Patient safety, ethics and whistleblowing : a nursing response to the events at the Campbelltown and Camden Hospitals

In November 2002, in what stands as one of the most significant whistleblowing cases in the history of the Australian health care system, four nurses went public with concerns they had about the management of clinical incidents and patient safety at two hospitals in Sydney, New South Wales. The handling of this case and its aftermath raises important moral questions concerning the nature of whistleblowing in health care domains and the possible implications for the patient safety and quality of care movement in Australia. This paper presents an overview of the case, the moral risks associated with whistleblowing, and some lessons learned.

Damages for pain and suffering in tort law

Legislation enacted between 2002 and 2005 by each Australian State and Territory reformed and partially codified the common law of personal injuries. This column examines the nature and history of damages for pain and suffering and analyses the approach taken by different Australian jurisdictions to compensation for non-economic loss. Non-economic loss is generally composed of pain and suffering, loss of amenities of life, and loss of enjoyment of life (some jurisdictions, eg New South Wales, also include disfigurement, and loss of expectation of life). Several jurisdictions have imposed thresholds that a claimant must meet as a prerequisite to suing for damages at common law.

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.

‘To exercise a beneficial influence over a man’ : marriage, gender and the native institutions in early colonial Australia

This chapter examines understandings of marriage among missionaries and humanitarians connected with two early colonial ‘Native Institutions’. A comparison of the Parramatta Native Institution in New South Wales and the Albany Native Institution in Western Australia demonstrates that concerns about marriage were central in discussions about the formation and maintenance of these Institutions. Both of these Institutions were established and supported by British evangelicals, who had brought with them to Australia powerful assumptions about gender roles, particularly in
marriage. These assumptions influenced their decisions regarding the children who resided in the Native Institutions. Within specific colonial contexts, however, the assumptions of humanitarians and missionaries did not remain static, and debates over the futures of the Aboriginal children they sought to educate reveal complex and shifting hierarchies of race, gender and class.

Biopharmaceutical innovation and industrial developments in South Korea, Singapore and Taiwan

South Korea, Singapore and Taiwan are well known as export-oriented developmental states which for decades employed industrial policy to target particular industries for government support. In the past fifteen years, these three countries all identified the biopharmaceutical industry as a strategic sector. This article explores, through economic analysis, the rationale for this decision and the strategies chosen for linking into the global bio-economy with the objective of catching up in biopharmaceuticals. The paper identifies three comparative advantages enjoyed by these countries in the biopharma sector: (1) public investments in basic research; (2) private investments in phase 1 clinical trials; and (3) a potentially significant contract research industry managing latter-stage clinical trials. Governments employ a range of industrial policies, consistent with these comparative advantages, to promote the biopharmaceutical industry, including public investment in biomedical hubs, research funding and research and development (R&D) tax credits. We argue that the most important feature of the biopharmaceutical industry in these countries is the dominant role of the public sector. That these countries have made progress in innovative capabilities is illustrated by input measures such as R&D expenditure as share of gross domestic product, number of patents granted and clinical trials, and volume of foreign direct investment. In contrast, output indicators such as approval of new chemical entities suggest that the process of catching up has only just commenced. Pharmaceutical innovation is at the stage of mainly generating inputs to integrated processes controlled by the globally incumbent firms.

The impact of racism upon the health and wellbeing of young Australians

The Institute for Citizenship and Globalisation at Deakin University has worked in partnership with the Foundation for Young Australians to conduct this research project into the impact of racism upon the health and wellbeing of young Australians. The research has been carried out in eighteen Australian secondary schools in Victoria, New South Wales, Northern Territory and Queensland. Students aged 15-18 were surveyed and interviewed in both the government and Catholic education systems in order to ascertain the experience of racism and racist behaviours among Australian youth and their impact on health and wellbeing. The scope of the research brief included the nature of the racist experience, its setting, the individual and institutional responses and its reporting. The research also aimed to examine the impact of the experience of racism upon the health and wellbeing of Australian youth. A glossary of terms is included in Appendix 1 to assist with the reading of this Report.

Examination of the "all hazards" approach to disaster management as applied to field disaster management and pre-hospital care in Australia

