Mutual Learning About Health System Performance in Australia's Intergovernmental Health Committee System?

Abstract

Since the early 1990s Australia, through the Australian Health Minister’s Advisory Council, began the process of developing a national health system performance framework. This includes service delivery measures for hospitals and has been used as a template for national data collections in mental health services. National performance frameworks have since become part of promoting greater integration of policy making and service delivery across Commonwealth and State jurisdictional health functions. The key focus of this paper is upon inter-governmental processes and routines to develop Australian national performance regimes in the realms of health and mental health care services. It presents initial findings from 26 elite interviews working across the inter-governmental interface, including some data about experiences of service managers.

The report provides two contributions to the existing literature on Australia’s federal health system and more specifically health governance. Firstly, it presents a literature review of studies and theoretical concepts that have been deployed to examine cross jurisdictional processes of decision making. There is particular attention for the European literature on inter-governmental committee systems. Secondly, the paper presents initial findings from an explorative study of Australia’s inter-governmental machinery in the realms of health and mental health care services. This explorative study was based upon an initial 26 elite interviews from respondents working (or having worked in) Australia’s inter-governmental machinery, including some respondents from representatives of relevant Commonwealth semi-autonomous bodies. The researcher also observed two inter-governmental committee proceedings although reported data here draws only from interviews. These findings provide a first insight into the inner workings of Australia’s inter-governmental health machinery. It is argued that there has been evidence of mutual learning from Australia’s National Health Performance initiatives, and, exchanges and recommendations for future research to further investigate and pinpoint the causal processes through which mutual learning occurs are provided.