo;Bare Life&rsquo; project deals with Australia&rsquo;s treatment of asylum seekers with reference to Agamben&rsquo;s work on sovereign power and uses the on-line second life world as both a metaphor for the refugee&rsquo;s desire for a new life, and a literal site of performance. The development showing explored the interactions between live performance and second life avatars in real time. This paper deals with the philosophical, ethical and practical problems that emerged during the development, and argues that the &lsquo;misreading&rsquo; is an inevitable, but useful part of finding ways to embody philosophical and political ideas in performance.<br />

Power and politics in a system implementation

The central concern of this study is to identify the role of power and politics in systems implementation. The current literature on systems implementation is typically divided into two areas, process modelling and factor based studies. Process modelling classifies the implementation into a linear process, whereas factor based studies have argued that in order to ‘successfully’ implement a system, particular critical factors are required. This literature misses the complexities involved in systems implementation through the human factors and political nature of systems implementation and is simplistic in its nature and essentially de-contextualises the implementation process. Literature has investigated some aspects of human factors in systems implementation. However, it is believed that these studies have taken a simplistic view of power and politics. It is argued in this thesis that human factors in systems implementation are constantly changing and essentially operating in a dynamic relationship affecting the implementation process. The concept of power relations, as proposed by Foucault (1976, 1977, 1978, 1980, 1982), have been utilised in order to identify the dynamic nature of power and politics. Foucault (1978) argued that power is a dynamic set of relationships constantly changing from one point in time to the next. It is this recognition that is lacking from information systems. Furthermore, these power relations are created through the use of discourse. Discourse represents meaning and social relationships, forming both subjectivity and power relations. Discourses are also the practices of talk, text and argument that continuously form that which actors speak. A post-structuralist view of power as both an obvious and hidden concept has provided the researcher a lens through which the selection and implementation of an enterprise-wide learning management system can be observed. The framework aimed to identify the obvious process of system selection implementation, and then deconstruct that process to expose the hegemonic nature of policy, the reproduction of organisational culture, the emancipation within discourse, and the nature of resistance and power relations. A critical case study of the selection and implementation of an enterprise-wide learning management system at the University of Australia was presented providing an in-depth investigation of the implementation of an enterprise-wide learning management system, spanning five years. This critical case study was analysed using social dramas to distinguish between the front stage issues of power and the hidden discourses underpinning the front stage dramas. The enterprise-wide learning management system implemented in the University of Australia in 2003 is a system which enables academic staff to manage learners, the students, by keeping track of their progress and performance across all types of training activities. Through telling the story of the selection and implementation of an enterprise-wide learning management system at the University of Australia discourses emerged. The key findings from this study have indicated that the system selection and implementation works at two levels. The low level is the selection and implementation process, which operates for the period of the project. The high level is the arena of power and politics, which runs simultaneously to the selection and implementation process. Challenges for power are acted out in the front stage, or public forums between various actors. The social dramas, as they have been described here, are superfluous to the discourse underpinning the front stage. It is the discourse that remains the same throughout the system selection and implementation process, but it is through various social dramas that reflect those discourses. Furthermore, the enactment of policy legitimises power and establishes the discourse, limiting resistance. Additionally, this research has identified the role of the ‘State’ and its influence at the organisational level, which had been previously suggested in education literature (Ball, 1990).

Inclusive schooling : contexts, texts and politics

The title ‘Inclusive schooling: contexts, texts and politics’, names a thesis which critically analyses the development of inclusive schooling in the small Australian Island state of Tasmania between 1996 and 1998. The ‘Inclusion of Students with Disabilities’ policy, introduced in 1995 by the Tasmanian Department of Education, Community and Cultural Development, provides an opportunity to understand the cultural context and politics of change in schooling over this period. The qualitative methodology deployed here is informed by poststructuralism and captures the everyday experiences of university teaching as a research site. The teacher/researcher as the visible maker of the research use metaphors of fibre and textile practice, techniques of textual juxtaposition and her positioned subjectivity as a female academic to tell a 'big story'. The researcher develops a 'double method' as a possible model for Inclusive research practice and educational policy analysis. Using a critical ethnographic method, derived from the work of Carspecken (1996), 'data stories' (Lather & Smithies 1997, p.34) are produced from the narratives of five key informants – a parent, two teachers, a policy-maker and the researcher. Assembled as the data of the thesis the multi-voiced texts provide an account of the sociocultural, professional and systemic context of Inclusive schooling over a three-year period. In the analysis these data are interpreted from a feminist poststructural standpoint. A deconstructuive reading of the data stories interprets the discourse of inclusive schooling emphasising the dominant foundation of the special education knowledge tradition. The idea of author function (after Foucault 1975, 1984b and Grundy and Hatton 1995) is used to interpret the 'texts' of the key Informants as discursive constructions. The researcher theorises inclusive schooling as an entangled, multiple and contradictory discourse, embedded in the social, cultural and material contexts, rather than a singular unitary Idea of the progress within the special education knowledge tradition. The study contributes a fine-grained analysis of the constructed knowledge of inclusive schooling in one locality. The thesis advocates continuing engagement with questions of epistemology and social transformation in inclusive schooling, rather than persisting with technical rationality and the status quo. The researcher takes the position that the opportunities to theorise inclusive schooling lie within the multiple and disparate constructed texts of the micro world of everyday practice and the macro understanding of understandings of contemporary social justice. The poststructuralist writing/reading questions traditionalist theorising in the special education field. Central to the negotiations of power and truth inclusive schooling research and practice is a communicative theory that transforms populist conceptions of inclusion.