Public service versus private interest : a comparative analysis of the Australian and British debates

This paper will compare and evaluate the effectiveness of commercial media lobbying and advocacy against public service media in two countries, the United Kingdom and Australia. The paper will focus empirically on the commercial media coverage of public service media issues in these countries (relating to the BBC and ABC respectively) over the period since the election of the Conservative-led Coalition in Britain in June 2010, and the election of the Gillard government in Australia in August 2010. Reference will be made to preceding periods as relevant to an understanding of the current environment. In both countries the main commercial media rival to public service media is News Corp and its associated organisations – News Ltd and Sky News in Australia, and News International and BSkyB in the UK. The paper will examine with analysis of print and online news and commentary content how News Corp outlets have reported and commented on the activities and plans of public service media as the latter have developed and extended their presence on digital TV and online platforms. It will also consider the responses of the ABC and BBC to these interventions. It will consider, thirdly, the responses of Australian and British governments to these debates, and the policy outcomes. This section of the paper will seek to evaluate the trajectory of the policy-public-private dynamic in recent years, and to draw conclusions as to the future direction of policy. Particular attention will be devoted to recent key moments in this unfolding dialogue. In Britain, debates around the efforts of News Corp to take over 100% of BSkyB, both before and after the breaking of the phone-hacking scandal in July 2011; in Australia, the debate around the National Broadband Network and the competitive tender process for ABC World, that country’s public service transnational broadcaster; and other key moments where rivalry between News Corp companies and public service media became mainstream news stories provoking wider public debate. The paper will conclude with recommendations as to how public service media organisations might engage constructively with commercial organisations in the future, including News Corp, and taking into account emerging technological and financial challenges to traditional rationales for public service provision.

A comparative study of governmental one-stop portals for public service delivery

The continuing need for governments to radically improve the delivery of public services has led to a new, holistic government reform strategy labeled “Transformational Government” that strongly emphasizes customer-centricity. Attention has turned to online portals as a cost effective front-end to deliver services and engage customers as well as to the corresponding organizational approaches for the back-end to decouple the service interface from the departmental structures. The research presented in this paper makes three contributions: Firstly, a systematic literature review of approaches to the evaluation of online portal models in the public sector is presented. Secondly, the findings of a usability study comparing the online presences of the Queensland Government, the UK Government and the South Australian Government are reported and the relative strengths and weaknesses of the different approaches are discussed. And thirdly, the limitations of the usability study in the context of a broader “Transformational Government” approach are identified and service bundling is suggested as an innovative solution to further improve online service delivery.

Confidence in the police : balancing public image with community safety : a comparative review of the literature

Examining the evolution of British and Australian policing, this comparative review of the literature considers the historical underpinnings of policing in these two countries and the impact of community legitimacy derived from the early concepts of policing by consent. Using the August 2011 disorder in Britain as a lens, this paper considers whether, in striving to maintain community confidence, undue emphasis is placed on the police's public image at the expense of community safety. Examining the path of policing reform, the impact of bureaucracy on policing and the evolving debate surrounding police performance, this review suggests that, while largely delivering on the ideal of an ethical and strong police force, a preoccupation with self-image may in fact result in tarnishing the very thing British and Australian police forces strive to achieve – their standing with the public. This paper advocates for a more realistic goal of gaining public respect rather than affection in order to achieve the difficult balance between maintaining trust and respect as an approachable, ethical entity providing firm, confident policing in this ever-evolving, modern society.

