Hierarchy and Power in Australian Health Care System: A Sociological Perspective

This essay examines the dominance of power and hierarchy in Australian health care and its impact on nurses through the Marxism and feminism sociological theory of perspective. It explores the existing hierarchy and power about the Australian health care system, discusses the relationship between hierarchy and power in regards to two sociological theories Marxism and feminism perspective with its implication on health care system. The consequences of the theory to the health care systems will also be evaluated.

Running head: HEALTH SOCIOLOGY 1
Health Sociology
Student’s Name
Institutional Affiliation

HEALTH SOCIOLOGY 2
Introduction
The health care system is considered as the primary concerns of the government of
Australia. This is because health care is very crucial need of an individual. The Australian Health
care system is characterized by different tiers and division based on their professional
responsibility, boundaries, and authority for health care provision (Germov, 2014). This essay
will examine the dominance of power and hierarchy in Australian health care and its impact on
nurses through the Marxism and feminism sociological theory of perspective. Initially, the essay
will explore the existing hierarchy and power about the Australian health care system.
Subsequently, it will discuss the relationship between hierarchy and power in regards to two
sociological theories Marxism and feminism perspective with its implication on health care
system (Annandale, 2012). Finally, the essay will conclude with how two theories differ from the
biomedical model of health. The consequences of the theory to the health care systems will also
be evaluated.
The study will give a comprehensive report on the various researches done on the
current situation of the health services and operations and try to give opinions on how to improve
them. From the findings on the sociological theories and from other suggestions the paper
provides an outline of how the medical specialists ought to apply the teachings into the health
systems of Australia. Health care is not an equal commodity to all Australian (Russell, 2007).
Hierarchy
There are less unfortunate individuals who are not able to acquire proper medication
due to cost, and from the past, the government or the arms of power are not willing to offer any
form of assistance. Are these people not part of the country? How does the government expect
them to survive without proper health care services? However, the number of men and women

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participating in a number of healthcare workforce varies sharply in distinct roles. Accordingly,
the higher number of women who participate represents the positive side, but it’s not satisfied
with their profession clarification (Kelly & Field, 2017). In that case, the number of men and
women participation in the health care workforce varies sharply in different roles
The primary and secondary health care are the two healthcare which is in Australia.
The Primary health care involves when an individual first get contact with a health specialist. An
individual does not need a referral for this level of care, which comprises of services which are
provided by general medical specialists, dental practitioners, Indigenous health workers, nurses,
pharmacists (Annandale, 2012). They are delivered in Community Health Services, Health
centers with a community and in organized public health promotion services. Secondary health
care is not an independent body (Kelly & Field, 2017). It is a gateway to broader health systems
where individuals are referred from primary centers to seek specialized medication. Finally, that
is the basic hierarchy of healthcare in Australia.
The arrangement of services differs from State to State; common elements comprise
of strong funding mechanisms, qualified workforce, reliable information from where you base
decisions and policies together with well-maintained facilities and the possibilities to deliver
quality medicines and technologies (Kelly & Field, 2017). These professionals are from both the
public and private sectors who work together to ensure good health to all Australians (Germov,
2014). The private sector is self-sponsored where they can cater to all their activities while the
public sector is funded by the state.
The historical functions of gender within the healthcare system was to eliminate
women from medicine based on perceptions that men are dominant (Kelly & Field, 2017).
However, these perception were derived from beliefs that women are in second-class status.

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Power
The study of power can help understand the institution’s system which applies in
health care systems. However, medical doctors have been dominating the health care system for
a long time now. Medicine is considered as the epitome of a profession that slowly introduced
the term Professional Dominance in healthcare service (Kelly & Field, 2017). There are other
programs that are set by the government like the Health Insurance Fund which help an individual
to acquire treatment free of charge in both the public and private health centers. Others include
development funds that assist individuals in remote areas like the Aborigines and the less
unfortunate people like refugees to acquire health care services (Germov, 2014).
Power and hierarchy of Australian health care system are also discussed in Marxism
and Feminism theories below. The medical dominance in the healthcare systems of Australian
started with the formation of a medical association to unify the doctors against the competitors
(Ryan & Deci, 2011). However, later on, the Victorian Government came up with legislation
that gave doctors the total power to use medical titles to sign death certificates which helped
them acquire the monopoly of their profession to control the scope of nursing.
The dominance can also be discussed through subordination which ensures that
nurses work under the authority of doctors and limitation which is control over the practice of
nurses. On the contrary, the medical dominance should not be achieved through the natural
process but via scientific knowledge and unequal public status of the profession
Sociological Theories in Health Care Systems
Sociological theories generally explain the interactions of people, relationships and
behavior are integrated to ensure social being of individuals. Health is a state of good condition