Disasters, emergencies, incidents, and major incidents - they all come back to the same thing regardless of what they are called. The common denominator is that there is loss of life, injury to people and animals and damage and destruction of property. The management of such events relies on four phases: 1. Prevention 2. Preparation 3. Response 4. Recovery Each of these phases is managed in a different way and often by different teams. Here, concentration has been given to phases 2 and 3, with particular emphasis on phase 3, Response. The words used to describe such events are often related to legislation. The terminology is detailed later. However, whatever the description, whenever prevention is not possible, or fails, then the need is to respond. Response is always better when the responders are prepared. Training is a major part of response preparation and this book is designed to assist those in the health industry who need to be ready when something happens. One of the training packages for responders is the Major Incident Medical Management and Support (MIMMS) Course and this work was designed to supplement the manual prepared by Hodgetts and Macway-Jones(87) in the UK. Included is what the health services responder, who may be sent to an event in which the main concern is trauma, should know. Concentration is on the initial response and does not deal in any detail with hospital reaction, the public health aspects, or the mental health support that provides psychological help to victims and responders, and which are also essential parts of disaster management. People, in times of disaster, have always been quick to offer assistance. It is now well recognised however, that the 'enthusiastic amateur', whilst being a well meaning volunteer, isn't always what is needed. All too often such people have made things worse and have sometimes ended up as victims themselves. There is a place now for volunteers and there probably always will be. The big difference is that these people must be well informed, well trained and well practiced if they are to be effective. Fortunately such people and organisations do exist. Without the work of the St John Ambulance, the State Emergency Service, the Rural Fire Service the Red Cross and the Volunteer Rescue Association, to mention only a few, our response to disasters would be far less effective. There is a strong history of individuals being available to help the community in times of crisis. Mostly these people were volunteers but there has also always been the need for a core of professional support. In the recent past, professional support mechanisms have been developed from lessons learned, particularly to situations that need a rapid and well organised response. As lessons are learned from an analysis of events, philosophy and methods have changed. Our present system is not perfect and perhaps never will be. The need for an 'all-hazards approach' makes detailed planning very difficult and so there will probably always be criticisms about the way an event was handled. Hindsight is a wonderful thing, provided we learn from it. That means that this text is certainly not the 'last word' and revisions as we learn from experience will be inevitable. Because the author works primarily in New South Wales, many of the explanations and examples are specific to that state. In Australia disaster response is a State, rather than a Commonwealth, responsibility and consequently, and inevitably, there are differences in management between the states and territories within Australia. With the influence of Emergency Management Australia, these differences are being reduced. This means that across state and territory boundaries, assistance is common and interstate teams can be deployed and assimilated into the response rapidly, safely, effectively and with minimum explanation. This text sets out to increase the understanding of what is required, what is in place and how the processes of response are managed. By way of introduction and background, examples are given of those situations that have occurred, or could happen. Man Made Disasters has been divided into two distinct sections. Those which are related to structures or transport and those related directly to people. The first section, Chapter 3, includes: • Transport accidents involving land, rail, sea or air vehicles. • Collapse of buildings for reasons other than earthquakes or storms. • Industrial accidents, including the release of hazardous substances and nuclear events. A second section dealing with the consequences of the direct actions of people is separated as Chapter 4, entitled 'People Disasters'. Included are: • Crowd incidents involving sports and entertainment venues. • Terrorism From Chapter 4 on, the emphasis is on the Response phase and deals with organisation and response techniques in detail. Finally there is a section on terminology and abbreviations. An appendix details a typical disaster pack content. War, the greatest of all man made disasters is not considered in this text.

Changes in the Australian Commonwealth departmental machinery of government 1928-1982

The Commonwealth departmental machinery of government is changed by using Orders in Council to create, abolish or change the name of departments. Since 1906 governments have utilised a particular form of Order in Council, the Administrative Arrangements Order (AAO), as the means to reallocate functions between departments for administration. After 1928 successive governments from Scullin to Fraser gradually streamlined and increasingly used the formal processes for the executive to change departmental arrangements and the practical role of Parliament, in the process of change, virtually disappeared. From 1929 to 1982, 105 separate departments were brought into being, as new departments or through merger, and 91 were abolished, following the merger of their functions in one way or another with other departments. These figures exclude 6 situations where the change was simply that of name alone. Several hundred less substantial transfers of responsibilities were also made between departments. This dissertation describes, documents and analyses all these changes. The above changes can be distilled down to 79 events termed primary decisions. Measures of the magnitude of change arising from the decisions are developed with 157.25 units of change identified as occurring during the period, most being in the Whitlam and Fraser periods. The reasons for the changes were assessed and classified as occurring for reasons of policy, administrative logic or cabinet comfort. 47.2% of the units of change were attributed to policy, 34.9% to administrative logic, 17% to cabinet comfort. Further conclusions are drawn from more detailed analysis of the change and the reasons for the changes.

