Understanding Network Governance: A Case Study Exploration of Active Canada 20/20

Consistent with the governance shift towards network forms of governance, a number of new social movements have formed in response to the declining levels of physical activity in the Western world. One such movement is Active Canada 20/20: A Physical Activity Strategy and Change Agenda for Canada. Network governance is employed as the theoretical framework for this case study exploration of Active Canada 20/20 and the political landscape surrounding its development and implementation. Semi-structured interviews were conducted in addition to document/policy analysis and direct observations. Analysis of the data resulted in three overarching themes – the defining characteristics of network governance, the political landscape, and intersectoral linkages – that interconnect multifariously based the nature of the Canadian federal government and its relationship with the voluntary sector for physical activity. Despite progress in driving Active Canada 20/20 forward, entrenched dynamics of power need to be navigated within the political landscape surrounding network governance.

The Canada Not For Profit Corporations Act: Perceived impact on the governance of federal sport organizations

This thesis examined the impact of the Canada Not-for-Profit Corporations Act (2009) on the governance of national sport organizations (NSO). The impact of the legislation was explored through the perceptions of NSO executive leaders and by analyzing the by-laws in effect before the legislation. The legislation was perceived to have the greatest impact on enhancing accountability, specifically affecting membership categories and director selection. The interview data showed that the legislation was necessary to enhance accountability in many NSOs. The Respondents also demonstrated that they understood the goals sought through the legislation. The data also showed that the boards of NSOs were already in alignment with the goals of the legislation. With respect to governance, the data indicated that NSOs rely almost exclusively on their regional sport associations as voting stakeholders. An emerging issue that came out of the results was the role of athletes in the governance of sport organizations.

Electronic waste governance: sustainable solutions to a global dilemma

Le présent mémoire a pour objet les formes, les caractéristiques et les défis de la gouvernance des déchets électroniques. L’auteure explore les impactes socioéconomiques et environnementales de divers types d’instruments conçus pour mitiger les risques à la santé humaine et à l’environnement que présentent les produits électroniques en fin de vie, notamment: les traités multilatéraux qui visent à prohiber le transfert des déchets hasardeux au pays en développement, les législations régionales, nationales et provinciales mettant en vigueur des systèmes de recyclage obligatoire des déchets électroniques, ainsi que d’autres initiatives, publics et privées, basées sur le principe de la responsabilité élargie des producteurs (REP). L’objectif de ce travail est de comprendre comment les acteurs impliqués dans le commerce de l’équipement électronique peuvent modeler les systèmes de production, d’usage et du traitement fin de vie des technologies contemporaines pour que ces dernières puissent continuer à faire élever les standards de vie et à avancer le développement des communautés humaines, en respectant simultanément le principe international de l’équité globale, l’environnement naturel et la qualité de vie des générations futures.

An Ethic of Connectedness: Book Review of The Connected Self: The Ethics and Governance of the Genetic Individual

Compte-rendu / Review

”Public Health Protection through Air Quality Controls”

Health is an important aspect of everybody’s life. Today, there is an increasing recognition and commitment to the pursuit of health both within government and beyond. Any attempt on the part of the " State to protect and promote people’s health, in turn, must be accompanied by effective controls on air quality, as air constitutes ‘ one of the important elements of man’s life and the consequences of air pollution covers a very wide spectrum ranging from material ---damage to personal discomfort and illness. The broad social and economic objectives adumbrated in the Directive Principles of State Policy including the commitment to improve public health underlying in Article 47 and the obligation to preserve and protect-the natural environment cast under Article 48A of the Constitution are being used as versatile weapons by the State to regulate the public health scenario. Preservation and maintenance of air quality is a significant area within the sphere of public health, where the regulatory arm of the law is not adequately touched and in this arena urgent State intervention through legislative and administrative action is called for in the well-being of the society. Judiciary also plays a pivotal role in this arena in the larger interest of the society and for the benefit of the present and future generations. The research study is an attempt to analyze how far the existing legal system, for maintaining air quality and in controlling air pollution, is effective in protecting public health. The study also analyzes the limitations of the control mechanisms. The study focuses on industrial air pollution, indoor and personal air pollution, vehicular pollution and noise pollution which are today appearing as the major public health hazards affecting the air quality. However, this is not to overlook the importance of controls required under other areas of public health.

Clinical Governance podcast.

Interview with Anne Baileff by Trevor Kettle

research governance framework

new version with modified Mental Health Act link

Roles of the non-medical prescribing leads within organisations across a Strategic Health Authority: perceived functions and factors supporting the role

Objectives Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. Methods Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. Key findings In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. Conclusion The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.

Il/legitimate risks? Occupational health and safety and the public in Britain, c. 1960-2015

The last 20 years have seen the emergence of a popular climate of antipathy towards occupational health and safety regulation within the UK, particularly within the mainstream British media. The governance of health and safety has thus in recent years become an increasingly visible and contested public and political issue. The extent of this contestation, and its impact on the State’s governance of health and safety in the workplace and beyond, is explained and historicized within this chapter. Why has public rhetoric about health and safety apparently become so important in framing the ways in which the State could legitimately act in recent years? The chapter demonstrates how since 1960 the State remained a significant player – one among many, admittedly – and that while its roles in managing health and safety had long been bounded by a number of factors, a variable that emerged with particular saliency over the last 20 years has been a mediated notion of ‘public opinion’. This focus serves to remind us of the ways in which State action has at certain moments been pushed in particular directions by factors beyond formal mechanisms of rule.

