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The residential aged care industry in Australia will expand rapidly over the next 10 years leading to substantial increases in government expenditure. Recent and future reforms are likely leading to changes in the structure of the industry with a potential impact on quality of care. The purpose of this paper is to stimulate broader public debate, based on the available evidence, about the preferred structure of this important industry. It examines the literature on the impact structure has on the quality of services and compares this with a fresh analysis of current trends. The paper argues that future policy should be evidence based and explicit about the structure of the industry that will emerge from current policy reforms. [ABSTRACT FROM AUTHOR]

Aim: This paper will review progress towards the identified targets within the Australian government policy document commonly known as 'Closing the Gap' and examine the role of nurses in supporting its implementation. Background: Australia is not alone in seeking to address the health inequity between Indigenous and non‐Indigenous people. Globally such health inequities are similar and require interventions supported by governments in conjunction with health and education systems to affect desired change. For this reason, it is timely to undertake a review of progress on the impact of the Closing the Gap initiative. Sources of evidence: The Australian national partnership agreement and subsequent annual performance reports issued between 2010 and 2017. Discussion: Targets set within the Australian government national partnership agreement have had a range of success. Those targets not on track require significant long‐term investment to ensure their success. Nurses as a large professional group are powerful advocates to speak up and support policy change that affects disempowered social groups. Conclusion: Long‐term social change takes time, yet without the commitment of Australian Governments through effective policy and economic support, the inequity in the health of Indigenous people will continue both now and in the future. Implications for health and social policy: Nurses, as the largest health professional group, are uniquely placed to support and implement social change at all levels of health care (primary, secondary and tertiary) and to lobby government to amend policy alongside those who are disempowered. Implications for nursing practice: Health promotion and education programmes that are led by nurses can make an impact to health disparities within groups who are most at risk. [ABSTRACT FROM AUTHOR]

With the development of policies specifically relating to rural health and health care provision, it seems apposite to consider evaluating their outcomes. Although little has apparently been done that specifically studies policy or processes, much of rural health research implicitly ‘measures’ policy effects; for example, study of the effects of rural medical education. Given what is known about the policy-making process, rural health researchers should beware of thinking that policy outcome evaluation might be straightforward or that evidence produced from evaluation will seamlessly influence future or evolving policy. Nonetheless, as rural health research and policy mature, it is worth adopting some of the complex approaches to health policy outcome measurement and applying them to understand our field – to find out the extent that policy, and indeed our role and research, have effects on rural health and care provision. In this paper, we identify some of the quirks of policy and policy evaluation and provide examples. [ABSTRACT FROM AUTHOR]

Summary: Effective government policies are crucial to creating healthy food environments. However, changing public policy is a slow and challenging process involving many competing factors. One cited factor is public opinion towards a proposed policy. This study aimed to systematically explore public opinion on regulatory nutrition policy issues in Australia from 2009 to 2019, to determine whether low levels of public opinion corresponded with the low levels of regulatory policy action in this country. We found that there was varying levels of public support in Australia for public health nutrition action. Regulatory‐ and legislative‐based policies generally had moderate to high levels of support except for food and drink taxes, which had low to moderate support. Despite high levels of public support for certain policy initiatives, national public health nutrition policy in Australia has not evolved consistently with the level of public support nor the evidence base over the past decade indicating other more important factors at play in policymaking. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Public support for restrictions on late night trading of licensed venues increased substantially between 2001 and 2013, a period with very few policy interventions in Australia. In early 2014 a set of high profile restrictions were introduced in Sydney, New South Wales. In this study, we examine whether these 2014 policy interventions affected public support for late trading restrictions.Design and Methods: We use data from the National Drug Strategy Household Survey, focussing especially on the 2013 (n = 23 521) and 2016 (n = 23 425) waves. A series of regression models with interaction terms between socio-demographic variable and year were used to examine how trends in support for late trading policies varied between different population groups.Results: Support for late trading restrictions fell substantially between 2013 and 2016-from 2.58 to 2.35 on a 0-4 point scale. In particular, support fell more in New South Wales than in other jurisdictions. Among New South Wales residents, support fell more for middle-aged and older respondents and more for drinkers than non-drinkers.Discussion and Conclusion: Support for late trading restrictions fell sharply, especially among those affected in New South Wales. Advocates for public health-oriented alcohol policy restrictions need to pay attention to public support in the aftermath of policy 'wins'. [ABSTRACT FROM AUTHOR]

Issue Addressed: Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed to underreporting of the problem. The purpose of this study was to investigate food security using the short form of the US Household Food Security Survey Module (HFSSM) within an Australian context; and explore the relationship between food security status and multiple socio-demographic variables.Methods: Two online surveys were completed by 2334 Australian participants from November 2014 to February 2015. Surveys contained the short form of the HFSSM and twelve socio-demographic questions. Cross-tabulations chi-square tests and a multinomial logistic regression model were employed to analyse the survey data.Results: Food security status of the respondents was classified accordingly: High or Marginal (64%, n = 1495), Low (20%, n = 460) or Very Low (16%, n = 379). Significant independent predictors of food security were age (P < 0.001), marital status (P = 0.005), household income (P < 0.001) and education (P < 0.001).Conclusion: Findings suggest food insecurity is an important issue across Australia and that certain groups, regardless of income, are particularly vulnerable. SO WHAT?: Government policy and health promotion interventions that specifically target "at risk" groups may assist to more effectively address the problem. Additionally, the use of a multi-item measure is worth considering as a national indicator of food security in Australia. [ABSTRACT FROM AUTHOR]

