Healthcare in Australia
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Name of institution
Introduction
The registered nurse practice occupies a key position in the delivery of safe high-end nursing care. It can be equated to being the backbone of the healthcare system, not only in Australia but across the globe (Duckett and Willcox, 2015). Healthcare practice and access are shaped by many factors. These can be internal factors within the healthcare system or external factors that include political, economic, historical, social and cultural issues. The essay seeks to critically look at the historical and cultural factors that have shaped the healthcare and healthcare access in Australia.
Key among the socio-cultural factors that have influenced healthcare is multiculturalism. Duckett and Willcox (2015) state that “political systems in Australia has also had an impact on the healthcare system. The federal system of governance has impacted on the construction, management, and funding of healthcare. These essay shall take a detailed review of the impact of each of multiculturalism and political system of Australia in healthcare and nursing practice.
Multiculturalism
Multiculturalism as a concept that became prevalent in the 1970s to promote tolerance to cultural diversity (Tan and Li, 2016). However, it has not been clearly differentiated from globalization and liberalism. Tan and Li, (2016) say that “it has a practical application in Australia and Canada”. It is closely related to the international migration of people across the borders. Historically, it is connected to the migrant workers, the colonial immigrants, and their family members as well as refugees. The idea aims at enhancing integration of immigrants. It carries the view that cultures, races, and ethnicities specifically the small communities need to be accorded special acknowledgment to their differences in the society
Renzaho et al., (2016) notes that people of immigrant background have been found to be in a poorer state of health and wellbeing as compared to the general population. The concern over the health status of the immigrants in Australia dates back to the late 1700s and early 1800s where immigrants to Australia were quarantined for them being suspected to be carrying contagious diseases like influenza and whooping cough. Over time, the immigrants have faced a myriad of challenges in relation to healthcare and its access. Renzaho et al., (2016) says “immigrants experience a lot of difficulties in getting social and healthcare services. The most obvious difference noted are the language barriers, dressing, and food consumption practices that pose great challenges to the patients, and employees in the various cultural settings.” This has created the need to train more personnel and even get other skilled personnel from other countries to assist in the management of the increasing international community in Australia.
The healthcare system and access have also been impacted by some cultural barriers like religion and the cultural heritage of the various communities who value preservation of their cultures. For example, female for the Middle East are fearful of male medical personnel. Also, those people who subscribe to denominations like Jehovah Witness always refuse to be transfused blood in the belief that they are polluting their holy bodies (Basic, Shanley and Gonzales, 2017). Basic, Shanley, and Gonzales (2017) note that the way people from various cultural settings have a vivid difference on how they express the health status, with some people, “especially those from English-speaking backgrounds tending to have more questions regarding their state of health as compared to immigrants from non-English speaking nations”.
With the development of multiculturalism and the desire to cater to the diverse need of the various communities, there was the need for nursing practices to address the challenges that came with it. This is addressed through transcultural or cross-cultural nursing. Under this concept, the cultural needs of the patient, equal access to treatment, respect the cultural beliefs and practices, communication and cultural safety are addressed.
In Australia, the influx of migrants leading to the increase in the population has led to the inadequacy of the healthcare personnel. It has created the need for more registered nurses to oversee the healthcare delivery. Also, there has been an influx of migrant nurses over time. It has greatly impacted on the workforce and capacity of Australia to provide health care to its multicultural community. It has helped in solving the challenges that come with workforce attraction and retention. The multicultural setting has led to notable changes in the role of registered nurse. Apart from assisting in the delivery of healthcare in general, nurses have to be advocates for cultural diversity and uphold cultural competence in their training and practice. The nurses have to have a clear understanding of the various groups of the people, their values, attitudes, beliefs, and practices of a specific group of people. Nurses have to provide individualized and culturally sensitive care. Nurses have to develop positive relationships with their clients to understand them better and reduce the ethnic disparities.
Political governance system
Australia system of governance is the federal system of government. It is made up of six partly self-governing states. The healthcare system is broadly provided in the public and private sector. The services are provided by private medical practitioners, private and hospitals operated by the government. The system of governance affects the healthcare of the country in a number of ways that include regulation and monitoring, provision of health care facilities and services, funding and policy development.
Dixit and Sambasivan (2018) state that “the greatest impact to the health care control by the political system of any nation is the policy development”. Policy development with a specific effect on the funding of the healthcare has been politically polarized. The reigning governments have always held the lead role in shaping the policy of the healthcare at the national level.
