Submission to KPMG review of the Federal Government Initiative to “analyse dementia program and services funded by the Department of Social Services"

The comments I make are based on my nearly twenty years involvement in the dementia cause at both a national and international level. In preparation, I read two papers namely the Ministerial Dementia Forum – Option Paper produced by KPMG Management Consultants (2014) and Analysis of Dementia Programmes and Services Funded by the Department of Social Services: Conversation Starter prepared by KPMG as a preparation document for those attending a workshop in Brisbane on April 22nd 2015. Dementia is a complex “syndrome” and as is often said, “when you meet one person with dementia, you have met one” meaning that no two persons with dementia are the same. Even in dementia care, Australia is a “lucky country” and there is much to be said for the quality and diversity of dementia care available for people living with dementia. Despite this, I agree with the many views expressed in the material I read that there is scope for improvement, especially in the way that services are coordinated. In saying that, I do not purport to have all the solutions nor claim to have the knowledge required to comment on all the programs covered by this review. If I appear to be a “biased” advocate for Alzheimer’s Australia across the States and Territories, it is because I have seen constant evidence of ordinary people doing extraordinary things with inadequate resources. Dementia care is not cheap and if those funding dementia services are primarily only interested in economic outcomes and benefits, the real purpose of this consultation will be defeated. In addition, nowhere in the material I have read is there any recognition that in many instances program funding is a complex mix of government (at all levels) and private funding. This makes reviewing those programs more complex and less able to be coordinated at a Departmental level. It goes without saying therefore that the Federal Government is not” the only player in this game”. Of all those participating in this review, Alzheimer’s Australia is best placed to comment on programs as it is more connected to people living with dementia and has probably the best record of consulting with them. It would appear however that their role has been reduced to that of a “bit player”. Without wanting to be critical, the Forum Report which deals with the comments made at a gathering of 70 individuals and organisations, only three (3) or 4.28% were actual carers of people living with dementia. Even if it is argued that a number of organisations present represented consumers, the percentage goes up only marginally to 8.57% which is hardly an endorsement of the forum being “consumer driven”. The predominance of those present were service providers, each with their own agenda and each seeking advantage for their “business”. The final point I want to make before commenting on more specific, program related issues, is that many programs being reviewed have a much longer history than is reflected in the material I have read. Their growth and development was pioneered by Alzheimer’s Australia organisations across the country often with no government funding. Attempts to bring about better coordination of programs were often at the behest of Alzheimer’s Australia but in the main were ignored. The opportunity to now put this right is long overdue.

Creating change in government to address the social determinants of health: How can efforts be improved?

Background The evidence base for the impact of social determinants of health has been strengthened considerably in the last decade. Increasingly, the public health field is using this as a foundation for arguments and actions to change government policies. The Health in All Policies (HiAP) approach, alongside recommendations from the 2010 Marmot Review into health inequalities in the UK (which we refer to as the ‘Fairness Agenda’), go beyond advocating for the redesign of individual policies, to shaping the government structures and processes that facilitate the implementation of these policies. In doing so, public health is drawing on recent trends in public policy towards ‘joined up government’, where greater integration is sought between government departments, agencies and actors outside of government. Methods In this paper we provide a meta-synthesis of the empirical public policy research into joined up government, drawing out characteristics associated with successful joined up initiatives. We use this thematic synthesis as a basis for comparing and contrasting emerging public health interventions concerned with joined-up action across government. Results We find that HiAP and the Fairness Agenda exhibit some of the characteristics associated with successful joined up initiatives, however they also utilise ‘change instruments’ that have been found to be ineffective. Moreover, we find that – like many joined up initiatives – there is room for improvement in the alignment between the goals of the interventions and their design. Conclusion Drawing on public policy studies, we recommend a number of strategies to increase the efficacy of current interventions. More broadly, we argue that up-stream interventions need to be ‘fit-for-purpose’, and cannot be easily replicated from one context to the next.

Making usability affordable in the design of e-government services: User-centred design for public sector websites

E-government provides a platform for governments to implement web-enabled services that facilitate communication between citizens and the government. However, technology-driven design approach and limited understanding of citizens' requirements have led to a number of critical usability problems on the government websites. Hitherto, there has been no systematic attempt to analyse the way in which theory of User-Centred Design (UCD) can contribute to address the usability issues of government websites. This research seeks to fill this gap by synthesising perspectives drawn from the study of UCD and examining them based on the empirical data derived from case study of the Scottish Executive (SE) website. The research employs a qualitative approach in the collection and analysis of data. The triangulated analysis of the findings reveals that e-government web designers take commercial development approach and focus only on technical implementations, which lead to websites that do not meet citizens' expectations. The research identifies that e-government practitioners can overcome web usability issues by transferring the theory of UCD to practice. © Copyright 2010 Inderscience Enterprises Ltd.

