Tenure, mobility and retention of nurses in Queensland, Australia: 2001 and 2004

[Abstract]: Aim: Data were collected on tenure, mobility and retention of the nursing workforce in Queensland to aid strategic planning by the Queensland Nurses’ Union. Background: Shortages of nurses negatively affect the health outcomes of patients. Population rise is increasing the demand for nurses in Queensland. The supply of nurses is affected by recruitment of new and returning nurses, retention of the existing workforce and mobility within institutions. Methods: A self-reporting, postal survey was undertaken of Queensland Nurses Union members from the major employment sectors of aged care, public acute and community health and private acute and community health. Results: Only 60% of nurses had been with their current employer more than five years. In contrast 90% had been nursing for five years or more and most (80%) expected to remain in nursing for at least another five years. Breaks from nursing were common and part-time positions in the private and aged care sectors offered flexibility. Conclusion: The study demonstrated a mobile nursing workforce in Queensland although data on tenure and future time in nursing suggested that retention in the industry was high. Concern is expressed for replacement of an aging nursing population

The geographic distribution of private health insurance in Australia in 2001

Background Private health insurance has been a major focus of Commonwealth Government health policy for the last decade. Over this period, the Howard government introduced a number of policy changes which impacted on the take up of private health insurance. The most expensive of these was the introduction of the private health insurance rebate in 1997, which had an estimated cost of $3 billion per annum. Methods This article uses information on the geographic distribution of the population with private health insurance cover to identify associations between rates of private health insurance cover and socioeconomic status. The geographic analysis is repeated with survey data on expenditure on private health insurance, to provide an estimate of the rebate flowing to different socioeconomic groups. Results The analysis highlights the strong association between high rates of private health insurance cover and high socioeconomic status and shows the substantial transfer of funds, under the private health insurance rebate, to those living in areas of highest socioeconomic status, compared with those in areas of lower socioeconomic status, and in particular those in the most disadvantaged areas. The article also provides estimates of private health insurance cover by federal electorate, emphasising the substantial gaps in cover between Liberal Party and Australian Labor Party seats. Conclusion The article concludes by discussing implications of the uneven distribution of private health insurance cover across Australia for policy formation. In particular, the study shows that the prevalence of private health insurance is unevenly distributed across Australia, with marked differences in prevalence in rural and urban areas, and substantial differences by socioeconomic status. Policy formation needs to take this into account. Evaluating the potential impact of changes in private health insurance requires more nuanced consideration than has been implied in the rhetoric about private health insurance over the last decade.John Glover, Sarah Tennant and Stephen Ducket

Leaks, legislation and freedom of speech: how can the law effectively promote public interest whistleblowing

In this article we outline the differences between leaking and whistleblowing, and provide possible justifications for leaking. We argue that, as a matter of principle, leaking information outside an organization will normally not further any public interest and should only be used as a last resort where problems have not been resolved internally. As uncontrolled leaking may be hazardous, we believe that the opportunity to blow the whistle in accordance with structured procedures offers a more satisfactory mechanism for exposing financial and other forms of wrongdoing (Carr and Lewis 2010). Next we describe how freedom of speech, whistleblowing legislation and internal reporting procedures provide alternatives to leaking and explain how they all operate unsatisfactorily in certain respects. In our analysis we refer to international conventions and the laws of four countries (USA, UK, France and Germany) that we consider representative of the different approaches to the treatment of whistleblowers. In conclusion, we suggest that regimes which are aimed at encouraging public interest disclosures through organizational insiders need improvement. Without this, unauthorized leaking could be tolerable in certain situations. Finally, we observe that public interest disclosure regimes need to take the human right dimension into accoun

United Nations Sustainable Development Goals: Promoting health and well-being through physical education partnerships

The United Nations recently approved the Sustainable Development Goals (SDGs) which forms a guideline policy for all nations. While the UN have strongly advised that partnerships are essential for the implementation of these global goals, within local communities there is little evidence of how this is best done or what it looks like in practice. This paper shares a health and wellbeing community initiative that achieves goals three and four of the SDGs, and in doing so models how to implement physical education partnerships as advocated by the UN. The highly successful innovative initiative is “Best Start: A community collaborative approach to lifelong health and wellness” (2011–2014).This paper shares a health and wellbeing partnership, modelling implementation of physical education (PE) advocated by the United Nations (UN). The Sustainable Development Goals (SDGs) exemplifies global efforts towards equality, specifically Goal 3 and 4 address health and wellbeing. The purpose of this paper is to provide insights into cross sector “partnerships”, identified as essential for the implementation of the SDGs. This is significant as the UN acknowledge a present gap of information on partnerships in action and a need for reporting from the ground level. The project “Best Start: A community collaborative approach to lifelong health and wellness”, began as a partnership between a university and nearby schools and quickly grew to involve Australian Registered Training Organisations, the local health industry, Education departments and sport governing bodies. The collaborations involved pre-service teachers teaching Health and PE lessons to children in a disadvantaged socio-economic area, creating valuable learning experiences for stakeholders. Local and global communities were involved in research and reform. The project creatively optimised resources available through state, Australian and international connections. International partnerships enabled identification of unique contextual opportunities. Programme planning was strengthened with data gathered from an England and Wales Ofsted awarded Primary Physical Education course. Various methods, including; semi-structured interviews, reflective journal, observations, document analysis, and Student Evaluation of Teaching Units (SETU) were adopted. SETU is valid and reliable data collected by the university for the purposes of research. The findings support that partnerships enable SDG implementation and the research paper offers direction for localisation

Economic hardship associated with managing chronic illness: a qualitative inquiry

<p>Abstract</p> <p>Background</p> <p>Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness.</p> <p>Methods</p> <p>Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66). Content analysis guided the interpretation of data.</p> <p>Results</p> <p>The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in self-management and risk reduction behaviours. Factors exacerbating hardship included ineligibility for government support, co-morbidity, health service flexibility, and health literacy. Participants who were on multiple medications, from culturally and linguistically diverse or Indigenous backgrounds, and/or not in paid employment, experienced economic hardship more harshly and their management of chronic illness was jeopardised as a consequence. Economic hardship was felt among not only those ineligible for government financial supports but also those receiving subsidies that were insufficient to meet the costs of managing long-term illness over and above necessary daily living expenses.</p> <p>Conclusion</p> <p>This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity of a critical analysis of health, social and welfare policies to identify cross-sectoral strategies to alleviate such hardship and improve the affordability of managing chronic conditions. In a climate of global economic instability, research into the economic impact of chronic illness on individuals' health and well-being and their disease management capacity, such as this study, provides timely evidence to inform policy development.</p

The contested place of religion in the Australian Civics and Citizenship curriculum: exploring the secular in a multi-faith society

In the absence of a dedicated subject for teaching general religious education, the inclusion of Civics and Citizenship education as a new subject within the first Federal Australian Curriculum provides an important opportunity for teaching the religious within Australian schools. The curriculum for Civics and Citizenship requires students to learn that Australia is both a secular nation and a multi-faith society, and to understand religions practiced in contemporary Australia. The term "secular" and the need for students to learn about Australia’s contemporary multi-faith society raise some significant issues for schools and teachers looking to implement Civics and Citizenship. Focusing on public (state-controlled) schools, the argument here draws on recent analysis within the Australian context (Byrne, 2014; Maddox, 2014) to suggest that religion remains an important factor in understanding and shaping democratic citizenship in Australia, that this should be acknowledged within public schools, and that a constructivist, dialogical-based pedagogy provides possibilities for recognising the religious within Civics and Citizenship education