Australia and East Timor : elitism, pragmatism and the national interest

For over two decades the issue of East Timor's right to self-determination has been a ‘prickly’ issue in Australian foreign policy. The invasion by Indonesian forces in 1975 was expected, as Australian policy-makers had been well informed of the events leading up to the punitive action being taken. Indeed, prior discussions involving the future of the territory were held between the Australian Prime Minister and the Indonesian President in 1974. In response to the events unfolding in the territory the Australian Labor Government at the time was presented with two policy options for dealing with the issue. The Department of Defence recommended the recognition of an independent East Timor; whereas the Department of Foreign Affairs proposed that Australia disengage itself as far as possible from the issue. The decision had ramifications for future policy considerations especially with changes in government. With the Department of Foreign Affairs option being the prevailing policy what were the essential ingredients that give explanation for the government's choice? It is important to note the existence of the continuity and cyclical nature of attitudes by Labor governments toward Indonesia before and after the invasion. To do so requires an analysis of the influence ‘Doc’ Evatt had in shaping any possible Labor tradition in foreign policy articulation. The support given by Evatt for the decolonisation of the Netherlands East Indies (Indonesia) gave rise to the development of a special relationship-so defined. Evidence of the effect Evatt had on future Labor governments may be found in the opinions of Gough Whitlam. In 1975 when he was Prime Minister, Whitlam felt the East Timor issue was merely the finalisation of Indonesia's decolonisation honouring Evatt's long held anti-colonialist tradition existing in the Australian Labor Party. The early predisposition toward Indonesia's cohesiveness surfaced again in the Hawke and Keating Labor governments of later years. It did not vary a great deal with changes in government The on-going commitment to preserving and strengthening the bilateral relationship meant Indonesia's territorial integrity became the focus of the Australian political elites’ regional foreign policy determinations. The actions taken by policy-makers served to promote the desire for a stable region ahead of independence claims of the East Timorese. From a realist perspective, the security dilemma for Australian policy-makers was how to best promote regional order and stability in the South East Asian region. The desire for regional cohesiveness and stability continues to drive Australian political elites to promote policies that gives a priority to the territorial integrity of regional states. Indonesia, in spite of its diversity, was only ever thought of as a cohesive unitary state and changes to its construct have rarely been countenanced. Australia's political elite justifications for this stance vacillate between strategic and economic considerations, ideological (anti-colonialism) to one of being a pragmatic response to international politics. The political elite argues the projection of power into the region is in Australia’s national interest. The policies from one government to the next necessarily see the national interest as being an apparent fixed feature of foreign policy. The persistent fear of invasion from the north traditionally motivated Australia's political elite to adopt a strategic realist policy that sought to ‘shore up’ the stability, strength and unity of Indonesia. The national interest was deemed to be at risk if support for East Timorese independence was given. The national interest though can involve more than just the security issue, and the political elite when dealing with East Timor assumed that they were acting in the common good. Questions that need to be addressed include determining what is the national interest in this context? What is the effect of a government invoking the national interest in debates over issues in foreign policy? And, who should participate in the debate? In an effort to answer these questions an analysis of how the ex-foreign affairs mandarin Richard Woolcott defines the national interest becomes crucial. Clearly, conflict in East Timor did have implications for the national interest. The invasion of East Timor by Indonesia had the potential to damage the relationship, but equally communist successes in 1975 in Indo-China raised Australia's regional security concerns. During the Cold War, the linking of communism to nationalism was driving the decision-making processes of the Australian policy-makers striving to come to grips with the strategic realities of a changing region. Because of this, did the constraints of world politics dominated by Cold War realities combined with domestic political disruption have anything to do with Australia's response? Certainly, Australia itself was experiencing a constitutional crisis in late 1975. The Senate had blocked supply and the Labor Government did not have the funds to govern. The Governor-General by dismissing the Labor Government finally resolved the impasse. What were the reactions of the two men charged with the responsibility of forming the caretaker government toward Indonesia's military action? And, could the crisis have prevented the Australian government from making a different response to the invasion? Importantly, and in terms of economic security, did the knowledge of oil and gas deposits thought to exist in the Timor Sea influence Australia's foreign policy? The search for oil and gas requires a stable political environment in which to operate. Therefore for exploration to continue in the Timor Sea Australia must have had a preferred political option and thoughts of with whom they preferred to negotiate. What was the extent of each government's cooperation and intervention in the oil and gas industry and could any involvement have influenced the Australian political elites’ attitude toward the prospect of an independent East Timor? Australia's subsequent de jure recognition that East Timor was part of Indonesia paved the way for the Timor Gap (Zone of Cooperation) Treaty signing in 1989. The signing underpinned Australia's acceptance of Indonesian sovereignty over East Timor. The outcome of the analysis of the issues that shaped Australia's foreign policy toward East Timor showed that the political elite became locked into an integration model, which was defended by successive governments. Moreover, they formed an almost reflexive defence of Indonesia both at the domestic and international level.

From country town to provincial city : Albury, 1934-1949

Examines the process of urbanisation in non-metropolitan New South Wales by focusing on the transition of Albury from country town to provincial city. The study traces changes in function, form, government and society.

Beyond caricature : exploring theories of educational policy production and implementation

Since the mid 1980s there has been a growing interest amongst sociologists in the study of education policy, which has coincided with a decline within the tradition of educational administration - having been subsumed by educational management - of 'detailed historical work, or work concerned primarily with politics or policy content' (Olga 1987. p. 138). While in the past other traditions associated with social policy and social administration, government and politics. and the history of education have also been concerned with education policy. most recent and substantive work (for example. Olga 1987 1990. Dale 1989, 1992, Dale & Olga 1991, 1993. Ball 1990, 1993, Bowe, et al. 1992. Lingard 1991,1993)has come "from within the sociology of education. especially from those working within, or influenced by, the 'new' sociology of education, and, especially, those of a Marxist or neo-Marxist persuasion or at least concerned with the relationship of the state to education as a central problem (Olga 1987. p.139)".