The Politics and Policies of Reproductive Agency

This study examines the politics and policies of reproductive agency through a redescription of three Finnish policy documents dealing with the declining birth rate: the Government report on the future 'Finland for people of all ages' (2004), Business and Policy Forum EVA report 'Condemned to Diminish?' (Tuomitut vähenemään?) (2003), and the Family Federation's 'Population Policy Program' (2004). The redescription is done with the help of the notion of reproductive agency, which draws on Drucilla Cornell's concepts of the imaginary domain and bodily integrity. The imaginary domain is the moral and psychic space people need in order to form their personality, which is created in constant identificatory processes. The aim of the processes is imaginary coherence. As the personality is embodied, forming one s imaginary coherence always includes attempts for bodily integrity, also entailing attempts to arrive at an understanding of one's procreative capacities. Besides Cornell, I draw on Judith Butler's thinking and comprehend gender performatively as doing, and in relation to that agency as part of the performative process of one's personality. Reproductive agency is understood in this study as the possibilities to live differently the hegemonic forms of procreative life. I deal with three redescriptive themes: the family, economics and gender. The family is a central element in that it is considered the main location of reproduction. With regard to reproductive agency, the documents include problematic conceptions of the family. It is defined as a heterosexual, monogamous, conjugal relationship, which affects reproductive agency in that these notions do not allow for different modes of family life. The second prominent aspect, economics, features on two levels: the macroeconomic level of GDP, employment and competitiveness, and the level of family policies and concern about family finances. Macroeconomic-level argumentation is problematic in the context of reproductive agency because it implies that procreation is a duty of citizens, and thus has effects on values attached to reproductive potential. On the other hand, family policies may advance reproductive agency in supporting families financially. However, such policies also define how the family is understood, thereby affecting reproductive agency. The third theme, gender, intersects with many issues in the policy documents. All three texts consider the roles of men and women differently: women are primarily responsible for the family, and both men's and women's reproductive agency is affected in that the roles in the procreative process are predefined. EVA and the Family Federation see women as the main target of population policies, and consider it legitimate to try to change women s reproductive decisions. Implicit in the notion of reproductive agency is the idea that it should be possible to overcome and live differently the sex difference, but the three documents do not open up opportunities for that. The notion of reproductive agency makes it also possible to question the legitimacy of population policies in general and offers new perspectives on the vocabularies used in the three policy texts, providing insights into the values and logics that support the concepts.

The growing visibility of creationism in Northern Ireland: are new science teachers equipped to deal with the issues?

The growing visibility of various forms of creationism in Northern Ireland raises issues for science education. Attempts have been made at political levels to have such “alternatives” to evolution taught in the science classroom, and the issue has received coverage in local press and media. A sample of 112 pre-service science teachers answered a survey on attitudes toward evolution. Preliminary analysis revealed many of these new teachers held views contrary to scientific consensus—over one fifth doubt the evidence for human evolution, and over one quarter dispute the common ancestry of life. Over two thirds indicated a preference for teaching a “range of theories” regarding these issues in science. In addition, 49 pre-service biology teachers viewed a DVD resource promoting “intelligent design” and completed an evaluation of it. The biology teachers also took part in either focus groups or additional questionnaires. A majority took the resource at face value and made positive comments regarding its utility. Many articulated views contrary to the stated positions of science academies, professional associations, and the UK government teaching directives regarding creationism. Most indicated a perception that intelligent design is legitimate science and that there is a scientific “controversy” regarding the legitimacy of evolution. Concern is raised over the ability of these new teachers to distinguish between scientific and non-scientific theories. The suggestion is made that the issue should be addressed directly with pre-service science teachers to make clear the status of such “alternatives.” The paper raises implications for science education and questions for further research.

