Laying the foundations for innovative and sustainable policy
Evidence Based Policy Making 2009
28–29 October 2009
Attended by Libby Kalucy, PHC RIS
The credible well positioned speakers at this valuable conference provided diverse perspectives on evidence and policy to an audience which seemed to come mainly from the policy sector.
The term ‘evidence informed’ policy is more realistic and appropriate than the deterministic ‘evidence based’ which assumes that evidence is the only basis for policy. Most speakers referred to the fact that the Prime Minister Kevin Rudd has openly espoused the use of evidence in policy, which suggests the current Australian government is receptive to evidence in its policy decisions.
Broad definitions of evidence were the rule rather than the exception. Evidence took many forms, including research findings, data and modelling, views of stakeholders and public, public submissions and surveys and overseas example of similar problems. Evidence must be fit for purpose, but is always incomplete.
One speaker referred to ‘synthesised empirical knowledge’ rather than gold standard experimental evidence. Terry O’Brien, Deputy Commission of the Productivity Commission concluded:
- The circumstances suited to a randomised controlled trial are not universal.
- No method of evaluation is a substitute for careful thought.
- Quantify where possible
Policy questions take the form of ‘what is the problem? How big is the problem? What would be the impact of change in policy?’ Advisors need to agree on dimensions of problem, reliable data sources, priorities for action, understand what else is in place, and be able to answer the proposition: ‘what difference will it make?’
Evidence can be generated by policy: the first stages of an incremental approach can be used as an experiment in Australia to build evidence to be used in later steps of policy. Policy implementation can thus reduce margin of error, producing better odds of good results.
Among many other ideas the conference addressed were: where evidence fitted into the policy process, the lack of incentives for researchers, policy preferences for interacting with researchers, and ways to obtain evidence despite tight timelines.
Claiming the space: Shaping the future of primary health care
AGPN National Forum 2009
4–7 November 2009
Attended by Libby Kalucy, PHC RIS
AGPN forum debates health reform
A good forum provides material and opportunity for debate and discussion. Reform was a dominant theme at all plenary sessions of this well organised Forum in Sydney in November 2009. The diverse perspectives shown by the following quotes stimulated vigorous debate among more than 1 000 delegates.
“The Rudd government will not shy away from reform because it can’t be done quickly or easily”. The Minister of Health, Nicola Roxon acknowledged it was rare in health to have profession-led change, and congratulated the Divisions for their role in shaping and leading change, taking the reform agenda in both hands. The Minister is aware of consistencies and differences between the feedback she hears at extensive consultations, which have been useful to identify the likely responses from different areas of the health sector.
“Be aware and be very scared… The health workforce need to be engaged and convinced for reform to work, and need to be driving the change process”. Dr Mukesh Haikerwal, former commissioner, National Health and Hospitals Reform Commission.
“Look before you leap into a poorly defined future”. Professor Philip Davies, former senior executive in the Australian Government Department of Health and Ageing, outlined his concerns with the specifics of the approach and the impact on Divisions. If the role of the Primary Health Care Organisations (PHCOs) was to focus on coordination and planning, accountable to the community not to members, they could not have a role in providing support services for service providers
“Reform is not a modification of a failing system”. Professor Dennis Pashen, President of Australian College of Rural and Remote Medicine reinforced the importance of professionals owning the reform agenda.
“Never trust politicians – never trust public servants as your friends. They march to the beat of a different drum. Be very very careful”. Dr Michael Bollen, GP politician involved with the inception of Divisions.
“If you don’t like the technical aspects, use it to give energy. Reform can be used to energise the sector, towards more responsiveness and accountability”. Dr David Colin Thomé, National Director of Primary Care, Department of Health, UK.
See <www.gpnetworkforum.com.au/call-for-abstracts> for further details of presentations.
Health services research: Reforming, responding, rewarding
6th Health Services and Policy Research Conference 2009
24-27 November 2009
Attended by Eleanor Jackson Bowers and Rachel Katterl, PHC RIS
The Health Services Research Association of Australia & New Zealand (HSRAANZ) Conference, held in Brisbane on 24-27 November 2009 was a full and varied event with much to interest health researchers and those who use research. A major theme was health reform and the presence of keynote speakers from the USA, Canada, New Zealand and the Netherlands, provided lively discussion and many opportunities for learning.
Speakers included James Morone, from the USA, author of the book Hell Fire Nation, who gave an entertaining talk on the challenges of health reform in the US as they try to push universal health care legislation through congress. Every healthcare debate is about who we think we are as a society and this theme was taken up by other speakers with Gert Westert, from the Netherlands reflecting that one word to describe their culture of healthcare is ‘solidarity’. Deborah Roche from the Ministry of Health in NZ described the prominence of the concept of ‘community’ within their healthcare system.
We heard many other informative presentations. Sharon Wilcox, past member of the National Health and Hospitals Reform Commission (NHHRC) provided the historical context for health reform in Australia. Jackie Cumming from NZ gave some findings about the Primary Health Organisations from the evaluation of their Primary Health Care Strategy. Colleen Flood from Canada described their Best Brain Consultations which bring together a group of experts and policy makers to discuss a policy related subject in private, which are ‘a wild success’. The Australian Primary Health Care Research Institute (APHCRI) reviewed the findings of some systematic reviews, and we also attended a session on mental health which gave evaluations of the Better Access initiative, the Suicide Prevention pilot of the Better Outcomes Initiative, Headspace and the Access to Allied Psychological Services (ATAPS) projects, and a great many more presentations which will feed into our work at PHC RIS. It was a great conference: thank you to the organisers and to the many enthusiastic presenters.
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