The declining performance of Australia’s secondary schools is limiting productivity growth. An ambitious, inclusive plan for policy reform is needed to move things in a better direction.
Productivity growth is the holy grail for economic policy makers. It comes when output is increased without having to increase inputs, or when we can get the same output for fewer inputs. Productivity growth in Australia has been elusive over the last few decades, largely because we have failed to invest in its enablers and have undermined the forces that drive productivity growth. The most important enabler is investment in knowledge – embedded in technology and in people. The most important force is free and fair institutions that support trade, allocate capital according to long term market forces and not cronyism, and promote structures that really do allow people with ideas and drive to “have a go”.
Australia’s declining educational performance in our secondary schools is and will continue to limit our productivity growth. It is a consequence of our failure to reform a badly damaged system and an exemplar of a wicked policy problem where the solutions pursued keep moving us in the wrong direction.
The problem is not the level of investment in the secondary education system, which at 2.1 per cent of GDP is well above the OECD average of 1.9 per cent. The problem is how this money is spent and the inequality in the opportunities it provides to young Australians. The flight to private schools has left the public system with a much higher share of young people who have already been disadvantaged. Selective public schools, at least in New South Wales, concentrate students from similar culturally and linguistically diverse backgrounds. Along with school districts where catchments reflect a similar socioeconomic and ethnic profile, these trends are further concentrating both disadvantage and advantage.
As a result, young people get to hang out with people like themselves. While this might sound like more fun, the concentration of disadvantage fundamentally undermines both aspirations and opportunity as many young people will lack exposure to different role models and access to networks that help in finding employment. It also raises the cost of achieving the same education outcome across schools as lack of aspiration and opportunity combine to erode the value to students in taking their schooling seriously. In addition, lack of diversity in schools plays to stereotypes, making it harder to address discrimination.
The problem is obvious, what to do about it is much harder. The Gonski funding formula was an attempt to reallocate public funding to better meet the costs of disadvantage in school populations. But almost ten years later the problem has continued to get worse. There is no shortage of commentary on what has gone wrong, from lack of funding to socioeconomic profiles being the wrong basis for a funding formula. There are also many proposals for reform, most involving more funding, that immediately get snagged on whether the states or the federal government should pick up the bill.
Education segregation is almost baked into the system
This state-federal funding divide is the first barrier to addressing the problems in the education system. The second barrier is that public funding for private school education is a political hot potato that no government wants to touch, other than to propose a funding boost as an election winner. The third barrier is that what is socially optimal is not individually optimal – families will always choose the best option for their child subject to their household budget constraint. This means they will choose private over public if they think the local school is unable to deliver the type of education they want for their children. For some, this is based on religious or other strong-held beliefs, but for most it is about perceptions of educational quality and a desire to select their children’s peer groups. Education segregation is almost baked into the system.
There is no quick fix to this policy conundrum. Band-aid solutions of more money here or there won’t make much difference as the fundamental problem stems from the broader, and growing, inequality in income, housing, health, and opportunity. Access to quality secondary education is one mechanism that will work to reverse this trend. This must be built on access to quality early learning and primary health care for children who currently lack access to these services.
Any investment strategy that aims to raise the return on our public (and private) education expenditure and reduce segregation needs a comprehensive bipartisan approach with state-federal cooperation. As this is clearly in the too hard basket for now, those advising governments need to think about the steps that will make it possible in the future.
These steps are not just for the education policy experts to follow. Rather, they are a way of making policy in these long-term and difficult to change areas that are more inclusive and less political.
The ten-step policy plan is as follows:
Set and socialise the agenda
Establish and keep updated an agreed fact base on the costs and outcomes of the current education system that explains the links to socioeconomic outcomes as both a cause and a consequence of the educational outcomes. Much of this research is already available. It needs to be compiled and communicated in a non-partisan way by state and federal education departments.
Establish a process to engage education advocates and the broader public in a conversation about the impacts of the current system, asking where Australians sit on the spectrum in terms of acceptable secondary education outcomes. This will inform the politics and is critical to establishing a long-term vision of what trade-offs Australians are willing to make in choice, quality, diversity and out-of-pocket costs.