Preventing public sector corruption : the relationship between parliamentary committees and corruption commissions

Parliamentary committees fulfil several important functions within the Parliament, with one of these being the oversight of various agencies including those that are designed to reduce corruption within the police service and other public sector agencies. The cross-party nature of committees combined with the protections of Parliament make them powerful agencies. Prenzler & Faulkner (2010) suggest that the ideal system for an agency that has oversight of a public sector integrity commission should include monitoring by a parliamentary committee, with an inspector attached to the committee. This occurs in Queensland, New South Wales and Western Australia. There has been very little research conducted on the role of parliamentary committees with oversight responsibilities for public sector integrity agencies. This paper will address this gap by examining the relationship between a parliamentary committee, a parliamentary inspector and a corruption commission. Queensland’s Parliamentary Crime and Misconduct Committee (PCMC/the Committee) and the Parliamentary Crime and Misconduct Commissioner (the Commissioner) provide oversight of the Crime and Misconduct Commission (CMC). By focussing on the PCMC and the Commissioner, the paper will examine the legislative basis for the Committee and Commissioner and their respective roles in providing oversight of the CMC. One key method by which the PCMC provides oversight of the CMC is to conduct and publish a review of the CMC every three years. Additionally, the paper will identify some of the similarities and differences between the PCMC and other committees that operate within the Queensland Parliament. By doing so, the paper will provide insights into the relationships that exist between corruption commissions, parliamentary committees and parliamentary inspectors and demonstrate the important role of the parliamentary committee in preventing instances of public sector corruption.

Queensland police service : an evaluation of HealthStart 2012

The HS program consists of a voluntary health screening and personalised feedback (via a website) which incorporates physical measurements, psychological stress assessment and blood tests. The following report describes the results of a research project that evaluated the effectiveness of the QPS-HS program and examines the health benefits it offers its participants. This report has three main areas that correspond to the research questions and includes three primary aims: 1.Review the literature pertaining to the health, social and economic value of wellness programs in workplaces. In particular, we reviewed policing worksites and other safety sensitive workplaces, to understand best-practice wellness programming and return on investment, in terms of value to employees, social value to the community, and economic value to employers; 2.Evaluate health outcomes of participants in the HS program, including physical measurements, such as blood tests and psychological well-being. These measures were to form an outcome evaluation and assess the effectiveness of the HS program in positively impacting physical and psychological health of HS participants; and 3.Assess employee awareness and perceptions of the HS program for a process evaluation.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

Physical activity and health-related quality of life among physiotherapists : a cross sectional survey in an Australian hospital and health service

Background Physiotherapists are a professional group with a high rate of attrition and at high risk of musculoskeletal disorders. The purpose of this investigation was to examine the physical activity levels and health-related quality of life of physiotherapists working in metropolitan clinical settings in an Australian hospital and health service. It was hypothesized that practicing physiotherapists would report excellent health-related quality of life and would already be physically active. Such a finding would add weight to a claim that general physical activity conditioning strategies may not be useful for preventing musculoskeletal disorders among active healthy physiotherapists, but rather, future investigations should focus on the development and evaluation of role specific conditioning strategies. Methods A questionnaire was completed by 44 physiotherapists from three inpatient units and three ambulatory clinics (63.7% response rate). Physical activity levels were reported using the Active Australia Survey. Health-related quality of life was examined using the EQ-5D instrument. Physical activity and EQ-5D data were examined using conventional descriptive statistics; with domain responses for the EQ-5D presented in a frequency histogram. Results The majority of physiotherapists in this sample were younger than 30 years of age (n = 25, 56.8%) consistent with the presence of a high attrition rate. Almost all respondents exceeded minimum recommended physical activity guidelines (n = 40, 90.9%). Overall the respondents engaged in more vigorous physical activity (median = 180 minutes) and walking (median = 135 minutes) than moderate exercise (median = 35 minutes) each week. Thirty-seven (84.1%) participants reported no pain or discomfort impacting their health-related quality of life, with most (n = 35,79.5%) being in full health. Conclusions Physical-conditioning based interventions for the prevention of musculoskeletal disorders among practicing physiotherapists may be better targeted to role or task specific conditioning rather than general physical conditioning among this physically active population. It is plausible that an inherent attrition of physiotherapists may occur among those not as active or healthy as therapists who cope with the physical demands of clinical practice. Extrapolation of findings from this study may be limited due to the sample characteristics. However, this investigation addressed the study objectives and has provided a foundation for larger scale longitudinal investigations in this field.

