Authors:
Christine Jorm, Margaret Banks & Sara Twohill
https://clinicalgate.com/the-changing-dynamic-of-policy-and-practice-in-australian-healthcare/
Introduction
Managing clinical work to achieve the best possible quality of care requires systems to be established and information to be shared. Policy is a mechanism through which these ends can be realised, and while often defined in a formal sense as a blueprint of intentions, health policy can also be described informally as the ‘courses of action that affect that set of institutions, organisations, services and funding arrangements’ in the healthcare system (Palmer & Short 2000:2). Recent policy in Australia has been directed to health system reform, but ‘good policy intentions’ are often hampered by complex funding and governance arrangements, specifically, in the case of Australia, by the politics of federalism where both state and federal levels of government share responsibility for health services. The duplication and division that shared responsibility brings impedes reform (Willis et al 2005), and the funding provided by the Commonwealth to state public hospitals via the Australian Healthcare Agreements (negotiated between both levels of government) provides the Commonwealth with opportunities to influence the shape and direction of reform. There is no easy ‘solution’ to the federal–state issue, although redesign efforts are occurring at multiple levels in the system to better link funding models with incentives for improved outcomes (Swerissen & Duckett 2002). The difficulty remains in determining which outcomes are chosen, how they are measured and the incentives and sanctions offered.