Establish the institutions responsible for delivering the agenda
Establish a Joint Education Steering Group made up of state and federal government representatives from their education, health and social services departments. A research secretariat attached to the group would assess policy proposals from any of these agencies against the long-term vision to see if it works toward or against it.
Task this steering group with ensuring ongoing engagement with civil society on the agenda. The group would also publish an assessment of the impact of education policy proposals made by governments (and opposition parties) on the quality of education in schools and the impact on segregation by socioeconomic area.
Establish a bipartisan commitment to not pursue education policies that undermine the long-term vision.
Target and test the investments
Fund trials of investments to raise the quality of a selected number of public schools in low socio-economic areas. Trials could include, for example, charter schools, partnering with existing private or high performing public schools, or greater autonomy for schools to experiment with new approaches.
Evaluate and publish the outcomes of different approaches with funding from the federal government.
Look at the impacts of investments in other levels of education and health on the future secondary school outcomes. For example, consider funding new trials for early learning investment in low socio-economic areas.
Commit to a formula for all new funding
Commit all new secondary school funding to replicating successful approaches in low socioeconomic school districts.
Agree on, and embed in legislation, a state-federal cost sharing arrangement that shares the cost of these educational trials and commits to a level of funding to replicate them.
Changing our school system to create schools in all socioeconomic areas where parents want to send their children and where the diversity of the student population is valued is a generational project. But we need to start somewhere, and it is too important to leave to the whims of the electoral cycle alone.
Dr Jenny Gordon is an Honorary Professor at the Centre for Social Research and Methods, at the Australian National University and a non-resident fellow at the Lowy Institute. Jenny was the Chief Economist at DFAT from 2019 to 2021, establishing the Office of the Chief Economist (OCE) to bring together trade and investment economics with development economics. Jenny joined DFAT from Nous Group where she helped build their economic analysis service offer. Prior to this she spent 10 years at the Productivity Commission as the Principal Advisor Research. Jenny has a PhD in Economics from Harvard University and started her professional career at the Reserve Bank of Australia.
Caption: Australian student writing on an exam paper (Photo by Lincoln Beddoe/iStock)
Governments at all levels need a new mindset which places Aboriginal and Torres Strait Islander shared decision making at the centre of policy development, design and delivery.
Over the past four years, a movement has been underway to change how the nation approaches the gaps in life outcomes between Aboriginal and Torres Strait Islander peoples and other Australians. It started when Aboriginal and Torres Strait Islander community-controlled bodies stood up and called for shared decision making with governments.
Aboriginal and Torres Strait Islander peoples have historically been excluded from decisions of governments that directly impact on us and the communities we live in. This is despite repeated calls over many decades for our full participation and evidence demonstrating that the only way to improve our people’s health and wellbeing is with our formal involvement. We know that the majority of Australians support this.
In 2017, when governments embarked on a renewal of the “Closing the Gap” policy, we knew we had to act. Fourteen Aboriginal and Torres Strait Islander community-controlled peak bodies petitioned the prime minister, premiers and chief ministers, asking that the proposed refreshed policy not be agreed. Instead, we sought that a partnership be negotiated between our community-controlled organisations and Australian governments to then determine an agreed way forward. We had a breakthrough in late 2018 when Australian governments publicly committed to developing a formal partnership with Aboriginal and Torres Strait Islander representatives, and that through this partnership a new Closing the Gap policy would be agreed.
The fourteen organisations then became almost forty, as we brought together community-controlled peak bodies across the country to form the Coalition of Peaks. We formed as an act of self-determination and to work in partnership with governments on Closing the Gap. Our membership is now over seventy organisations, representing our peoples in areas including health, land, early childhood, education, business, housing and legal services. This is the first time that Aboriginal and Torres Strait Islander community-controlled organisations and leaders have come together in this way.