Race matters : Indigenous employment in the Australian public service

This thesis demonstrated that race mattered as a contributing factor to the low Indigenous participation rates within the Australian Public Service. The thesis showed that the public service reproduced social relations privileging non-Indigenous executives while positioning Indigenous executives as deficient. The thesis explains how the everydayness of racism assumes the racial neutrality of institutions because the concept of race is externalised as only having relevance to the racial other. Non-Indigenous executives regard Indigeneity as being synonymous with inferiority to explain Indigenous disadvantage. Consequently, the Indigenous experience of everyday racism is perpetuated and contributes to declining rates of employment.

Health and safety for clean-up and recovery workers

This paper will identify and discuss the major occupational health and safety (OHS) hazards and risks for clean-up and recovery workers. The lessons learned from previous disasters including; the Exxon Valdez oil spill, World Trade Centre (WTC) terrorist attack, Hurricane Katrina and the Deepwater Horizon Gulf of Mexico oil spill will be discussed. The case for an increased level of preparation and planning to mitigate the health risks for clean-up and recovery workers will be presented, based on recurring themes identified in the peer reviewed literature. There are a number of important issues pertaining to the occupational health and safety of workers who are engaged in clean-up and recovery operations following natural and technological disasters. These workers are often exposed to a wide range of occupational health and safety hazards, some of which may be unknown at the time. It is well established that clean-up and recovery operations involve risks of physical injury, for example, from manual handling, mechanical equipment, extreme temperatures, slips, trips and falls. In addition to these well established physical injury risks there are now an increasing number of studies which highlight the risks of longer term or chronic health effects arising from clean-up and recovery work. In particular, follow up studies from the Exxon Valdez oil spill, Hurricane Katrina and the World Trade Centre (WTC) terrorism attack have documented the longer term health consequences of these events. These health effects include respiratory symptoms and musculoskeletal disorders, as well as post traumatic stress disorder (PTSD). In large scale operations many of those workers and supervisors involved have not had any specific occupational health and safety (OHS) training and may not have access to the necessary instruction, personal protective equipment or other appropriate equipment, this is especially true when volunteers are used to form part of the clean-up and recovery workforce. In general, first responders are better equipped and trained than clean-up and recovery workers and some of the training approaches used for the traditional first responders would be relevant for clean-up and recovery workers.

eHealth-as-a-Service (eHaaS) : towards universal stakeholder engagement

With the introduction of the Personally Controlled Health Record (PCEHR), the Australian public is being asked to accept greater responsibility for their healthcare by taking an active role in the management of personal health information. Although well designed, constructed and intentioned, policy and privacy concerns have resulted in an eHealth model that may impact future health sharing requirements. Hence, as a case study for a consumer eHealth initative in the Australian context, eHealth-as-a-Service (eHaaS) serves as a disruptive step in in the aggregation and transformation of health information for use as real-world knowledge. The strategic value of extending the community Health Record Bank (HRB) model lies in the ability to automatically draw on a multitude of relevant data repositories and sources to create a single source of the truth and to engage market forces to create financial sustainability. The opportunity to transform the beleaguered Australian PCEHR into a realisable and sustainable technology consumption model for patient safety is explored. Moreover, the current clerical focus of healthcare practitioners acting in the role of de facto record keepers is renegotiated to establish a shared knowledge creation landscape of action for safer patient interventions. To achieve this potential however requires a platform that will facilitate efficient and trusted unification of all health information available in real-time across the continuum of care. eHaaS provides a sustainable environment and encouragement to realise this potential.

eHealth-as-a-Service (eHaaS) : a data-driven decision making approach in Australian context

