School of Social and Political Sciences - Research Publications
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ItemExploring productivity and collaboration in Australian Indigenous health research, 1995-2008(BMC, 2013-11-08)BACKGROUND: Building research capacity in Indigenous health has been recognised as integral in efforts to reduce the significant health disparities between Indigenous and other Australian populations. The past few decades have seen substantial changes in funding policy for Australian Indigenous health research, including increases in overall expenditure and a greater focus on collaborative and priority-driven research. However, whether these policy shifts have resulted in any change to the structure of the research workforce in this field is unclear. We examine research publications in Australian Indigenous health from 1995-2008 to explore trends in publication output, key themes investigated, and research collaborations. METHODS: A comprehensive literature search was undertaken to identify research publications about Australian Indigenous health from 1995-2008. Abstracts of all publications identified were reviewed by two investigators for relevance. Eligible publications were classified according to key themes. Social network analyses of co-authorship patterns were used to examine collaboration in the periods 1995-1999, 2000-2004 and 2005-2008. RESULTS: Nine hundred and fifty three publications were identified. Over time, the number of publications per year increased, particularly after 2005, and there was a substantial increase in assessment of health service-related issues. Network analyses revealed a highly collaborative core group of authors responsible for the majority of outputs, in addition to a series of smaller separate groups. In the first two periods there was a small increase in the overall network size (from n = 583 to n = 642 authors) due to growth in collaborations around the core. In the last period, the network size increased considerably (n = 1,083), largely due to an increase in the number and size of separate groups. The general size of collaborations also increased in this period. CONCLUSIONS: In the past few decades there has been substantial development of the research workforce in Indigenous health, characterised by an increase in authors and outputs, a greater focus on some identified priority areas and sustained growth in collaborations. This has occurred in conjunction with significant changes to funding policy for Indigenous health research, suggesting that both productivity and collaboration may be sensitive to reform, including the provision of dedicated funding.
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ItemQuasi-Markets and Service Delivery Flexibility Following a Decade of Employment Assistance Reform in Australia(CAMBRIDGE UNIV PRESS, 2011-10-01)In 1998, we were witnessing major changes in frontline social service delivery across the OECD and this was theorised as the emergence of a post-Fordist welfare state. Changes in public management thinking, known as New Public Management (NPM), informed this shift, as did public choice theory. A 1998 study of Australia’s then partially privatised employment assistance sector provided an ideal place to test the impact of such changes upon actual service delivery. The study concluded that frontline staff behaviour did not meet all the expectations of a post-Fordist welfare state and NPM, although some signs of specialisation, flexibility and networking were certainly evident (Considine, 1999). Ten years on, in 2008, frontline staff working in Australia’s now fully privatised employment sector participated in a repeat study. These survey data showed convergent behaviour on the part of the different types of employment agencies and evidence that flexibility had decreased. In fact, in the ten years between the two studies there was a marked increase in the level of routinisation and standardisation on the frontline. This suggests that the sector did not achieve the enhanced levels of flexibility so often identified as a desirable outcome of reform. Rather, agencies adopted more conservative practices over time in response to more detailed external regulation and more exacting internal business methods.
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ItemNETWORKS AND INTERACTIVITY Ten years of street-level governance in the United Kingdom, the Netherlands and Australia(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2012-01-01)The systemic reform of employment services in OECD countries was driven by New Public Management (NPM) and then post-NPM reforms, when first-phase changes such as privatization were amended with ‘joined up’ processes to help manage fragmentation. This article examines the networking strategies of ‘street-level’ employment services staff for the impacts of this. Contrary to expectations, networking has generally declined over the last decade. There are signs of path dependence in networking patterns within each country, but also a convergence of patterns for the UK and Australia, but not The Netherlands. Networking appears to be mediated by policy and regulatory imperatives.
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ItemFront-line work in employment services after ten years of New Public Management reform: Governance and activation in Australia, the Netherlands and the UK(Sage Publications, 2010)This study examines the impact of administrative reforms upon the work of front-line staff in the employment services of three reform-oriented countries – Australia, the Netherlands and the United Kingdom. These changes have involved greater use of private agents, more detailed performance contracts, clearer expectations about outcomes for job-seekers, and increased competition between agencies seeking government work. The study compares the work characteristics and strategies of front-line staff in agencies in the three systems in 2008 and a decade earlier, using surveys. The results show that there are substantial differences in the level of tailoring and investment in these countries. There are three relatively stable modes of governance in these cases and the most stable of these types across countries and across time is what we term the corporate-market mode – more generally labelled New Public Management (NPM). Despite the expectations of theorists and of reformers, the role of network governance proves neither as stable nor as generalised as expected.