If Aboriginal and Torres Strait Islander peoples share in decisions about the policies that impact on us, the decisions and the quality of programs and services that flow from them will be vastly better; take account of our needs, cultures and circumstances; and achieve better outcomes.
Through our initiative, we negotiated and agreed the 2019 Partnership Agreement on Closing the Gap with governments. The Partnership Agreement sets out how the Coalition of Peaks and governments will share decisions with governments on developing, implementing, and monitoring and reviewing the Closing the Gap policy for the next ten years. This is an historic achievement, but we did not pause to reflect for long and we urgently set about the task of negotiating a new National Agreement on Closing the Gap.
Signed in 2020, the National Agreement is the first intergovernmental agreement designed to improve the lives of Aboriginal and Torres Strait Islander peoples that has been negotiated and agreed with our representatives. Along with the Partnership Agreement, it represents a major disruption to previous policies and approaches in Indigenous affairs: it asserts a right of our peoples, as First Peoples, to an ongoing role in shaping and implementing public policy and programs about us and for us. It contends that if Aboriginal and Torres Strait Islander peoples share in decisions about the policies that impact on us, the decisions and the quality of programs and services that flow from them will be vastly better; take account of our needs, cultures and circumstances; and achieve better outcomes.
The National Agreement is centred on four Priority Reforms designed to challenge and change the way governments work with our peoples and communities. They are intended to address the biggest gap that our peoples face: the gulf between the political autonomy and economic resources of Aboriginal and Torres Strait Islander peoples and non-Indigenous people and the impact of governments on our lives.
Decades of entrenched thinking that only governments know what is best for us is hard to change.
Priority Reform One is about shared decision making with governments to ensure the full involvement of Aboriginal and Torres Strait Islander peoples at the national, state and local or regional level and embedding their ownership and expertise to close the gap. It is intended to take us beyond governments setting up their own structures to consult Aboriginal and Torres Strait Islander peoples, including appointing advisers, and, instead, is about formal partnership arrangements negotiated and agreed to by governments and representatives of our peoples.
Priority Reform Two is a commitment to strengthen and place our community-controlled services at the heart of delivering programs and services to our people. There is strong evidence that our community-controlled services are better for Aboriginal and Torres Strait Islander peoples, achieve better results and help make sure we get the support we need. Further, no other way of delivering and governing services guarantees Aboriginal and Torres Strait Islander empowerment and protects our identities and cultures for the long term.
Priority Reform Three is a commitment by governments to ensure that mainstream agencies and institutions that deliver services and programs to Aboriginal and Torres Strait Islander peoples undertake systemic and structural transformation to contribute to Closing the Gap. Mainstream services, and the institutions that deliver them, have potential to improve life outcomes for Aboriginal and Torres Strait Islander peoples. However, they are too often unsafe and culturally damaging to our peoples.
Priority Reform Four is a commitment to ensuring Aboriginal and Torres Strait Islander peoples have access to, and the capability to use, locally relevant data and information to monitor the implementation of Closing the Gap and drive our own development. Better access to data means that we can make more informed decisions for our futures and hold governments to account.
Each of the Priority Reforms include specific commitments to actions by all governments and they each have their own target and indicators that governments have agreed to report publicly on every year.
The Coalition of Peaks is clear though: this is just the beginning. Whilst we have seen some significant changes from governments in response to the Partnership and National Agreements, challenges remain and the path being forged is rocky. Decades of entrenched thinking that only governments know what is best for us is hard to change. It is still too easy for governments to default to the old norms where our peoples are, at best, consulted, based on terms set by government and where decisions are made behind closed doors. Governments also need to see Closing the Gap as a whole-of-government responsibility, rather than the responsibility of Indigenous affairs ministers and their department alone.
Moving the Priority Reforms from the rhetoric to reality requires governments to radically recalibrate how it approaches Indigenous affairs. This includes a new mindset which places Aboriginal and Torres Strait Islander shared decision making at the centre of policy development, design and delivery and fosters whole-of government innovation in the implementation of their commitments. The path to Closing the Gap is set out in the Partnership and National Agreements – we need the nation to take a leap forward.
