Nurses’ Perspectives of the Political Fallout from Health Care Reform: The New South Wales Experience

Mr Stuart Andrew Newman,
Prof. Jocalyn Lawler
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The health care system in New South Wales – Australia’s largest state, has experienced a series of system restructures as part of the health reform agenda and these restructures have progressively narrowed the interface between politics / politicians and those who manage service delivery. We are experiencing an unprecedented level of politicisation of health care and political intervention in the day-to-day management of health services, accompanied by growing public debate surrounding the effectiveness and quality of the system.

A major consequence of this politicisation and political intervention has been the positioning of nursing at the centre of the cost / quality / safety debate. Nurse managers are now being required to manage the intersection between very public political discourse surrounding health and the corresponding consumer expectations of service quality, accessibility and cost. As a result, the ability of nurse managers to provide and manage nursing services has been adversely affected. While we look to health policy to offer solutions to the problems of cost, quality and safety, politicisation and political intervention is reducing the effectiveness of the system as a whole, and indeed contributing to many of the problems it is attempting to remedy despite public rhetoric to the contrary.

This paper analyses the increasing politicisation of health care and political intervention in the day-to-day management activities of nurse managers against a background of major public controversies surrounding the quality of service and patient safety within the NSW health system. The paper also reports the findings of a recent study on the impact of health reform on nurse managers and focuses on the affect of the current political / health environment on the level of uncertainty nurse managers have about their ability to provide adequate nursing services in the future given the current and likely health policy directions.

Keywords: Health Care Reform, Politicisation and Politics in Health, Nurse Managers, Management of Nursing Services
Stream: Other or Stream Unspecified
Presentation Type: Paper Presentation in English
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Mr Stuart Andrew Newman

Director: International and Professional Relations, Faculty of Nursing and Midwifery (MO2), The University of Sydney
Sydney, NSW, Australia

Stuart has been a registered nurse and has worked in a variety of settings, including public and private hospitals and educational institutions. He has had extensive experience in health service management in various positions ranging from Nursing Unit Manager to Executive Officer/Director of Nursing. Stuart holds a Diploma in Teaching (Nursing), a Bachelor of Education (Nursing) and a Master of Health Administration.
Stuart is currently enrolled in doctoral studies at the University of Sydney where he is researching the impact of health reform on nurse managers and their management of nursing services.
Stuart is currently employed as a lecturer in health services management and holds the portfolio of Director, International and Professional Relations in the Faculty of Nursing and Midwifery, The University of Sydney.

Prof. Jocalyn Lawler

Dean, Faculty of Nursing and Midwifery, The University of Sydney
Sydney, NSW, Australia

Jocalyn began her nursing career in Broken Hill in outback Australia in 1967. She holds qualifications in nursing, social science and education and took Doctor of Philosophy from the University of New South Wales in 1989. Her research interests concern the experience of illness, methodologies for nursing research, nurses’ social and interpersonal management of the body, and the reasons why nurses’ work is poorly understood and invisible. Jocalyn took up her position as Professor of Nursing at the University of Sydney in 1992; and she has been Dean of the Faculty of Nursing & Midwifery since 1999

Ref: I06P0126