Abstract: Australia is one of the few countries which has specific health policies for boys/men and girls/women as distinct groups. In this article I present an analysis of the discourses of gender, equity and disadvantage drawn upon in Australia's men's health policy. Through comparison with the women's health policy, I show that a dual focus on the essential differences between men and women and the ways in which the health system has failed men contribute to an adversarial gender politics, positioning men and women as rivals with competing needs. Reflecting broader debates concerning the negative impact of societal change on boys/men, I argue that, in its current form, Australia's health policy both taps into and, crucially, legitimises backlash politics, enabling it to ‘pass’ as sound public policy. [ABSTRACT FROM AUTHOR]

Issue addressed In order to assess the impact of healthy school canteen policies on food availability for students, valid methods of measuring compliance are needed that can be applied at scale. The aim of this study is to assess the validity and direct cost of four methods to assess policy compliance: 1) principal and 2) canteen manager self-report via a computer-assisted telephone interview; and 3) comprehensive and 4) quick menu audits by dietitians, compared with observations. Methods A cross-sectional study took place in the Hunter region of NSW, Australia, in a sample of 38 primary schools that had previously participated in a randomised controlled trial to improve healthy canteen policy compliance. Policy compliance was assessed using the four methods specified above. Percentage agreement, kappa, sensitivity and specificity compared with observations was calculated together with the direct time taken and costs of each method. Indirect costs (including set-up costs) for all measures have not been included. Results Agreement with observations was substantial for the quick menu audit (kappa=0.68), and moderate for the comprehensive menu audit (kappa=0.42). Principal and canteen manager self-report resulted in poor agreement and low specificity with the gold standard. The self-reported measures had the lowest cost, followed by the quick menu audit and lastly the comprehensive menu audit. Conclusion The quick menu audit represents a valid and potentially low-cost method of supporting policy implementation at scale. So what? This study demonstrates that a quick menu audit represents a valid measure of undertaking assessment of school canteen policy compliance at a population level. [ABSTRACT FROM AUTHOR]

The author comments on the reform on the alcohol and drug treatment policy in Victoria. The topics discussed include the reforms carried out by the government since 1994 to 2014, the developments in the alcohol and other drug (AOD) treatment policy of the government, and the key drivers for the imposed reforms.

Utilisation of public inquiries and royal commissions in Westminster systems of government is a source of continuing interest. That royal commissions continue to be appointed when there is an increasing array of other institutions governments can now employ and given that royal commission reports often have very adverse impacts on the appointing governments, remains a key issue. So the appointment by the Queensland government of not one, but two royal commissions in 2005 into the same topic – the recruitment and performance of doctors recruited abroad working in Queensland public hospitals – provides a special opportunity to analyse the circumstances in which a royal commission mechanism is activated. That one of these royal commissions had to be disbanded because of legal action taken by several of those being investigated is another reason to assess these royal commissions. This is almost without precedent in Australia and has implications for the future conduct of such bodies. Lastly, how the Queensland government was able to minimise the blame from the subsequent royal commission's highly critical report, is also instructive and worthy of assessment. [ABSTRACT FROM AUTHOR]

Aims: To examine the costs, outcomes and cost savings of three models of prenatal cystic fibrosis (CF) carrier screening compared to no screening from a public health sector perspective. Methods: A decision tree was generated to estimate costs and outcomes for each screening model for a hypothetical cohort of 38 000 pregnancies. Sensitivity analysis assessed the impact of model parameter variation. Results: Under baseline assumptions, the initial annual cost to provide a prenatal CF carrier-screening programme is Au$5.32 million, Au$3.35 million and $2.93 million for one-step, two-step simultaneous and two-step sequential screening respectively. Annual costs are significantly lower for an established programme. No screening model provides a net saving over a lifetime horizon; however, the results were sensitive to variation in lifetime cost of care, screening test costs and number of pregnancies per carrier couple. Conclusions: Under some scenarios, prenatal CF carrier screening is cost saving to the health system; however, this is not conclusive and depends on several factors. Cost remains a potential barrier due to the substantial level of funding required in the short term. Feasibility and psychosocial, ethical and legal implications of screening need to be considered. Additionally, consultation is required with the Australian community on the acceptability and/or desire for prenatal CF carrier screening. [ABSTRACT FROM AUTHOR]

The article examines the government policy for obesity in Australia. It characterizes the current policy for obesity in the country as a collective and systematic failure to alter diet, physical activity and culture despite public initiatives by organizations such as International Obesity Task Force and World Health Organization. It demonstrates policy leverage points at which all regulations has potential to prevent obesity problem in the country. The problem on obesity requires the collaboration of many disciplines including from the health sciences such as nutrition science.

The formulation of a health policy in relation to alcohol is described by the Chairman of the Committee responsible for its drafting in the context of Australia's pursuance of a National Campaign Against Drug Abuse. The fate of particular proposals included in the draft document, but excluded from the final endorsed policy, is discussed in relation to the activities of the alcohol industry and, in particular, the intervention of the Minister for Health in South Australia, Australia's premium wine growing region. Inferences are drawn about the negotiation of public health policy in this area, the role of research and the need to demonstrate widespread public support for the recommendations of such research. [ABSTRACT FROM AUTHOR]

The article focuses on how to solve the challenges of workforce shortages and maldistribution for improving primary healthcare (PHC) system by the Australian government.