Healthcare Policy Analysis: Kingdon's Model and NSW Government

This report provides a comprehensive analysis of Australian healthcare policy concerning homelessness, employing John Kingdon's Multiple Stream Framework (MSF). It examines the problem, policy, and political streams, detailing how each influences the development and implementation of homelessness policies. The report explores the increasing public awareness of homelessness, the evolution of policy responses at both federal and state levels (specifically focusing on NSW), and the initiatives undertaken by various stakeholders, including NGOs. It also reviews the implementation of the NSW homelessness strategy, focusing on community engagement, risk factor reduction, and protective factors. The analysis considers alternative approaches and their impact from a public health perspective, evaluates the overall usefulness and limitations of Kingdon's framework, and discusses the influence of media portrayal on the issue. The report highlights the importance of affordable housing, government proposals for rent assistance and rental investment incentives, and the special focus on Aboriginals and Torres Strait Islanders. It concludes by assessing the NSW government's shift towards a multidisciplinary policy aimed at reducing the risk factors associated with homelessness.

Running head: HEALTHCARE POLICY
Healthcare Policy
Name of the Student
Name of the University
Author Note

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1. Introduction
According to the definition of National Coalition for the Homeless (2017), a person is
homeless when he or she lacks any permanent, standard and adequate residence during the
night-time. There has always been homeless person in developed countries like the USA, UK
and Australia. The economic consequences and demographic factors have fluctuated, along
with the proportion and percentage of the homeless population. However, there are
comparatively fixed skid rows where the homeless population congregate (Mackenzie et al.
2016). The government of Australia recognises homeless as a complex issue that affects a
significant section of the Australian population. It requires systematic efforts across different
agencies, sectors and other community level. While the territory and state level governments
are responsible for the delivery of service, the Commonwealth supports state and the other
territory government in their role for delivering services to the people who are homeless in
Australia and to those who are on a verge of being homeless. The main funding for
development of the policy and homeless and procuring proper care for the people who are
homeless mainly comes from the National Affordable Housing agreement (NAHA) and the
National Partnership Agreement on Homelessness (NPAH). According to the budget
published on 2017-18, the government of Australia is working with territories and states in
order to reform NAHA and NPAH into a new National Housing and Homelessness
agreement NHHA (Australian Government Department of Social Services, 2017). The
following report will depict the Kingdon’s theoretical framework and analyse the homeless
policy area by the use of this model. The implementation of the current homeless policy will
be done under the perspective of the NSW government. The implementation of the present
NSW multidisciplinary interagency policy will be examined while analysing the alternative
approaches and their subsequent impacts from the point of view of public health. The overall

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usefulness and limitations of the framework will be identified and then subsequently
reviewed.
2. Policy analysis theoretical framework: Kingdon’s model
John Kingdon’s Multiple Stream Framework (MSF) is a powerful tool used for
detailed understanding of the policy. It also helps in setting of the agenda through three
separate streams: problems, policies and politics (Knaggård 2015).
(Source: Knaggård 2015)
The problem stream deals with the perceptions of prevailing problems that are seen as
“public” in the understanding that actions from government is important to solve them. These
problems usually reach the awareness of the makers of the policy because of the dramatic
events like crises, through feedback from the existing programs that attract the attention of
the public (Béland and Howlett 2016). People view a specific situation as a “problem”

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depending upon its divergence with their level of understanding on certain state of affairs.
The policy stream is the overall output of the experts and the policy analysts who examine the
stated problems and the proposed remedy. Under this stream, the possibilities for policy
action followed subsequent inaction are highlighted, analysed and then streamlined to a group
of ostensibly feasible options. The political stream is composed for factors that promote the
body politic like the swings in the national mood, legislative or executive turnover and
interest group in the campaigns of advocacy. According to Kindgon, the three stream flow
through different channels and is more or less independent of each other until at a specific
point of time, a specific policy window opens. Only then do the parallel streams intersect
each other (Béland and Howlett 2016).
3. Supporting homelessness policy area
3.1 Problem stream
In the past, the problem of homeless has grabbed attention of public at an increasing
rate. Not only the percentage of homeless population has increased at a dramatic rate, within
the last few years, but also the composition of homeless people has change dramatically
during this tenure. For example, the middle-aged men constitute a shrinking fraction of the
homeless population. Increase in the public awareness in homeless population, is also
associated with the change in the geographic location of homeless people who are becoming
more localised in the surrounding neighbourhood and the communities that would not have
noticed their significant presence in the near past (Mackenzie et al. 2016).
The issue of homeless in Australia was is dated back in early 1970s. the result
published by the Australian Institute of Health and Welfare (AIHW) stated that during 2011,
the percentage of homelessness have increased by 8% during the last 5 years (89.728 to
105,237). The number of people who are accessing the homelessness services is also