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physically, emotionally and socially. Therefore, health is a very crucial tool for maintaining good
relation and interaction with others in the society. Under the sociological theories, we have
majored on Marxism and feminism (Lupton & Najman, 2015).
Marxism Theory
Under this theory of sociology, we understand that dispute arises due to unfairness in
health care services. The social inequalities among individuals such as race, class, ethnicity, and
gender are portrayed in health conditions and health care services. From the statistics, it is clearly
shown that people receive health care services differently in Australia (Annandale, 2012). Many
people at the remote places find it hard to access proper health care compared with those in the
urban areas. It is very disastrous that many of these people who are less unfortunate are the most
vulnerable to diseases where they are unable to acquire good health care (Germov, 2014).
Marxism explains the social inequality is not based on monetary but political influence too. In
that case, the power which is provided by politics in regulating the health care system is also
seen in this theory.
The Marxism theory discourages efforts by the health specialists to have in control
the whole medicine practice and to assume that all the social problems affecting people were due
to medicine and not sociological factors (Ryan & Deci, 2011). This theory lays focus on the
professional power of doctors. The positive aspect is that they assumed themselves as the only
educated people in the society who can help people out of these social problems (Russell, 2007).
The cynical view dictated that they imagined having a pay rise if they managed to dominate all
social issues to be medical problems. For instance use of contraceptives as birth control pills
among women is medical but giving birth is a social role of women in the society thus bringing
conflict between the social sector and the medical instructions.

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The implications of Marxism theory
The Marxism theory analyses the class relation. Labor processes and politics but
hence fails explaining women's oppression. Accordingly, it concludes that it applies to all
members of the society irrespective of gender Ryan, R. M., & Deci, E. L. (2011. In that case, it
caused a need for Marxism feminism since it assumes that suppression of women is not resulting
to any issue.
Feminist Theory
The Feminist theory seeks to balance areas where the distribution of power is not
equalized among gender. However, it operates in the fields like abortion rights, violent crimes
against women and maternity leave matters Ryan, R. M., & Deci, E. L. (2011. Accordingly, it is
the most common associated sociology theory with feminism since it highlights how women
have contributed to social interaction and different institutions. Furthermore, it describes the
societal differences in gender.
Implications of Feminist Theory
The feminist theory has stated men’s control over women’s roles in the medical
profession. As an illustration, women involved in healing were predominant within the domestic
and community areas, but their professional practice is always evaded by marriage and family
relations (Bunton, Burrows & Nettleton, 2015). However, this theory fails to address significant
reasons as to why women are always underrated within healthcare systems.
Biomedical model

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The two theories Marxism and Feminism happen to be related since they argue
against dominant positions which the health care providers get within the health care system but
the biomedical model demands that doctors need to have power in all decision making and does
not recognize nurses but expects them to be humanizers (Bunton, Burrows & Nettleton, 2015).
Accordingly, the biomedical model requires the nurses to use technology while Marxism and
feminism theory needs them to utilize their ability along with nurturing nature to deploy a
relationship with patients.
Impacts on Health Practitioners
As a Health practitioner, there are critical values that one needs to have. One of them
is always to recognize that working on people's health is a calling from God and should be done
in full responsibility (Bunton, Burrows & Nettleton, 2015). It is also very crucial to be a social
being; relating well with classes of people without discrimination. All people are equal and
deserve fair treatment. From the study, we have noted that power which in the hierarchy is very
important in running the health care system. We as the physicians we need to respect the
authority and take part in maintaining the policy and decisions made (Russell, 2007). Another
critical lesson is on the value of the society and traditions. We need to embrace the traditions of
the culture to develop a good relationship with them.
Physicians are professional people in the society. Therefore they should portray their
dignity in their character to be role models to the rest. Their life should implicate what they say;
living a healthy life to avoid illnesses ((Bunton, Burrows & Nettleton, 2015)). The patient and
the physician should be free to each other so that the patient can explain his or her illnesses while
the physician is also in a position to prescribe and guide the patient on healthy living.