A commitment in 2010 by the Australian Federal Government to spend $466.7 million dollars on the implementation of personally controlled electronic health records (PCEHR) heralded a shift to a more effective and safer patient centric eHealth system. However, deployment of the PCEHR has met with much criticism, emphasised by poor adoption rates over the first 12 months of operation. An indifferent response by the public and healthcare providers largely sceptical of its utility and safety speaks to the complex sociotechnical drivers and obstacles inherent in the embedding of large (national) scale eHealth projects. With government efforts to inflate consumer and practitioner engagement numbers giving rise to further consumer disillusionment, broader utilitarian opportunities available with the PCEHR are at risk. This paper discusses the implications of establishing the PCEHR as the cornerstone of a holistic eHealth strategy for the aggregation of longitudinal patient information. A viewpoint is offered that the real value in patient data lies not just in the collection of data but in the integration of this information into clinical processes within the framework of a commoditised data-driven approach. Consideration is given to the eHealth-as-a-Service (eHaaS) construct as a disruptive next step for co-ordinated individualised healthcare in the Australian context.

The transformation of bureaucracy? Structural change in the Commonwealth public service 1983-93

Commentators have predicted bureaucratic organisations would undergo substantial change as a result of social and economic pressures. We ask whether reforms to the Australian public service over the 1983–93 period exemplify this process. We use the methods of organisational analysis to characterise the direction of change, basing our assessment on the standard structural variables of complexity, formalisation and centralisation, together with a cultural variable. We find evidence that, overall, departments of state in the APS were becoming less bureaucratic in their structure, culture and internal function in the 1983–93 period. However, the effect was not uniform across departments, or unambiguous — formalisation, for example, increased in some respects and decreased in others. Centralisation increased overall, despite devolution of some decision-making.

eHealth-as-a-Service (eHaaS) : the industrialisation of health informatics, a practical approach

With the introduction of the Personally Controlled Health Record (PCEHR), the Australian public is being asked to accept greater responsibility for their healthcare. Although well designed, constructed and intentioned, policy and privacy concerns have resulted in an eHealth model that may impact future health information sharing requirements. Thus an opportunity to transform the beleaguered Australian PCEHR into a sustainable on-demand technology consumption model for patient safety must be explored further. Moreover, the current clerical focus of healthcare practitioners must be renegotiated to establish a shared knowledge creation landscape of action for safer patient interventions. To achieve this potential however requires a platform that will facilitate efficient and trusted unification of all health information available in real-time across the continuum of care. As a conceptual paper, the goal of the authors is to deliver insights into the antecedents of usage influencing superior patient outcomes within an eHealth-as-a-Service framework. To achieve this, the paper attempts to distil key concepts and identify common themes drawn from a preliminary literature review of eHealth and cloud computing concepts, specifically cloud service orchestration to establish a conceptual framework and a research agenda. Initial findings support the authors’ view that an eHealth-as-a-Service (eHaaS) construct will serve as a disruptive paradigm shift in the aggregation and transformation of health information for use as real-world knowledge in patient care scenarios. Moreover, the strategic value of extending the community Health Record Bank (HRB) model lies in the ability to automatically draw on a multitude of relevant data repositories and sources to create a single source of practice based evidence and to engage market forces to create financial sustainability.

The limits to public service : rural communities, professional families, and work mobility

Australia faces an ongoing challenge recruiting professionals to staff essential human services in rural and remote communities. This paper identifies the private limits to the implicit service contract between professions and such client populations. These become evident in how private solutions to competing priorities within professional families inform their selective mobility and thus create the public problem for such communities. The paper reports on a survey of doctors, nurses, teachers and police with responsibility for school-aged children in Queensland that plumbed the strength of neoliberal values in their educational strategy and their commitment to the public good in career decisions. The quantitative analysis suggested that neoliberal values are not necessarily opposed to a commitment to the public good. However, the qualitative analysis of responses to hypothetical career opportunities in rural and remote communities drew out the multiple intertwined spatial and temporal limits to such public service, highlighting the priority given to educational strategy in these families’ deliberations. This private/public nexus poses a policy problem on multiple institutional fronts.