Pharmaceuticals in Australia: developments in regulation and governance

The pharmaceutical domain represents a type of internationalised policy network theorised in recent writings on neo-liberalism, neo-corporatism and governance. This article presents an analysis of developments in prescription drug regulation in Australia. A relatively stable, state-managed pattern of interaction has been superseded by less closed exchange, and the government itself has fragmented into agencies pursuing different objectives. Developments in the three core regulatory areas are described: safety and efficacy controls, social policy (access and equity), and state support for industry (economic) development. Consensus-building occurs within the context of the National Medicines Policy. The pharmaceutical industry, represented by Medicines Australia, has a stake in all aspects of pharmaceutical policy and regulation, and draws upon unique resources (expertise and lobbying capacity). The context for the developments described is Australia's abandonment of a protectionist version of the Keynesian welfare national state in favour of the model of the competition state, which is oriented towards support for the growth of high technology industries such as pharmaceuticals, premised on partnerships with business.

Issues in developing e-health systems: an Australian case study

Over the last few years, perceptions of the importance of eHealth have increased rapidly, together with the use of IS&T in the delivery of health and social services. Although “e” approaches to health and social services have much potential, they are not panaceas, and the use of new technologies in improving the efficiency and effectiveness of such systems cannot be considered in isolation from their wider context. eHealth systems remain complex socio-organisational systems and, as we will argue and illustrate through this case study, require that a balanced approach to feasibility and desirability analysis be taken.

The case study in this paper describes a feasibility study into the potential effectiveness of a smartdevice-based electronic data collection and payment system which was proposed for the provision of disability services. A key finding of the study was that the most significant impediment to such a system was the highly diffused, fragmented, interlocking organisational structure of the social service administration itself. Rather than raise issues specific to the implementation or diffusion of new technologies in designing e-health services, it raised issues associated with decision making and control in such an environment, and with the design of the underlying organisational system: for service provision, the level of detail required in the service data, and the locus of decision-making power among the stakeholders.

In our account we illustrate the existence of multiple, incommensurate but valid perceptions of the human service provision problem, and discuss the implications for developers or managers of information systems in the arena of e-health or governance. We examine this environment from sociological and information systems perspectives, and confirm the usefulness of socio-organisational approaches in understanding such contexts.

The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster

Folate fortification : a case study of public health policy-making

Introducing Evidence Based Health Policy: Problems and Possibilities, Section 1: What is the Problem?, 1: Competing Rationalities: Evidence based Health Policy, 2: Beyond Two Communities, Section 2: What does Evidence Mean?, 3: Evidence based Medicine - The Medical Profession and Health Policy, 4: Mind The Gap: Assessing the Quality of Evidence for Public Health Problems, 5: Health Policy and Normative Analysis: Ethics, Evidence and Politics, 6: What is New in Health Information? Evidence for Health Consumers and Policy Making, 7: From Evidence based Medicine to Evidence based Public Health, Section 3: Policy Case Studies, 8: The Viagra Affair: Evidence as the Terrain for Competing Partners, 9: Folate Fortification: A Case Study of Public Health Policy-Making in a Food Regulation Setting, 10: The Supply and Safety of Blood and Blood Products - Evidence, Risk and Policy, 11: The Development of Nurse Practitioner Policy, 12: Creating Healthy Public Policy for Oral Health: How was the Evidence Used?, 13: Regulation of Traditional Chinese Medicine in Victoria, 14: The Victorian Primary Health Care Reforms: A Case Study of Evidence-based Policy Making, 15: Evidence-based Practice in the Australian Drug Policy Community, 16: Challenging the Evidence - Women's Health Policy in Australia, 17: Evidence and Aboriginal Health Policy, 18: The Limits to Technical Rationality in the Health Inequalities Policy Process, 19: Evidence-based policy: A Technocratic Wish in a Political World, Section 4: Is the transfer of evidence into policy possible?, 20: The Community Model of Research Transfer, 21: Getting Research Transfer into Policy and Practice in Maternity Care, 22: Improving the Research and Policy Partnership: An Agenda for Research Transfer and Governance, 23: Framing and Taming 'Wicked' Problems

New directions in biodiversity policy and governance? : a critique of Victoria's land and biodiversity white paper

The overall condition of biodiversity in many parts of Australia is poor and declining, despite the establishment of national parks and other reserves, and the adoption of conservation activities on private land. The impacts of climate change add further challenges to sustaining biodiversity. In response to these issues, in December 2009, the State Government of Victoria released a major policy statement that aimed to provide the framework and directions to secure the health of Victoria's biodiversity and associated land and water resources over the next 50 years. Given Victoria's reputation for environmental policy reform and innovation, the question arises as to whether the Victorian approach will provide a model for other Australian jurisdictions to adopt or adapt. Drawing on insights from environmental policy, discourse theory, and ecological theory, this article provides a critique of Victoria's approach, focusing on the way in which biodiversity is conceptualised and governed.

The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis

One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways.