Australian dental policy reform and the use of dental therapists and hygienists

Oral diseases including dental caries and periodontal disease are among the most prevalent and costly diseases in Australia today. Around 5.4% of Australia’s health dollar is spent on dental services totalling around $2.6 billion, 84% of which are delivered through the private sector (AIHW 2001). The other 16% is spent providing public sector services in varied and inadequate ways. While disease rates among school children have declined significantly in the past 20 years the gains made among children are not flowing on to adult dentitions and our aging population will place increasing demands on an inadequate system into the future (AHMAC 2001). Around 50% of adults do not received regular care and this has implications for widening health inequalities as the greatest burden falls on lower income groups (AIHW DSRU 2001). The National Competition Policy agenda has initiated, Australia-wide, reviews of dental legislation applying to delivery of services by dentists, dental specialists, dental therapists and hygienists and dental technicians and prosthetists. The review of the Victorian Dentists Act 1972, was completed first in 1999, followed by the other Australian states with Queensland, the ACT and the Northern Territory still developing legislation. One of the objectives of the new Victorian Act is to ‘…promote access to dental care’. This study has grown out of the need to know more about how dental therapists and hygienists might be utilised to achieve this and the legislative frameworks that could enable such roles. This study used qualitative methods to explore dental health policy making associated with strategies that may increase access to dental care using dental therapists and hygienists. The study used a multiple case study design to critically examine the dental policy development process around the Review of the Dentists Act 1972 in Victoria; to assess legislative and regulatory dental policy reforms in other states in Australia and to conduct a comparative analysis of dental health policy as it relates to dental auxiliary practice internationally. Data collection has involved (I) semi-structured interviews with key participants and stakeholders in the policy development processes in Victoria, interstate and overseas, and (ii) analysis of documentary data sources. The study has taken a grounded theory approach whereby theoretical issues that emerged from the Victorian case study were further developed and challenged in the subsequent interstate and international case studies. A component of this study has required the development of indicators in regulatory models for dental hygienists and therapists that will increase access to dental care for the community. These indicators have been used to analyse regulation reform and the likely impacts in each setting. Despite evidence of need, evidence of the effectiveness and efficiency of dental therapists and hygienists, and the National Competition Policy agenda of increasing efficiency, the legislation reviews have mostly produces only minor changes. Results show that almost all Australian states have regulated dental therapists and hygienists in more prescriptive ways than they do dentists. The study has found that dental policy making is still dominated by the views of private practice dentists under elitist models that largely protect dentist authority, autonomy and sovereignty. The influence of dentist professional dominance has meant that governments have been reluctant to make sweeping changes. The study has demonstrated alternative models of regulation for dental therapists and hygienists, which would allow wider utilisation of their skills, more effective use of public sector funding, increased access to services and a grater focus on preventive care. In the light of theses outcomes, there is a need to continue to advocate for changes that will increase the public health focus of oral health care.

Fundamental elements in examining a child’s right to education : a study of home education research and regulation in Australia

Home education provides valuable educational and developmental opportunities for children. An examination of Australia’s research indicates many best educational practices, including more informed mediation, contextualised learning, and opportunities to exercise autonomy. Key features include learning embedded in communities and program modification in response to students’ needs. Current state and territory legal requirements are examined within the context of this research and Australia’s obligations to international human rights treaties. All jurisdictions accept home education as one way to meet compulsory education requirements. The extent to which respective laws then reflect understanding of home education research and practice varies. Most jurisdictions allow for a variety of educational approaches. Some oversight regulation could however be modified to reflect a better understanding of home education. Consultation with home educators and reference to research would assist the development of more uniform legislation and policy across Australia, and enable better regulatory practice.

The state of legislation and policy protecting Australia's mangrove and salt marsh and their ecosystem services

Saline coastal wetlands, such as mangrove and coastal salt marsh, provide many ecosystem services. In Australia, large areas have been lost since European colonization, particularly as a result of drainage, infilling and flood-mitigation works, often starting in the mid-19th century and aimed primarily towards converting land to agricultural, urban or industrial uses. These threats remain ongoing, and will be exacerbated by rapid population growth and climate change in the 21st century. Establishing the effect of wetland loss on the delivery of ecosystem services is confounded by the absence of a nationally consistent approach to mapping wetlands and defining the boundaries of different types of coastal wetland. In addition, climate change and its projected effect on mangrove and salt marsh distribution and ecosystem services is poorly, if at all, acknowledged in existing legislation and policy. Intensifying climate change means that there is little time to be complacent; indeed, there is an urgent need for proper valuation of ecosystem services and explicit recognition of ecosystem services within policy and legislation. Seven actions are identified that could improve protection of coastal wetlands and the ecosystem services they provide, including benchmarking and improving coastal wetland extent and health, reducing complexity and inconsistency in governance arrangements, and facilitating wetland adaptation and ecosystem service delivery using a range of relevant mechanisms. Actions that build upon the momentum to mitigate climate change by sequestering carbon – ‘blue carbon’ – could achieve multiple desirable objectives, including climate-change mitigation and adaptation, floodplain rehabilitation and habitat protection.

The entrepreneurial arts leader : cultural policy, change and reinvention

"The Entrepreneurial Arts Leader is grounded in an understanding of cultural policy, management, art history, entrepreneurship and creativity, and is cross-disciplinary. It features a comprehensive bibliography and models of entrepreneurial arts leaders, and will be of seminal importance to arts managers, administrators, cultural policy makers and students."--BOOK JACKET

Data protection and privacy: the Australian legislation and its implications for IT professionals

The notion of privacy takes on a completely different meaning when viewed from the perspective of an IT professional, an organisation using technology to support strategic directions or a member of the public. This paper looks past the technical issues involved in data protection and examines some of the business, social and regulatory aspects that have become important to those involved in the management, storage and dissemination of electronic information. The paper documents some of the legislative developments in privacy and data protection and examines what these developments mean for IT professionals for whom the link between data captured, stored and processed into information and the resulting effect on privacy is important. The Commonwealth Privacy Act 1988 based on work done by the Council of Europe, the OECD and the European Union provides some general guidelines but only for the public sector. However, new legislation imminent. Thus, IT professionals need to be aware of the changing situation and examine their organisation’s current practices to ensure compliance with future laws.

(Im)plausibilities: a rhizo-textual analysis of policy texts and teachers' work

In this paper I argue for the use of Deleuzian theories in educational contexts. In particular, I am interested in the use of the concept of rhizomes, and the analysis of texts as rhizomes, drawing on Deleuze and Guattari's work in A Thousand Plateaus (1987). I discuss the possibilities for using rhizomatics in educational contexts through an exploration of the construction of an 'apparatus of social critique' (Buchanan, 2000). I then describe a rhizomatic understanding of the relationships between teachers and policy texts, which can disrupt commonsense understandings of these relations. I provide examples from my own research (Honan, 2001) of a rhizo-textual analysis of policy texts. This rhizo-textual analysis involved an exploration of the construction of the subject position, teacher, within one policy text, as well as a mapping of two teachers' readings of this text. The paper concludes with a discussion of the implications for using Deleuzian theory in educational contexts, implications for both policy developers and educational researchers.

Transacting with citizens: Australian government policy, strategy and implementation of online tax lodgement

Many governments have shown leadership in encouraging their citizenry to conduct transactions on-line. The policies that underpin these initiatives refer to a blend of civic benefits and efficiency goals. They combine the rhetoric of customer service with social shaping through ‘government as model user’ and procedures that require online activities. Many initiatives are described as ‘electronic service delivery’, terms that indicate an intention to provide much more than an additional channel for government interaction with citizens. Australia, as an innovator in eGovernment is a good example of this approach and its national government has specified policy goals for its online strategy. In this paper we examine the case of one Australian online delivery initiative, electronic tax lodgement (e-tax) and consider how well that initiative has met the policy goals of the government. Combining insights from Rogers’ Diffusion of Innovation theory and political analysis, we outline potential difficulties that governments face in implementing ESD initiatives. Our conclusion from this case study is that the provision of good technology is only a small part of the ESD challenge. It shows how success of an ESD implementation may yield contradictory outcomes in terms of overall eGovernment strategies. This case highlights the need for long-term
implementation plans and integration of initiatives with broader government strategy.

