"Punching above their weight': a qualitative examination of local governments' organisational efficacy to improve the social determinants of health

OBJECTIVE: The World Health Organization calls upon local government worldwide to play a greater role in improving public health by improving the social determinants of health. This research aimed to determine how local governments in Victoria, Australia, conceptualised their organisational efficacy to address public health with reference to their statutory obligations. METHODS: Sixteen in-depth interviews were conducted with Victorian local government health planners. Thematic analysis was used to determine the importance of state health priorities and the perceived organisational efficacy of local government to address health via social determinants. RESULTS: While there were disparities between state and local priorities for health, local government believes it can make an important contribution to improving health through 'upstream' approaches. CONCLUSIONS: Victorian local government has strongly adopted the socio-ecological model of health and is aware of the important role that its diverse policy and program areas play in creating healthy communities. The Victorian State Government's priorities, which adopted a more 'downstream' approach, were less influential. Implications for public health: State governments' priority settings should be responsive to local governments' unique local knowledge of health priorities. There is value in legislating a social determinants role for local government, provided it is supported by state and national government policies that facilitate public health

Project Finance for Public Private Partnerships: Evidence from Australia

© 2016 American Society of Civil Engineers. PPP projects are contractually complex and require the participation of many actors and a large number of tripartite and quad-partite agreements that connect the actors jointly and severally. Central to the PPP agreement is the role of project lenders, often syndicated and represented by a lead financier and a securities trustee. The party most exposed to project risk in financial terms is the financier. In most project finance arrangements, lenders play an important role in monitoring the consortium's performance under the contract which subsists in parallel to the performance monitoring of the government agency to ensure the services delivered by the consortium meet specification. This paper presents a study using a cross-sectional analysis of PPP financing in Australia with three case studies in Victoria, Queensland, and New South Wales (NSW), Australia. The object of the analyses is to discover common features in the way major infrastructure PPP projects are financed in Australia, identify differences to practices in overseas markets, and gain knowledge and lessons learnt that may inform future PPP policy and private finance in Australia and overseas