University Health Policy Politics Report: Analysis and Critique

This report delves into the intricate relationship between politics and healthcare policy, examining how political forces shape health initiatives and their consequences. It begins by establishing the connection between power and policy development, emphasizing the role of political actors and thei...Read More

Running head: POLICY POLITICS IN HEALTHCARE
POLICY POLITICS IN HEALTHCARE
Name of the Student
Name of the university
Author’s note

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Introduction
Relationship between politics and power that influences health policy development
Health care policies can be termed as plans, decisions and actions that has been
undertaken for achieving the health care goals of the public. Health care policies are formulated
as per the need of the population. Politics for better or for worst consequences, plays an
important role in health related affairs. Health problems has always been included in the political
agenda of all the parties. The responses of the government is always affected by the perception
of the society about the severity of the problem, the responsibility of the issue including the
population that has been affected. It cannot be denied how bounded rationality, fragmentation of
the political institutions, resistance from the other parties and the fiscal restrictions leads the
political parties to adopt some incremental policies other than genuine reforms even if they are
faced with some serious health consequences (Waring et al., 2018). It then determines the
conditions under which a large scale conversion of the health policy occurs, that focuses on
various critical stages of the development of policies and the role of the policy impresarios for
seizing the chances for improvement. Finally it reviews the challenges that are confronting the
officials and the agencies that are responsible for the implementation and the administration of
the health policies. If politics is all about power, then whoever is in power will want to reshape
the policies as per their goodwill. They will necessarily avoid those areas that will reveal their
weakness. Policies are the products of the belief system of the actors of the policy subsystem
(Hunter, 2015). They not only includes politicians, but civil servants, the representatives of the
target group and emergence of policies then occur from the negotiation of these actors.

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Ethical dilemmas involved in the formulation of the health and the aged care policies
Virtually, all the health policy deals with the quality of the care provided, be it the quality of the
medicine, or the cost of the medicine. The health administrators and the policy makers wait for
earning in dollars spent for the formulation of the policy, whereas the providers are more
concerned about the activities of cost containment that affects the ability and the access to
suitable health care facilities. Health care administrators and the policy makers are often
responsible for making financial decisions which can impact the life of the patients and the
quality of the delivered care. It often becomes very challenging for them to balance all the
pitfalls of the budget, ethics and quality (Hall et al., 2016). The health care policies that has been
formulated for the indigenous people of Australia might act unjustified for White Australians and
vice versa.
Privacy laws and politics enables the health care professionals to maintain the rights to
privacy an autonomy. The health care organisation is extremely reliant on certain technologies
like electronic health records for recording, storing and the disseminating information that are
sensitive and should not be disclosed. One such law is the Health Insurance Portability and
Accountability Act (HIPAA) (Edemekon & Haydel, 2019). But, there are certain circumstances
where confidentiality has to be broken for preventing harm to a third party. Another example of
ethical dilemma is the Restraint policy with respect to mental health patients. The policy states
that no restraints should be put on elderly people under any circumstances. In case of elderly
patients with bipolar disorders, exhibiting aggressive behaviors, restraints can be applied to
prevent harm to the other members of the ward (Rakhmatullina, Taub & Jacob, 2013). However,
it should always be treated as the last resort after, all the feasible alternatives have been tried.
One of the example of ethical issue related to a public policy is that Ethiopian abortion law has

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been legalised. Being a strong religious country, the law is still controversial Many of the
abortion providers faces the ethical dilemma regarding their religious convictions and the
commitment to the patients (Ewnetu et al., 2020).
The impact of the health, social and the aged care policies on the disadvantaged group of the
community
There are both positive and negative impact of the health care policies on the
disadvantaged communities. Socio-economic inequality is associate with unequal exposure to the
social, environmental and the economic risk factors that in turn contribute to inequalities in
health. People with higher level of income and the educational opportunities have lower levels of
mortality and morbidity Thomson et al., 2016). Various policies occurring at several levels
includes policies for disease management, policies for the management of chronic diseases,
policies for alcohol and substance abuse disorder, policies for the provision of primary care
facilities. The upstream interventions mainly involved institutional control regulating the supply
of a particular object or any activity (Thomson et al., 2016). Whereas the downstream
interventions or the policies involve individual level approaches and the success of these policies
depends upon how the chosen community engages successfully with the initiatives in
comparison to the others. There are policies focusing on environmental factors like, policies for
setting limit on the emission of gases or the percentage of emission that needs to be controlled by
the refineries. Some of the notable policies might address the food insecurity of the
disadvantaged groups. Some of the notable policies that has been beneficial to the disadvantaged
groups are Pharmaceutical Benefits Scheme (PBS) providing access to medications free of cost
or at low price. Medicare policy, covering all the Australia’s under a Universal insurance
coverage. Policies like “national Strategy for food security in the remote indigenous

