914 resultados para Public Sector Mental Health Services


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This research project set out to explore Unitary Authority (UA) involvement in festivals and special events across Wales. It considers the level and nature of UA involvement and investigates activity by event purpose; reasons for, and characteristics of, UA engagement; and, crucially, the extent and nature of event evaluation. The study’s aim was to begin the development of a baseline of information for further research into the growing use of festivals and special events as a strategy for local economic development in Wales. A quantitative survey approach facilitated a comprehensive snapshot of UA responses whilst also incorporating discursive elements. A telephone survey was designed and undertaken with representatives of all 22 UA departments responsible for festivals and events in Wales. The research reveals a significant level of festival and special event activity across Wales, supported primarily for its perceived socio-cultural value. However, evaluation would appear to be focused on improving processes and measuring economic outputs rather than assessing whether socio-cultural objectives are being achieved. Whilst overwhelmingly positive about efforts to improve approaches to evaluation, respondents held clear views about the complications most likely to hamper any such efforts. These responses focused upon the need for flexibility, cost effectiveness and comparability across festival and special event typologies.

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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

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Since the 1980s, in Australia and other developed nations, public sector management philosophies and how the public sector is organized have changed dramatically. At the same time, there have been many demands, and several attempts, to preserve and promote ethical behaviour within the public sector - though few go much beyond the publication of a code. Both developments require an understanding of how public organizations operate in this new environment. Organizational and management theory are seen as providing important potential insights into the opportunities and pitfalls for building ethics into the practices, culture and norms of public organizations. This book brings together the experience and research of a range of "reflective practitioners" and "engaged academics" in public sector management, organizational theory, management theory, public sector ethics and law. It addresses what management and organization theory might suggest about the nature of public organizations and the institutionalization of ethics.

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The decision as to which procurement system to adopt is a complex and challenging task for clients of construction projects. Despite a plethora of tools and techniques available for selecting a procurement method, clients are still uncertain about what method to adopt for a given construction project to achieve success. This paper examines ‘how and why’ procurement methods are selected by public sector clients in Queensland (QLD) and Western Australia (WA). Findings from workshops with senior managers in procurement selection revealed that traditional lump sum methods (TLS) are preferred even though alternative forms could be better suited for a given project. Participants of the workshops agreed that alternative procurement forms should be considered for projects but an embedded culture of uncertainty avoidance meant the selection of TLS methods. It was perceived that only a limited number of contractors operating in the marketplace have the resources and experience to deliver projects using the non-traditional methods.

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Aboriginal women are treated differently by non-indigenous health care providers based on perceptions of Aboriginality and skin colour and white race privilege within health care environments. The experiences shared below are from some of the Aboriginal woman respondents in a research project undertaken within Rockhampton, a regional area in Central Queensland (Fredericks, 2003). The experiences give an insight into how the Aboriginal women interviewed felt and their observations of how other Aboriginal women were treated within health care settings based on skin colour and perceptions of Aboriginality. A number of the women demonstrated a personal in-depth analysis of the issues surrounding place, skin colour and Aboriginality. For example, one of the women, who I named Kay, identified one particular health service organisation and stated that, ‘it is a totally white designed space. There is nothing that identifies me to that place. I just won’t go there as a client because I don’t feel they cater for me as a black woman’. Kay’s words give us an understanding of the reality experienced by Aboriginal women as they move in and out of places within health environments and broader society. Some of these experiences are examples of direct racism, whilst other examples are subtle and demonstrate how whiteness manifests and plays out within places. I offer acknowledgement and honour to the Aboriginal women who shared their stories and gave me a glimpse of their realities in the research project from which the findings presented in this chapter are taken. It is to this research project that is the subject of this chapter.

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Purpose: The determination of the most appropriate procurement system for a capital works project is a challenging task for public sector clients considering the array of assessment criteria that are considered and the procurement methods that are available. This is particularly pertinent to the Western Australian public sector where they have had a propensity to use traditional lump sum as the default procurement solution despite knowing that the selection of an inappropriate procurement method may lead to cost and time overruns, claims, and disputes’ on projects. This paper presents a six step procurement method evaluation approach that requires public sector agencies to consider in detail an array of options so as to obtain value for money. Design/methodology/approach: A procurement evaluation approach is developed and is examined using a focus group of 12 participants comprising of a public sector client, project team and key stakeholders. The focus group was used to examine the developed approach in the context of a real-life capital works project. Findings: The procurement method evaluation approach was deemed to be pragmatic and enabled decision-makers to re-evaluate outcomes from previous steps in the process. All focus group participants stated the six step process enabled a recommendation that was grounded in reflection and detailed evaluation. Practical implications: The developed procurement approach has enabled the public sector client evaluate the way in which they view procurement method selection and examine how they obtain ‘value for money’. Originality/value: The six step procurement approach makes use of quantitative and qualitative techniques and is reliant on discourse and reflection in making a procurement method recommendation. Consequently, the approach enables public sector clients to account for the complexities often associated with procurement selection.

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Purpose: Choosing the appropriate procurement system for construction projects is a complex and challenging task for clients particularly when professional advice has not been sought. To assist with the decision making process, a range of procurement selection tools and techniques have been developed by both academic and industry bodies. Public sector clients in Western Australia (WA) remain uncertain about the pairing of procurement method to bespoke construction project and how this decision will ultimately impact upon project success. This paper examines ‘how and why’ a public sector agency selected particular procurement methods. · Methodology/Approach: An analysis of two focus group workshops (with 18 senior project and policy managers involved with procurement selection) is reported upon · Findings: The traditional lump sum (TLS) method is still the preferred procurement path even though alternative forms such as design and construct, public-private-partnerships could optimize the project outcome. Paradoxically, workshop participants agreed that alternative procurement forms should be considered, but an embedded culture of uncertainty avoidance invariably meant that TLS methods were selected. Senior managers felt that only a limited number of contractors have the resources and experience to deliver projects using the nontraditional methods considered. · Research limitations/implications: The research identifies a need to develop a framework that public sector clients can use to select an appropriate procurement method. A procurement framework should be able to guide the decision-maker rather than provide a prescriptive solution. Learning from previous experiences with regard to procurement selection will further provide public sector clients with knowledge about how to best deliver their projects.