WTO government procurement rules and the local dynamics of procurement policies: A malaysian case study

This article examines efforts to create binding international rules regulating public procurement and considers, in particular, the failure to reach a WTO agreement oil transparency in government procurement. The particular focus of the discussion is the approach taken by Malaysia to these international procurement rules and to the negotiation of an agreement on transparency. Rules governing public procurement directly implicate fundamental arrangements of authority amongst and between different parts of government, its citizens and non-citizens. At the same time, the rules touch upon areas that are particularly sensitive for some developing countries. Many governments use preferences in public procurement to accomplish important redistributive and developmental goals. Malaysia has long used significant preferences in public procurement to further sensitive developmental policies targeted at improving the economic strength of native Malays. Malaysia also has political and legal arrangements substantially at odds with fundamental elements of proposed global public procurement rules. Malaysia has, therefore, been forceful in resisting being bound by international public procurement rules, and has played all important role in defeating the proposed agreement oil transparency. We suggest that our case study has implications beyond procurement. The development of international public procurement rules appears to be guided by many of the same values that guide the broader effort to create a global administrative law. This case study, therefore, has implications for the broader exploration of these efforts to develop a global administrative law, in particular the relationship between such efforts and the interests of developing countries.

Everything that rises must converge: a neo-Marxist analysis of Canadian business-government relations

The following thesis presents an analysis of business-government relations within a neo-Marxist framework. Specifically, the discussion encompasses how the business interest group. the Business Council on National Issues, maintains consensus and unity amongst its monopoly capital members. Furthermore. the study elaborates on the process through which the group's interests are acknowledged and legitimized by the state under the "public interest" f8fue. Most of the literature pertaining to business-government relations within the context of interactions between business interest groups and the state, and such specific branches of the state as the government and/or the civil service. emphasize a liberal-pluralist perspective. Essentially, these writings serve to reflect and legitimate the current slatus quo. Marxist discourses on the subject, while attempting to transcend the liberal-pluralist framework. nevertheless suffer from either economic determinism .. ie., stressing the state's accumulation function but not its legitimation function or historical specificity. A cogent and comprehensive neo-Marxist analysis of business-government relations must discuss both the accumulation and legitimation functions of the state. The process by which the concerns of a particular business interest group become part of the state's policy agenda and subsequently are formulated and implemented into policies which legitimate its dominance is also studied. This inquiry is significant given the liberal-pluralist assumptions of a neutral state and that all interest groups compete "on a level playing field". The author's neo-Marxist paradigm rejects both of these assumptions. Building on concepts from nea-Marxist instrumentalism. structuralism. state monopoly capitalism, and forms and functions of the state perspectives. the author proposes that policies which legitimize the interests of the monopoly capital fraction cannot. be discerned only from the state's activities. per StJ. Clearly, if the liberal-pluralist 3 contention of multiple and conflicting interest groups, including those within the capitalist class, is taken at face value, M interest group such as the Business Council on National Issues (BCND, must somehow maintain. internal consensus Md unity amongst its members. Internal consensus amongst its members ensures that the state can better acknowledge and articulate its concerns into policies that maintain hegemonic dominance of the monopoly capital fraction under the "public interest" fllf.JJdq. The author contends that the BCNI focuses most of its interactions on the upper echelons of the civil service since it is this branch of the state which is most responsible for policy formulation and implementation. The author's paradigm is applied within the context of extensively analyzing newspaper coverage. BCN! publications, and other published sources, as well as a personal interview with an executive administrative member of the BeNI. The discussion focuses on how agreement and unity amongst the various interests of the monopoly capital fraction are maintained through the business organization, its policy scope, and finally its interactions with the state. The analysis suggests that while the civil service is an important player in expressing the interests of the BCNI's membership through policies which ostensibly also reflect the "public interest", it is not the only strategic target for the BCNI's interactions with the state. The author's research also highlights the importance of government officials at the Cabinet level and Cabinet Committees. Senior elected officials from the Federal government are also significant in avoiding intergovernmental or interprovincial conflict in implementing policies that legitimize hegemonic dominance of the monopoly capital fraction over other fractions and classes.

Tribunals and Guidelines: Exploring the Relationship Between Fairness and Legitimacy in Administrative Decision-Making

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Materiality, subjectification, and government: the geographies of Britain's Motorway Code

In this paper I provide a critical discussion of Foucault's work on government and governmentality. I argue that geographers have tended to overlook the ways in which practices of self-government and subjectification are performed in relation to programmes of government, and suggest that they should examine the technical devices which are embedded in networks of government. Drawing upon these observations I suggest how geographers might proceed, tracing the geographies of a specific artefact: the British government's 1958 Motorway Code. I examine how the code was designed to serve as a technology of government that could shape the conduct of fairly mobile and distant subjects, enabling them to govern their conduct and the movements of their vehicles.