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communities aiming to improve their food security (Carey et al., 2016). Again, the national
mental health policy 2008 has provided a strategic vision ensuring that all the Australians
especially the disadvantaged and the vulnerable group get access to effective and appropriate
treatment.
Chosen policy to be critiqued and its rationale
This paper aims to assess and critique the National mental health recovery framework.
Mental illness is very common in Australia. About 20 % of the Australians suffer from mental
illness every year. There had been an increase of the 2.6 percentage points from the year 2014-
2015, due an increase in the number of individuals reporting from depression, anxiety related
conditions and feelings of depression (Parliament of Australia, 2019). As per the Australian
Institute of Health and Welfare’s (AIHW), a total of 542,554 years of healthy life has been lost
due to mental health disorders. In spite of the mental health strategies and the policies adopted by
the Australian government, not much improvement was witnessed in the rate of mental health
disorders (Parliament of Australia, 2019). Hence, it is necessary to critique and analyze the
policy documents to look for any gaps, such they can be addressed successfully.
Thesis statement: Politics and the leaders in power has always played a crucial rule in the
formulation of the policies, which suit their reign and is mainly based on the interest of the
public. Most of the policies formed are welfare policies and are primarily addressed towards the
disadvantaged group of the society. This paper will provide a critique and analysis of the “A
national framework for recovery-oriented mental health services”. The main aim is to find out
any possible literature gap present, providing the scope of more comprehensive policy
development.

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Discussion
This paper will use the policy cycle proposed by Althaus, Bridgman and Davis. The steps
of the policy cycle consists of- Identification of the issues, analysis of the policy, Identification
of the instruments of the policy, consultation for testing the strength of the analysis, decision,
implementation and assessment. The steps that will be required for the chosen policy analysis are
identification of the issues, policy analysis, and identification of the policy instruments, decision,
implementation and evaluation. The use of the steps has been detailed below;-
Identification of the issues – The issue or the context is identified and is presented before the
government or thee is always a need for an overhaul of the existing policy. The target audience
of the National framework for recovery oriented mental health service has been formulated under
the direction of the Mental Health, Drug and the Alcohol Principle Committee. The document
provides interventions for the mental health patients of Australia, with the main aim of
improving the mental health in Australia. The framework has focused on the lived experience of
the patients with mental health problems and how they can be used to improve the mental health
service delivery in Australia.
Policy analysis- For analyzing the policy, it is necessary to research, evaluate and reflect. The
role of the evidence producing researches in the formulation of a policy has been under dispute
for quite a long time (Jann & Wegrich, 2017). The loops and the gaps between the outcomes and
the formulation of the policies is not new. It has been argued by the policy makers, that what
precisely is necessary for the formulation of the policy (Müller, 2016). Since, time immemorial,
the policy frameworks has been using a biomedical approach to the health. But this proposed
framework has emphasized on the bio-psychosocial model of health, where both the biological

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and social factors have play an important role in the causation of the disease and treatment
(Babalola, Noel & White, 2017). The approach has introduced new and innovative ways of
conceptualizing mental health difficulties and engendered changes within the research (Babalola,
Noel & White, 2017).
Identification of the policy instruments – In order to response to the policy problems, it is
necessary to understand the possible responses. Whether a new legislation will be required to
revise the policy or an adjustment will just be required.
Consultation for evaluating the strength of the analysis- Consultation should take place both in
and outside the government with both the expert and public input. It is necessary to coordinate
between the agencies for ensuring the coherence of the policy and in particular.
Implementation- In this stage, the policy is given expression through legislation or programs.
Evaluation- This evaluation is necessary that the government can gauge the effect of the policy
and adapt the design of the policy.
Critiquing the policy by using the policy cycle
Mental health recovery is a popular topic of discussion in the global mental care setting.
The current concept of the mental health recovery has brought about a major shift in the
philosophical viewpoint of the mental health systems (Jacob, Munro & Taylor, 2015). Lived
experience participation, people having personal experience of mental health refers to the ways,
where people with personal experience mental illness, service use and recovery. The
participation might occur in a broad varieties of ways from the advisory group members,
systemic advocacy positions, educations and one-on-one support roles. The Fourth National

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Mental Health Plan: An agenda for collaborative government action in mental health 2009–14
have also recognized the role of the mental health service and experts, who play an important
role in developing an environments that are supportive of the recovery. This concept led the
formation of such framework exclusively focusing on the experience of lived experience.
Furthermore, according to Australia’s National health priorities, mental health was one of the
priorities that needs to be focused upon.
The political push was provided by the Australian’s minister’s advisory council, which
comprises of all the ministers of health endorsed each of the elements of the action plan. The
policy have also mentioned about the contribution of The Safety and Quality Partnership
Standing Committee of the Mental Health, Drug and Alcohol Principal Committee, who is
accountable for progressing the action plan. One of the strength of the policy is that this
framework is applicable to all the State and the common wealth funded mental health services.
The national framework has also advocated for the mental health service by informing the
National practice standards for the mental health workforce (2013) to modify or redesign their
workforce by including people having lived experience of mental health disorder.
This framework also proposed to address the various determinants of mental health.
Some of the important determinants of mental health involves distal, proximal, institutional,
legal and the cultural factors. Other important factors involve socio-economic status,
homelessness, social factors, intimacy (Silva, Loureiro & Cardoso, 2016). Income inequality has
always been associated with mental health illness independently. Early life experiences,
substance abuse increases the risk of suicide. Food insecurity has been found to be one of the
major determinants of depression. Racism has been directly associated with poor mental health