Policy, preparation and prevention : proactive minimisation of student plagiarism

Countless cases of plagiarism are detected across the Australian higher education sector each year. Generally speaking, policy and other responses to the issue focus on punitive, rather than on educative, measures. Recently, a subtle shift is discernable. As well as ensuring appropriate consequences for plagiarists, several universities are beginning to formalise the inclusion of learning and teaching strategies in anti-plagiarism related policy and practice, as well as paying closer attention to the communication of unambiguous definitions of plagiarism. This article outlines one example of the emerging educative approach and details the ways in which this approach has been implemented across an entire university. The necessity of evidence-based evaluation of approaches to reducing plagiarism in higher education is discussed.

Quality of life indexes for national policy: review and agenda for research

A number of governments and public policy institutes have developed ldquoQuality of Life Indexesrdquo – statistics that attempt to measure the quality of life for entire states or regions. We develop 14 criteria for determining the validity and usefulness of such QOL indexes to public policy. We then review 22 of the most-used QOL indexes from around the world. We conclude that many of the indexes are successful in that they are reliable, have established time series measures, and can be disaggregated to study subpopulations. However, many fall short in four areas: (1) indexes vary greatly in their coverage and definitions of domains of QOL, (2) none of the indexes distinguish among the concepts of input, throughput, and output that are used by public policy analysts, (3) they fail to show how QOL outputs are sensitive to public policy inputs, and (4) none have examined convergent validity against each other. We conclude that many of these indexes are potentially very useful for public policy and recommend research to further improve them.

Competition law and policy : cases and materials

This book evaluates Australian competition law including the economics and politics that lay at its heart. This fully revised second edition draws together a comprehensive collection of material providing an excellent and up-to-date guide to Australian competition law.

The harm chain : a public policy development and stakeholder perspective

This paper introduces the concept of a ‘harm chain’ as a mechanism to further broaden the way in which firms and public policy makers consider potential negative outcomes from marketing activities. The purpose of conceptualizing a ‘harm chain’ is to examine specifically the creation of harm within networks of marketing exchanges that might occur throughout preproduction, production, consumption and post-consumption activities. The authors suggest that addressing issues where harm occurs allows both firms and policy makers to identify whether exchanges bring about harm, how relevant parties can address the core cause of harm, as well as how those who are harmed can be protected.

Urban growth centres on the periphery : ad hoc policy vision and research neglect

The focus of this paper is peripheral urban growth centres on the edges of capital cities in Australia and the challenges they face as dormitory suburbs attempting to establish their own local business development. These challenges create dilemmas as infrastructure and climate change place pressure on long commuting times, while developing strong locally based communities is limited by many resource and demand constraints. The main research question is to examine how these challenges are being addressed in both public policy and academic research. Two propositions emerge from this analysis. The first is that, despite clear recognition of these challenges by public policy makers, there is a lack of coherent policy vision in addressing the dilemmas that are facing these urban growth centres. The second is that, despite all the concerns and lack of policy vision, there is a dearth of useful academic research in Australia to understand the dilemmas and provide guidance for appropriate policy options. In the context of ad hoc policy and academic neglect; Casey, Melton and Wyndham are the three major urban peripheral local government areas in Victoria that are profiled in this paper. They serve as examples in examining incoherence of policy and then analysing the elements that are needed for effective and strong peripheral growth centres that could propel these centres towards efficient and equitable liveable communities. A broad composite model of regional economic development is used to examine the attendant problems in these urban centres and the various viable policy options for addressing these problems. In the process, this paper aims to provide a basis for further rigorous academic investigation of peripheral urban growth centres in Australia and, arising from this, more coherent policies for the economic development of such centres.

Legislation and statutory interpretation

A clear and accessible guide to one of the most important skills all students of law must master: the skill of understanding legislation. The authors provide an engaging overview of important aspects of the legislative process, its application and interpretation, together with examples questions and excerpts of relevant legislation. This book is specifically designed for students studying the statutory process and statutory interpretation or anyone interested in knowing more about this subject.