Legitimacy and rights in the EU: questions of identity

Rights as well as democracy play a crucial role in the legitimacy of the EU and constitutional patriotism has been influential in attempting to link them together. The article seeks to engage in a critique of constitutional patriotism on two fronts. First, it distinguishes between the various types of right that exist within EU law-Community, citizenship and fundamental-and then analyses the place of these rights within various political models of the EU ranging from nationalism to republicanism. It argues that constitutional patriotism does not enjoy a monopoly on rights discourse in the EU: most models of the EU see a place for rights; it is just that the type of right supported varies. Secondly, advocates of constitutional patriotism argue that EU rights generate European identity. The article questions the extent to which this is the case, arguing that identity potential varies considerably according to the type of EU right concerned.

Statebuilding and governance: the conundrums of legitimacy and local ownership

The chapter explores the role of legitimacy in statebuilding. It first explores the concept of legitimacy and why it matters for successful statebuilding; it surveys how international statebilding efforts have tried to strengthen the legitimacy of post-conflict states; and examines the practices of local ownership in statebuilding, and how they relate to legitimation efforts.

How culture and government shape entrepreneurial innovation: the case of Korean and UK online gaming firms

This paper examines institutional sources of product innovation with reference to the online gaming sector of Korea and the UK. It examines the combined impact of formal and informal institutions and their interaction with multiple case studies. Despite the growing importance of innovative products in contemporary entertainment (including interactive games), the ‘informal’ source of innovation has attracted limited attention. By closely looking at the idea exploration, generation and selection process (where creativity plays a major role), we intend to find out how values and public policy affect product innovation. This study shows that the value of Korean and UK online gaming firms (regardless of their different socio-economic contexts) plays an important role in generating product innovation. An additional point is that Korean firms are likely to take advantage of government policy support to overcome inadequate institutional settings in conjunction with the initial conditions of online game development.

Trees for development? Articulating the ambiguities of power, authority and legitimacy in governing Ghana’s mineral rich forests

The growth of mining activities in Africa in the last decade has coincided with increased attention on the fate of the continent’s forests, specifically in the contexts of livelihoods and climate change. Although mining has serious environmental impacts, scant attention has been paid to the processes which shape decision-making in contexts where minerals and forests overlap. Focussing on the illustrative case of Ghana, this paper articulates the dynamics of power, authority and legitimacy of private companies, traditional authorities and key state institutions in governing mining activities in forests. The analysis highlights how mining companies and donors promote a neoliberal model of resource management which entrenches their ability to benefit from mineral exploitation and marginalises the role of state institutions and traditional authorities in decision-making. This subsequently erodes state authority and legitimacy and compounds the contested nature of traditional authorities’ legitimacy. A more nuanced examination of foundational governance questions concerning the relative role of the state, traditional authorities and private interests is needed.

Distributive impact of public policy

Includes bibliography

Can the green economy enhance sustainable mountain development? The potential role of awareness building

Mountain socio-ecological systems produce valuable but complex ecosystem services resulting from biomes stratified by altitude and gravity. These systems are often managed and shaped by smallholders whose marginalization is exacerbated by uncertainties and a lack of policy attention. Human–environment interfaces in mountains hence require holistic policies. We analyse the potential of the Global Mountain Green Economy Agenda (GMGEA) in building awareness and thus prompting cross-sectoral policy strategies for sustainable mountain development. Considering the critique of the green economy presented at the Rio + 20 conference, we argue that the GMGEA can nevertheless structure knowledge and inform regional institutions about the complexity of mountain socio-ecological systems, a necessary pre-condition to prompt inter-agency collaboration and cross-sectoral policy formulation. After reviewing the content of the GMGEA, we draw on two empirical cases in the Pakistani and Nepali Himalayas. First, we show that lack of awareness has led to a sequence of fragmented interventions with unanticipated, and unwanted, consequences for communities. Second, using a green economy lens, we show how fragmentation could have been avoided and cross-sectoral policies yielded more beneficial results. Project fragmentation reflects disconnected or layered policies by government agencies, which inherently keep specialized agendas and have no incentive to collaborate. Awareness makes agencies more likely to collaborate and adopt cross-sectoral approaches, allowing them to target more beneficiaries, be more visible, and raise more funds. Nevertheless, we also identify four factors that may currently still limit the effect of the GMGEA: high costs of inter-agency collaboration, lack of legitimacy of the green economy, insufficiently-secured smallholder participation, and limited understanding of the mechanisms through which global agendas influence local policy.