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(Shim & Compton, 2018). The concerned frame work/policy have proposed help for the
indigenous people, to include the aboriginal health workers in the workforce, provision of
rehabilitation care to the patients. But, nowhere, it has been mentioned about addressing the
issues like poverty and homelessness. There was very less information about the funding for the
mental health services, especially meant for the vulnerable or the disadvantaged group of people.
However, the recovery oriented framework has focused on the determinants like culture and
family on the mental health recovery. According to this framework, the recovery of a person
occurs at home, family, community, friends, locality, churches, schools and workplaces. Thus
the recovery oriented services can be used to enable and nurture the associations such that people
receive most of the benefits from the support. This framework has emphasized on community
participation in the recovery of a person.
It has been discussed previously, that racism and discrimination is an important
determinant of mental health. Disparities in mental health based on the minority racial status.
This has been characterized by inequities in access to mental health care facilities, severity of the
symptoms, diagnosis and treatment (Medlock et al., 2017). With respect to this statement, it can
be stated that the recovery oriented mental health practice or the allied services accepts the fact
that each person have its own uniqueness and hence the treatment goes beyond any standardized
form of treatment. It mainly emphasizes on social inclusion and the life quality.
Media interventions has been found to be useful for influencing the health policies.
Media interventions can be defined as purposive as well as organized activities that utilizes a
varieties of media channels for informing, persuading and motivating population (Bou-Karroum
et al., 2017). Media can convey information related to health and can also influence the health

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behavior of an individual (Buse et al., 2013). Media can also host special programs related
mental health and issues like inclusion of lived experienced individuals in the mental health
workforce. This can be done by inviting some community members having lived experience to
participate in the show. However, the concerned policy document with which we are currently
working does not contain any such information about whether the media has influenced the
Ministry of Health to formulate such policies.
Evidence based policy urges the introduction of extensive research in the public policy
debates and the internal public sector processes for the evaluation of the policy and the
evaluation of the program. This approach helps the policy makers to make an informed decision
making. The evidence based policies also makes explicit whatever is known through scientific
evidence. The policy framework document has engaged in extensive researches as it has
elaborated on important terms like various conceptual models, the recovery process, with
important definition of terms like “recovery oriented practice”, “diversity”. The document has
been classified in to several themes like policy context, its relationship with the mental health
service standards of Australia, the elements of the National recovery framework, the concept of
recovery, how language can be used as a mode of recovery. The framework have broadly
described about the capabilities and the domains of the service delivery.
Need for evaluation
The evaluation of the policy is an important exercise for any countries. It has been opined by the
researchers that evaluation of the policy can be done in the pre-stage stage of the policy, the
formulation, implementation and the post implementation stage. Evaluation of the policy helps to
identify the gaps in the policy (Khan & Rahman, 2017). The evaluation can be carried out one

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year after the publication of the policy, by monitoring the rates of the issue for which the policy
has been implemented. The evaluators can also use the performance indicators in terms of the
program design, the planned activities and the cost. The evaluation of the policy can be carried
out by seeking feedback from the stakeholders and the public.
Conclusion
The main strength of the policy is that there are very few policies that have ever provided
insight to the mental issues and the families, who are the main element of a culture that is
recovery oriented. The practice domains that has been mentioned in the policy document
promotes hope and optimism for people with mental illness. The policy provides emphasis on
providing a holistic care services to the aboriginals and other vulnerable groups like elderly,
women and children. The framework has challenged stigma and discrimination against
individuals with mental health services. It has focused on the development of the workforce
planning.
The limitation of the plan is that not much information has been given about the
stakeholders or any organization with collaborative partnership can be formed for promoting a
recovery oriented practice. The significance of this policy is that it recognizes and embraces all
the possibilities that can cause recovery and wellbeing due to the intrinsic strength and capacity
for people suffering from or have experienced mental illness. This policy would assist the
families to understand the ways they can help in their recovery while also assisting them with
their own requirement for therapy, education or counselling.

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It can be recommended that the policy document refers to some importance of referrals
where the patients and the families might get help. Furthermore more emphasis, should be given
on the development of such workforce having lived experience. The policy document does not
contain an evaluation plan, which is an important part of a policymaking.
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