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increasing steadily. At the beginning of the 199s, the researcher and the professionals played
an important role in increases the awareness about the alarming rate of homeless to the
Australian government (Australian Council of Social Service 2019)..
At the federal domain, numerous attempts have been made in order to address the
homelessness. The labour government has campaigned this issue in the year 1993 following
the national election in that year. It was mainly concerned with the homeless people from
Aboriginal background and not to the people from non-indigenous background or people who
are at risk of getting homeless. During the year 2011, the focus concept of homeless was
classified into two parts, primary homelessness and secondary homelessness. Primary
homelessness is the person who resides on streets or sleeps in parks and use railway carriages
for the temporary shelters. The secondary homeless people include who frequently move
from one temporary shelter to n other lie youth refugees or people who applies for the
emergency accommodation. Again there is tertiary homelessness like people who resides in
the premises where they do not have the required security of a lease guaranteeing them
accommodation. The federal government also made classification based on rough sleepers
like people who sleep under open sky (Australian Council of Social Service 2019). This led
to enforcement of dealing with different sectors of homeless people with proper shelters.
Additionally the stakeholders who are interested in the concept of homelessness pushed the
government to introduce different policies for different class of homeless people. Followed
by affective assessment and monitoring (Greenland and Henley 2016). In 2019 federal
election, a proposal was given for the development of New Housing and the Homelessness
Strategy in a target to increase the affordable housing for the people who are from the low-
income households in order to reduce the vulnerability of homeless. The government has also
made a proposal of increase in the rent assistance by 30% in order to promote private renting
among the people who are from low financial background along with a proposal of rental

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investment incentive for encouraging investment in construction of affordable rental housing
like social housing for the people with low income. A proposal of $10 billion was also made
in order to provide standard housing for the people who are homeless. Special focus was
given to the Aboriginals and the Torres Strait Islanders for assisting them with the housing
strategy under the funding agreements coming from the Commonwealth and State and
Territory governments (Johnson 2019).
At state level, numerous initiatives were introduced at different state levels. The NSW
Family and Community Service in the year 2018 have introduced a five year (2018 to 20203)
plan for reducing the homeless in NSW. This is a comprehensive approach for preventing and
improving homelessness. The strategy recognized that homelessness is not just a problem
associated with housing, the policy focus on the financial and structural drivers of
homelessness. The three main area of focus of NSW homeless policy include early
identification of the vulnerable people, providing quality support and services and making the
overall system simpler, person-centred and integrated (NSW Family and Community Service
2019). At private level also several NGOs are raking initiatives in order to reduce the
homeless percentage in NSW like the Parramatta City Council Homelessness Policy
proposed by Parramatta City Council in the year 2019. According to the Kingdon’s model
assumptions, the data or hypothetical approach cannot bring change in the social structure
(Béland and Howlett 2016). Parramatta City Council in the year 2019 also recommended a
stringent strategy at the national level in order to reduce homelessness in Australia. Media
also play a determining role in portraying homelessness. However, as per the reports
published by The Guardian, the Australian media is lagging in reporting or projecting
homelessness in comparison to other countries like the US and UK.

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3.2 Policy stream
In the past decades, there have been gamut opinions for policy development in order
to address the homeless by various stakeholders like these suggestions include what Kingdon
describe as a “policy primeval soup”. The inquiry report by the legislative committee
highlighted numerous recommendations in order to improve the status of homeless in
Australia. The majority of recommendations are based on previous evidences and policies
published both at local and at international levels. Like the recommendations given by the
United Nations lead to the development of the Australian Homelessness Monitor 2018 under
the collaboration of the stakeholders like Social Policy Research Centre, the government of
Queensland and Institute for Social Science Research. This complies with the assumptions of
Kingdon’s model that policy responses are based on the previously published research and
policies. Other stakeholders like the Australian Human Rights commissioners recommended
employing right based approach for addressing homelessness. Although the temporary
housing for the refuges or homeless people in Australia is under the federal government, the
stakeholders are of the opinion that it is important to introduce additional quality measures
(NSW Family & Community Service. 2019). Moreover, they also focused on the importance
of developing action plans in multidisciplinary levels for improving the quality of life of
homeless people in Australia (Nielssen et al. 2018). These plans include housing support to
people who are homeless and development of employment options for the homeless people in
order to give them financial support to afford their won housing expenses at subsides rents
((Nielssen et al. 2018).
3.3 Policy stream
The liberal government has proposed that the Aboriginals and the Torres Strait
Islanders are at a priority during the election campaign during 2016. In order to align with the
national and the federal government directions towards homeless, the NSW government

