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Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Climate Change | Research article

Establishment of radiation therapy services in North West Tasmania: a community need or election strategy?

Authors: Sancia West, Elizabeth Shannon, Elaine Crisp, Tony Barnett

Published in: BMC Health Services Research | Issue 1/2019

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Abstract

Background

This case study examines the impetus for policy change that resulted in the establishment of a radiation therapy service in rural North West Tasmania, Australia. Provision of local radiation therapy services improves accessibility for those in rural and regional areas. However, providing these services and maintaining them is not achievable for all areas. The drivers to establish services in more regional locations are not always well understood.
This article presents a case study of how a radiation therapy service was established in North West Tasmania. It applies a health policy analysis model (the Advocacy Coalition Framework) to examine the impetus for policy change and draws conclusion about how the framework can be applied to the development of health services in rural areas.
Understanding the impetus for policy change allows health service planners to apply this knowledge to influence the health agenda. Knowing the way in which policy change can be driven creates an opportunity to become more strategically involved in policymaking.

Method

Documents related to the case study were analysed for expressed beliefs, using the Advocacy Coalition Framework, to determine any identifiable coalition of actors that held consistent, shared beliefs and were engaged in non-trivial action to the establish radiation therapy services in North West Tasmania.

Results

Document analysis confirmed the presence of a Health Policy Coalition that was concerned about sustainability and safety in establishing the service. No additional coalition was identified. Instead, the possible role of the media and the marginal nature of the local Federal electorate were likely to have impacted the subsequent policy change.

