Health system reform and social capital

The pressures for health system reform have reached a critical stage over the past ten years as our understanding of the determinants of health has increased and deepened. Far from being conjecture and theory, the evidence for a broad range of determinants of health, from the biological and medical through to a broad range of economic and social determinants, has mounted.

Have we really thought through health reform?

With all the discussion around about health care reform in Australia we are missing a fundamental issue about health and illness. They are not the same! There is a disconnect between the rhetoric of reform, the apparent political support for prevention and health promotion, and the realities of decisions being taken and understanding of the underlying assumptions of health determinants.Preventing ill health and promoting health have been seen as the point of departure for good health care, at least rhetorically, ever since the Alma Ata Declaration (1978) and the Ottawa Charter (1986). Australia along with other member states of the WHO is signatories to both and they have underpinned official health policy with a rhetorical flourish in many a document since.

Health system reform and social capital

Jim Hyde suggests that the research on building the capacity of communities and the accumulation of social capital shows that how we organize our health systems - in both micro and macro contexts - is important. He argues that collaboration, flexibility and community participation must become central in health structures.

Two steps forward, one step back : Indonesia’s arduous path to reform

Australians have long worried about whether Indonesia is ‘special’ or ‘normal’. Instead, we need to deal with Indonesia as it really is—a country experiencing simultaneously the challenges of political reform, economic development and a shifting regional security environment. The country’s political future is less certain than we would hope: after SBY’s term of government ends, the choice of a successor will be critical in determining the future of reform. We can’t rule out that Indonesia might slide back to old ways of doing business—democratisation is a fraught process.
As the Indonesian economy grows, so too do the prospects for Indonesia to establish its natural position as the leader of Southeast Asia. As the world is re-examining Indonesia, so too Indonesia is looking afresh at the world—more interested in external issues than it was a decade ago. The Southeast Asian subregion increasingly finds itself at the centre of a more strongly interconnected Indo-Pacific region—so Indonesia’s strategic importance is going up.
It’s important for Australia to build a better strategic relationship with Indonesia. The two are complementary partners. Australia should be proactive in exploring new opportunities for cooperation with a reform minded Indonesia—it’s in our interests to draw Indonesia into a more important strategic role in regional security.
Professor Damien Kingsbury, the author of this Strategy, is the Director, Centre for Citizenship, Development and Human Rights, Faculty of Arts and Education, Deakin University, Melbourne.

Sacrificial girls : a case study of the impact of streaming and setting on gender reform

This article reports on research funded by the Australian Research Council to investigate school responses to gender equity. It addresses the efforts of a disadvantaged school to tackle what they perceived to be gender inequalities, but in the process of constructing a top-set and bottom-set/ stream class they are developing new forms of old inequalities and new forms of inequalities. This research indicates that despite popular assertions that girls’ education has become the priority of schools and education systems, girls are being further disadvantaged through attempts to implement market strategies coupled with gender reform agendas grounded in liberal notions of equity and relying on unsophisticated notions of affirmative action. In addition, this study highlights the extent to which a media-driven debate about boys’ education has influenced the constitution of boys as the ‘new disadvantaged’ with the capacity to determine the nature of gender reform agendas and programmes in schools.

NSW parliamentary inquiry recommends partial reform to provocation law

This piece reviews the recommendations for reform put forward by the NSW Parliamentary Committee into the Partial Defence of Provocation. 

Out of the shadows: a discussion on law reform for the prevention of financial abuse of older people

Financial abuse of older people too often lives ‘in the shadows, hidden by fear and shame’. This and the protective love between family members can screen changes that are critical to an older person’s financial and living arrangements. Rather than a single event, it is usually a series of well-intentioned but ill-considered financial acts, which at some point tips over into abuse interwoven with an intricate web of family relationships. Was a transfer of title or a loan to an adult child really misappropriation? Has thoughtlessness become undue influence or even theft?