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ItemA network approach for researching partnerships in health.(Springer Science and Business Media LLC, 2005-10-07)BACKGROUND: The last decade has witnessed a significant move towards new modes of governing that are based on coordination and collaboration. In particular, local level partnerships have been widely introduced around the world. There are few comprehensive approaches for researching the effects of these partnerships. The aim of this paper is to outline a network approach that combines structure and agency based explanations to research partnerships in health. Network research based on two Primary Care Partnerships (PCPs) in Victoria is used to demonstrate the utility of this approach. The paper examines multiple types of ties between people (structure), and the use and value of relationships to partners (agency), using interviews with the people involved in two PCPs--one in metropolitan Melbourne and one in a rural area. RESULTS: Network maps of ties based on work, strategic information and policy advice, show that there are many strong connections in both PCPs. Not surprisingly, PCP staff are central and highly connected. Of more interest are the ties that are dependent on these dedicated partnership staff, as they reveal which actors become weakly linked or disconnected without them. Network measures indicate that work ties are the most dispersed and strategic information ties are the most concentrated around fewer people. Divisions of general practice are weakly linked, while local government officials and Department of Human Services (DHS) regional staff appear to play important bridging roles. Finally, the relationships between partners have changed and improved, and most of those interviewed value their new or improved links with partners. CONCLUSION: Improving service coordination and health promotion planning requires engaging people and building strong relationships. Mapping ties is a useful means for assessing the strengths and weaknesses of partnerships, and network analysis indicates concentration and dispersion, the importance of particular individuals, and the points at which they will fragment. A narrative approach adds an assessment of whether the partnerships are being used and valued. The approach outlined here, which examines structure and agency as separate but related explanations, has much to offer in examining partnerships.
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ItemInnovation and innovators inside government: From institutions to networks(WILEY, 2007-10)Innovation and innovators inhabit an institutional space, which is partially defined by formal positions and partially by informal networks. This article investigates the role of politicians and bureaucrats in fostering innovation inside government and provides an empirical explanation of who the innovators are, whether this is mostly an attribute of position or role, or mostly an effect of certain forms of networking. The study uses original data collected from 11 municipal governments in Australia in order to define and describe the normative underpinnings of innovation inside government and to show the importance of advice and strategic information networks among politicians and senior bureaucrats (n = 947). Social network analysis is combined with conventional statistical analysis in order to demonstrate the comparative importance of networks in explaining who innovates.
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ItemBeing around and knowing the players: Networks of influence in health policy(PERGAMON-ELSEVIER SCIENCE LTD, 2006-05)The accumulation and use of power is crucial to the health policy process. This paper examines the power of the medical profession in the health policy arena, by analysing which actors are perceived as influential, and how influence is structured in health policy. It combines an analysis of policy networks and social networks, to examine positional and personal influence in health policy in the state of Victoria, Australia. In the sub-graph of the influence network examined here, those most widely regarded as influential are academics, medically qualified and male. Positional actors (the top politician, political advisor and bureaucrat in health and the top nursing official) form part of a core group within this network structure. A second central group consists of medical influentials working in academia, research institutes and health-related NGOs. In this network locale overall, medical academics appear to combine positional and personal influence, and play significant intermediary roles across the network. While many claim that the medical profession has lost power in health policy and politics, this analysis yields few signs that the power of medicine to shape the health policy process has been greatly diminished in Victoria. Medical expertise is a potent embedded resource connecting actors through ties of association, making it difficult for actors with other resources and different knowledge to be considered influential. The network concepts and analytical techniques used here provide a novel means for uncovering different types of influence in health policy.
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ItemChanging professions - General Practitioners' perceptions of autonomy on the frontline(SAGE PUBLICATIONS LTD, 2003-03)Professional autonomy is a much-used concept which has operated with scant empirical attention directed at understanding its meaning among practitioners. This study investigates how General Practitioners (GPs) understand their professional autonomy, and what they perceive to be the main threats to it. Four focus groups were attended by 25 GPs in Melbourne. We found that GPs aspire to an ‘ideal type’ of professional who has the freedom to determine what is best for patients, but they believe their autonomy is threatened by financial constraints, greater accountability requirements, and more demanding patients. These findings reveal how GPs understand autonomy in their practice, and indicate that their concerns may have little to do with the deprofessionalization and proletarianization theses. Micro-level studies of GPs in the workplace, combined with greater understandings of different aspects of professional autonomy, appear useful in understanding how GPs’ work and autonomy is changing.