HEALTH SOCIOLOGY 8
Medical practitioners should be informed and well trained. Physicians ought to have
adequate information on their field of medicine. The licensing of practice should be given to
autonomously qualified individuals who are willing to work in the field of medicine (Bunton,
Burrows & Nettleton, 2015). Supervisors and the management should be strict on observing how
work is done to prevent cases of experimenting with people's lives. Medicine is a crucial field
and requires total concentration.
A physician can also act as a government advisor of healthcare. Medical practitioners
are the most concerned with health care, and so they should be on the front line to address issues
affecting the health systems. Issues to do with development and innovation of health service and
supply of health facilities like drugs should be discussed frequently (Cameron & Trivedi 2009).
There are also issues of poverty where some individuals are not in a position to pay for their
medication. Physicians should be able to locate such cases and address those concerned to assist
the patients.
Physicians should set up programs for public awareness. Some diseases are
mushrooming from the current living styles (Bunton, Burrows & Nettleton, 2015). Some of these
diseases are cancer, diabetes among others. Many people who are diagnosed with these deadly
diseases are not even aware of how to deal with the situation Ryan, R. M., & Deci, E. L. (2011.
Medical practitioners should be organizing open days where they educate people on various
conditions, causes, and prevention. This is very effective to the community who learn many
things identify on themselves the symptoms of those diseases (Piggott, 2009). They can also
invite Non -Governmental Organizations to give support on health-related issues like cancer-
screening.

HEALTH SOCIOLOGY 9
In conclusion, health care systems are all the activities that surround effective and
efficient health care services. However, the existing hierarchy of power, the medical
professionals can work in respect and coordination while observing regulations and policy set
aside for good governance in the health sector. The theorists based on gender and class can be
used to explain power and Hierarchy within the Australian Health System, and feminism and
Marxism theory have illustrated the dominance of male practitioners being privileged over
female nursing. The government should, therefore, work tirelessly in ensuring that all persons
especially women to access appropriate health care as highlighted by feminist theory (H Russell,
2007). Division of labor on nurses is of significance.
References
Annandale, E. (2012). The sociology of health and medicine: a critical introduction. Polity.
https://www.wiley.com/en- us/The+Sociology+of+Health+and+Medicine
%3A+A+Critical+Introduction%2C+2nd+Edition-p-9780745634616

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Armstrong, B. K., Gillespie, J. A., Leader, S. R., Rubin, G. L., & Russell, L. M. (2007).
Challenges in health and health care for Australia. Medical Journal of Australia, 187(9),
485.
https://www.ncbi.nlm.nih.gov/pubmed/17979607
Bunton, R., Burrows, R., & Nettleton, S. (2015). Sociology and health promotion. In The
sociology of health promotion (pp. 11-18). Routledge.
https://www.questia.com/library/108347806/the-sociology-of-health-promotion-critical-analyses
Cameron, A. C., Trivedi, P. K., Milne, F., & Piggott, J. (2009). A micro-econometric model of
the demand for health care and health insurance in Australia. The Review of economic
studies, 55(1), 85-106.
https://journals.bmsu.ac.ir/jhpsh/index.php/jhpsh/article/download/18/pdf_15
Germov, J. (2014). Second opinion: an introduction to health sociology. UK: Oxford University
Press, 556p.
https://global.oup.com/academic/product/second-opinion-9780195520149?cc=us&lang=en&
Kelly, M. P., & Field, D. (2017). Medical sociology, chronic illness and the body. Sociology of
Health & Illness, 18(2), 241-257.
https://www.researchgate.net/publication/
9089394_Lay_Experiences_of_Health_and_Illness_Past_Research_and_Future_Agendas
Lupton, G. M., & Najman, J. M. (Eds.). (2015). Sociology of health and illness: Australian
readings. Macmillan Education AU.

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https://revistas.ucm.es/index.php/POSO/article/download/36635/35475
Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099-
1104.
Mechanic, D. (2006). Medical sociology.
https://onlinelibrary.wiley.com/doi/pdf/10.1111/ijsw.12226
Ryan, R. M., & Deci, E. L. (2011). Self-determination theory and the facilitation of intrinsic
motivation, social development, and well-being. American Psychologist, 55(1), 68.
https://pdfs.semanticscholar.org/0a5f/d9f90632ba0e7be5cbae52813429b05bb7d5.pdf