The costs of medical services in the nation is provided by the private insurance and agencies of the government with some of it being settled in out of pocket payments by the patient. Behan (2012) argues that “the government funds the healthcare system through Medicate scheme”. The plan bankrolls outpatient treatment and funds the free universal access to hospital treatment. The Medicare scheme is funded through a policy where there are a two percent charges on the taxpayers getting incomes above a certain amount of money. There are an extra one percent charges on the high-income people having no private health insurance. Of the other necessary charges, the government chips in and settle them from the general revenues (Kay and Boxall, 2015).
McPake and Mahal (2017) note that “the national government has always encouraged individuals having income beyond a certain level of revenues to acquire private insurance for themselves”. Looking at this, health care access in the nation is made easy, a factor that has enabled the nations to be ranked high among the developed countries in terms of health expenditure. The governments have control over the insurance private insurance. The private insurance schemes in Australia are regulated under the government legislation, The Private Health Insurance Act of 2007.
Dixit and Sambasivan (2018) argue that “the federal government is responsible for the administration of the Medicare programs. It pays the doctors and the nursing staff as well as financing hospitals run by the states”. Australian Institute of Health and Welfare is a body tasked with coming up with statistics and information with regard to the state of healthcare. The states are tasked with the administration of public hospitals. They can come up with their own initiatives to handle some particular challenges like breast cancer and dental health among others. The well-coordinated administration and control of health service in the nation have been crucial in the provision of high-quality healthcare.
The governments’ policy, regulation, and monitoring have had both direct and indirect impact towards the health care system and professional nursing practice. The nurses make up more than half of the clinical roles in the hospitals. NMBA (2016) notes that “the government exerts its role in the professional practice of nursing through the Nursing and Midwifery Board of Australia, the body tasked with professional regulation and standard setting. It also sets up the codes of conduct and the guidelines within the profession”. With the ever-evolving world of advancement in technology and changes in the needs of the clients as well as ways of healthcare delivery. The government comes in through setting up of regulatory frameworks to oversee high quality and standardized care of the citizens (Australian Qualification Framework Council, 2013). The regulatory framework also provides for the best channels to be used in the process of decision making. The continuous professional development of the registered nurses is also taken care of through NMBA.
Conclusion
Summing it up, the role of a registered nurse in the provision of health care cannot be underestimated in any setting. The state healthcare and healthcare access are under the influence of several factors within the system and outside the healthcare system. In Australia multicultural community that came with immigration brought in some challenges of health care including new diseases, put pressure on the healthcare system. However, there was the necessity to handle the challenges and therefore research was enhanced. T
he political factors have played a role as exhibited through the system of governance and administration of the healthcare services. Availability of high quality and affordable services has been improved through the favorable policies developed by the government and administered through the various regulatory bodies line the NMBA. Thus, cultural and political factors have shaped the role of registered nurse in the provision of professional services in the nation.
References
Australian Qualification Framework Council (2013) Australian qualifications framework,
Australian Qualification Framework Council, South Australia.
Basic, D., Shanley, C., & Gonzales, R. (2017). The Impact of Being a Migrant from a Non-English- Speaking Country on Healthcare Outcomes in Frail Older Inpatients: an Australian Study. Journal of cross-cultural gerontology, 32(4), 447-460.
Behan, P. (2012). Solving the Health Care Problem: How Other Nations Succeeded and Why the United States Has Not. SUNY Press.
Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective. SAGE open medicine, 6, 2050312118769211.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Dwyer, T., Rossi, D., Craswell, A., Holzberger, D., & Gardner, M. (2016). Strengthening health services through optimising nursing: Evaluation of nursing led services with nurse practitioners in regional Queensland.
Kay, A., & Boxall, A. M. (2015). Success and failure in public policy: Twin imposters or avenues for reform? Selected evidence from 40 years of health‐care reform in Australia. Australian Journal of Public Administration, 74(1), 33-41.
McPake, B., & Mahal, A. (2017). Addressing the Needs of an Aging Population in the Health System: The Australian Case. Health Systems & Reform, 3(3), 236-247.
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice.
Renzaho, A., Polonsky, M., Mellor, D., & Cyri)l, S. (2016. Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations. Australian Health Review, 40(1), 3-10.
Tan, N., & Li, S. (2016). Multiculturalism in Healthcare: A Review of Current Research into Diversity Found in the Healthcare Professional Population and the Patient Population. International Journal of Medical Students, 4(3), 112-119.