Conclusions

The study found evidence that policy change was achieved primarily as a result of a political strategy designed to win support during a Federal election. This has important implications for health policy in rural areas, especially for those population centres located in marginal seats. During an election cycle the decision to establish new health services may not be wholly influenced by an identified coalition or issue such as sustainability, community needs or rationality.
Literature
1.
go back to reference North West Radiotherapy Clinical Expert Panel. Advice for provision of radiotherapy services to people with cancer from North West Tasmania. Hobart: North West Radiotherapy Clinical Expert Panel; 2011. North West Radiotherapy Clinical Expert Panel. Advice for provision of radiotherapy services to people with cancer from North West Tasmania. Hobart: North West Radiotherapy Clinical Expert Panel; 2011.
2.
go back to reference Brindley M, Turner K. The future role and contribution of regional capitals to Australia: A Tasmanian perspective. Submission. Launceston: Regional Development Australia (Tasmania); 2015. Brindley M, Turner K. The future role and contribution of regional capitals to Australia: A Tasmanian perspective. Submission. Launceston: Regional Development Australia (Tasmania); 2015.
3.
go back to reference Senate Community Affairs References Committee. The cancer journey: informing choices. Report on the inquiry into services and treatment options for persons with cancer. Canberra: Senate Community Affairs References Committee; 2005. Senate Community Affairs References Committee. The cancer journey: informing choices. Report on the inquiry into services and treatment options for persons with cancer. Canberra: Senate Community Affairs References Committee; 2005.
4.
go back to reference Parliamentary Standing Committee on Public Works. North West Cancer Care Centre. Hobart: Parliament of Tasmania; 2012. Parliamentary Standing Committee on Public Works. North West Cancer Care Centre. Hobart: Parliament of Tasmania; 2012.
5.
go back to reference Clark N. Cancer service upgrade in doubt. The mercury; 2010. Clark N. Cancer service upgrade in doubt. The mercury; 2010.
6.
go back to reference Duckett S, Geeves P, Kinne L, Ratcliffe K. Hospital services in Tasmania. Aust Health Rev. 2002;25(1):141–55.CrossRefPubMed Duckett S, Geeves P, Kinne L, Ratcliffe K. Hospital services in Tasmania. Aust Health Rev. 2002;25(1):141–55.CrossRefPubMed
7.
go back to reference Shannon E. Tasmania’s Richardson review: engaging communities in health care reform. Public Adm Today. 2005;2(1):33–9. Shannon E. Tasmania’s Richardson review: engaging communities in health care reform. Public Adm Today. 2005;2(1):33–9.
8.
go back to reference Grube D. The rhetorical framing of policy intervention. Aust J Polit Sci. 2010;45(4):559–78.CrossRef Grube D. The rhetorical framing of policy intervention. Aust J Polit Sci. 2010;45(4):559–78.CrossRef
9.
go back to reference Tasmania, House of Representatives. Debates. Hobart: Tasmanian Government; 2010. p. 29–111. Tasmania, House of Representatives. Debates. Hobart: Tasmanian Government; 2010. p. 29–111.
11.
go back to reference Australia, House of Representatives. Debates. Australian Government; 2010. p. 2437–8. Australia, House of Representatives. Debates. Australian Government; 2010. p. 2437–8.
12.
go back to reference Contract Review Committee. Additional Radiation Oncology Treatment Unit for Northern Tasmania. Hobart: Tasmanian Government; 2008 Contract Review Committee. Additional Radiation Oncology Treatment Unit for Northern Tasmania. Hobart: Tasmanian Government; 2008
13.
go back to reference Bingham L. Health officials mount case for cancer Centre. Advocate. 2009. Bingham L. Health officials mount case for cancer Centre. Advocate. 2009.
14.
go back to reference The Coalition’s plan to boost local health services [press release]. Devonport, 6 August 2010. The Coalition’s plan to boost local health services [press release]. Devonport, 6 August 2010.
15.
go back to reference Sabatier P. Top-down and bottom-up approaches to implementation research: a critical analysis and suggested synthesis. J Public Policy. 1986;6(1):21–48.CrossRef Sabatier P. Top-down and bottom-up approaches to implementation research: a critical analysis and suggested synthesis. J Public Policy. 1986;6(1):21–48.CrossRef
16.
go back to reference Jenkins-Smith H, Sabatier P. Evaluating the advocacy coalition framework. J Public Policy. 1994;14(2):175–203.CrossRef Jenkins-Smith H, Sabatier P. Evaluating the advocacy coalition framework. J Public Policy. 1994;14(2):175–203.CrossRef
17.
go back to reference Yin RK. Case study research: design and methods. Newbury Park: Sage Publications; 1994. Yin RK. Case study research: design and methods. Newbury Park: Sage Publications; 1994.
18.
go back to reference Jenkins-Smith H, Nohrstedt D, Weible C, Sabatier P. The advocacy coalition framework: foundations, evolution, and ongoing research. In: Sabatier P, Weible C, editors. Theories of the policy process. 3rd ed. Boulder: Westview; 2014. Jenkins-Smith H, Nohrstedt D, Weible C, Sabatier P. The advocacy coalition framework: foundations, evolution, and ongoing research. In: Sabatier P, Weible C, editors. Theories of the policy process. 3rd ed. Boulder: Westview; 2014.
19.
go back to reference Sabatier P. An advocacy coalition framework of policy change and the role of the policy-oriented learning therein. Policy Sci. 1988;21(2/3):129–68.CrossRef Sabatier P. An advocacy coalition framework of policy change and the role of the policy-oriented learning therein. Policy Sci. 1988;21(2/3):129–68.CrossRef
20.
go back to reference Jenkins-Smith H, Sabatier P. Methodological appendix: measuring longitudinal change in elite beliefs using content analysis of public documents. In: Sabatier P, Jenkins-Smith H, editors. Policy change and learning: an advocacy coalition approach. Boulder: Westview Press; 1993. Jenkins-Smith H, Sabatier P. Methodological appendix: measuring longitudinal change in elite beliefs using content analysis of public documents. In: Sabatier P, Jenkins-Smith H, editors. Policy change and learning: an advocacy coalition approach. Boulder: Westview Press; 1993.
21.
go back to reference Linear Accelerator North West Regional Hospital [press release]. AMA Tasmania, 7 August 2010. Linear Accelerator North West Regional Hospital [press release]. AMA Tasmania, 7 August 2010.
22.
go back to reference Radiotherapy machine not feasible at NWRH [press release]. AMA Tasmania, 14 January 2010. Radiotherapy machine not feasible at NWRH [press release]. AMA Tasmania, 14 January 2010.
24.
go back to reference Adams P, Hardwick J, Embree V, Sinclair S, Conn B, Bishop J. Literature review: models of cancer services in rural and remote communities. NSW: Cancer Institute NSW; 2009. Adams P, Hardwick J, Embree V, Sinclair S, Conn B, Bishop J. Literature review: models of cancer services in rural and remote communities. NSW: Cancer Institute NSW; 2009.
25.
go back to reference Dalton R. The adverse attributes of specific purpose payments in Australia. S Cross UL Rev. 2006;10(1):43–88. Dalton R. The adverse attributes of specific purpose payments in Australia. S Cross UL Rev. 2006;10(1):43–88.
26.
go back to reference Bingham L. Coast’s cancer service in more turmoil. Advocate. 2009. Bingham L. Coast’s cancer service in more turmoil. Advocate. 2009.
27.
go back to reference Bingham L. Elphinstone fed up with govt cancer services excuses. Advocate. 2010. Bingham L. Elphinstone fed up with govt cancer services excuses. Advocate. 2010.
28.
go back to reference Bingham L. NW cancer centre - not on hold: Minister. Advocate. 2011. Bingham L. NW cancer centre - not on hold: Minister. Advocate. 2011.
29.
go back to reference Bingham L. Political suicide’ to delay cancer services. Advocate. 2012. Bingham L. Political suicide’ to delay cancer services. Advocate. 2012.
30.
go back to reference Beland D, Cox RH. Ideas as coalition magnets: coalition building, policy entrepreneurs, and power relations. J Eur Public Policy. 2016;23(3):428–45.CrossRef Beland D, Cox RH. Ideas as coalition magnets: coalition building, policy entrepreneurs, and power relations. J Eur Public Policy. 2016;23(3):428–45.CrossRef
31.
go back to reference Mintrom M, Salisbury C, Luetjens J. Policy entrepreneurs and promotion of Australian state knowledge economies. Aust J Polit Sci. 2014;49(3):423–38.CrossRef Mintrom M, Salisbury C, Luetjens J. Policy entrepreneurs and promotion of Australian state knowledge economies. Aust J Polit Sci. 2014;49(3):423–38.CrossRef
Metadata
Title
Establishment of radiation therapy services in North West Tasmania: a community need or election strategy?
Authors
Sancia West
Elizabeth Shannon
Elaine Crisp
Tony Barnett
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Climate Change
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4085-2

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