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published an annual report in the year 2017 to 2018. The aim of this report is to socio-
economic trends that are potentially underlying the changing homelessness rates in NSW and
in other parts of Australia. The inquiry of the legislative committee and the new focus by the
Liberal federal government results in the opening of new policy window. The government of
NSW represented by the housing minister stated that due to the significance of the issue, that
government is unable to wait for the announcement of the government for national action
plan (Nielssen et al. 2018). Thus the review of the interagency policy was done and in that
there was as divergence of the focus from the Aboriginals and Torres Strait Islanders to a
comprehensive multidisciplinary policy that focus on the reduction in the risks factors that
make a population or an individual to become homeless. This can be considered as an
alternative as stated by the Kingdon in is model (Béland and Howlett 2016).
4. Implementation: Preventing and responding to homelessness
In the reviewed policy named NSW homelessness Strategy 2018 to 20203, the
government of NSW shifted the focus towards increasing the community engagement and
improving the risk factors promoting the development of homelessness like the financial
stress and breakdown of the family. The NSW government also promoted implementation of
protective factor in order reduce the chances of homelessness like increases the employment
opportunity and involvement in the community participation (NSW Family and Community
Service 2019). In addition to this, the government of Australia has raised homeless
campaigns for increasing awareness about homeless population. this annual week awareness
program was actively supported by churches and the missions running winter vigils in order
to commemorate the people who have died on the streets. This homelessness campaigns was
called "Housing Ends Homelessness” and it held on August 2018 and will occur during 4th to
10 August during 2019 . This homelessness campaign is influenced by the homelessness

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campaign in the year 2018 that was arranged to marked the 40th anniversary of “Cathy Come
Home”. The campaign mainly focused the homeless people in the Northern Ireland (Council
for the Homeless Northern Ireland 2018). The campaign done by UK involved support from
media however, the same was missing in the Australian campaign. However, the campaign
held in Australia was successful in establishing public awareness. The evaluation was done
based on the number reported cases to the help-lines that revealed that people are now more
considerate in extending their hands for the people who are homeless.
5. Alternative strategy
The stakeholders like protective law suggested several alternative strategies for the
homeless people like increasing the level of academic education of the homeless people so
that they become eligible for the job and sustain their own living or strict restriction of the
substance abuse that is a leading cause of homeless among the Aboriginals and Torres Strait
Islanders (Polcin 2016). These approaches will help to empower the homeless to become
independent and earn their own livelihood. Reduction in the street victimization was also
proposed n order improve the overall quality of life like the mental health of the homeless
people. This will further help to reduce the chances of substance abuse (Tyler and Melander
2015). The study conducted by Krüs et al. (2016) under the perspective of the homeless
people residing in Canada highlighted that safety of the homeless people must be prioritized.
This can be done by the intersecting regimes of the process of stigmatization and the
criminalization associated with the homeless people. This is be followed by legal recourse
and improvement in the perpetuated labor condition in order to improve the overall health
condition of the people who are homeless (Kertesz and Johnson 2017).
Other strategies include screening of the homeless people by well-trained workers in
institutions working directly with the homeless people such healthcare service providers. This
will help in highlighting the race who at risk of getting homeless or who are suffering from

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poor health condition. This will also help the service providers to increase their knowledge
about the exact requirement of the homeless people. Other recommendation include
establishment of counseling centre that are categorically build for the homeless people. The
service must be provided in a culturally competent manner and that too under the provision of
diverse language. The right based approach must be undertaken in order to improve the
overall outcome (Kertesz and Johnson 2017).
6. Conclusion: Usefulness and limitations of the framework
Kingdon’s framework is reliable for describing the process of developing policies and
gap in policies for the homeless population. The model was used to describe the homeless
people in Australia. Unlike the traditional policy frameworks, the model admits that the
process of policy generation is always not reasonable but is a dynamic process. Moreover, the
framework was successful in describing the how the homeless people have increased ruing
the course to time in Australia. The model was also useful in dissipating the role of
multidisciplinary approach for improving the condition of homelessness. Although Kingdon’s
model assumed a decentralized approach of policy-development, it was successful in
describing the role of government in framing the policy. The model however, has certain
limitations like it failed to explain how government takes decision in the policy solutions. It
also fails to explain how the government adopted a comprehensive prevention strategy by
rejecting legislative reforms. Additionally it failed to explain how the selected policy can be
evaluated in the past years.

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