Ms Pat Turner AM is an Aboriginal woman from Central Australia, the daughter of an Arrernte man and a Gurdanji woman. She is the lead convener of the Coalition of Peaks and the chief executive officer of the National Aboriginal Community Controlled Health Organisation.
COVID-19 reminded us that insights from the lab and the social world must be considered in tandem to tackle some of our hardest public health challenges.
Though my role in the COVID-19 pandemic has largely been to function as a public science communicator, most of my professional life has been spent as a laboratory-based researcher dissecting the nature of virus infections and the very specific ‘adaptive’ immune response that protects us.
Some who worked with me as junior colleagues early in their careers, particularly Katherine Kedzierska at the Doherty Institute and Paul Thomas at St Jude Children’s Research Hospital, Memphis, have now taken the technology that we (especially Steve Turner, now at Monash University) and others developed in mice to analyse how people respond to the SARS-CoV-2 virus.
One positive from the COVID-19 emergency has been the availability of increased financial resources and the involvement of talented immunologists who normally work in other areas. Overall, this has led to our developing a detailed understanding of immunity to SARS-CoV-2 and, in fact, an expanded view of the host response to viruses and vaccines. Another positive has, of course, been the rapid roll-out of the new mRNA vaccines, after decades of laboratory-based invention and development.
But, as we all understand, the type of hard science done in well-funded, sophisticated laboratories is only part of the story when it comes to dealing with a pandemic. The rapid public health response to COVID-19 in Australia was enabled by the fact that Mike Catton and Julian Drucefrom the Victorian Infectious Disease Reference Laboratory (VIDRL) at the Doherty Institute developed a sensitive PCR test as soon as the virus sequence was published (mid-January 2020). That was used a few days later to confirm the first case of COVID-19 in Victoria and to isolate the causative SARS-CoV-2 virus, which VIDRL immediately offered to legitimate research and diagnostic facilities across the planet.
Such diagnostic virology expertise reflects the involvement of high quality, experienced professionals working in first class and secure government laboratories. It is essential for any rational and effective public health response.
The type of hard science done in well-funded, sophisticated laboratories is only part of the story when it comes to dealing with a pandemic.
Limiting the toll from COVID-19 has, of course, been about many areas of human expertise that go far beyond the work of research and diagnostic laboratories. In our political system, policy decisions must, of course, be made ultimately by elected representatives. But they in turn depend on the advice of Chief Medical Officers, who draw on the advice of public health doctors (many of whom are trained in epidemiology) and established, standing committees – like Australian Technical Advisory Group on Immunisation(ATAGI) – in relevant areas.
Epidemiological models are, in fact, sophisticated, mathematically developed “thought experiments” that, based in the best available data about disease incidence and spread, provide decision makers with a spectrum of options. Most will be familiar with the publicity around the Doherty Institute(plus six other universities) modelling team led by paediatrician and epidemiologist Jodie McVernon. The predictive value of these epidemiological models is, of course, subject to the vagaries of both the virus and of human behaviour!
As a very focused, laboratory-based investigator, I first became acutely aware of the centrality of the behavioural and social sciences in pandemic responsiveness during the early 1980s’, when HIV/AIDS came out of nowhere.
In Australia, the Hawke government response led by Health Minister Neil Blewett immediately involved the shadow health spokesman Jim Carlton, and they worked closely and productively together. Following the medical advice, health authorities quickly rolled out free, mobile treatment clinics in flashpoint areas (like Kings Cross) and distributed clean, disposable needles (AIDS is a blood-borne disease) to injecting drug users.
By contrast, the US response under President Ronald Reagan was a disaster playing to the perceptions of judgemental “religious conservatives”. Free needles were never offered in the USA, and HIV became established in the drug dependant population there, but not here.
Another positive initiative from the COVID experience will be the establishment of a new Australian Institute of Infectious Diseases(AIID), adjacent to the existing Doherty Institute at the University of Melbourne’s Parkville site. When this new AIID building is completed, the Burnet Institute will move up from its current location near the Alfred Hospital.
Badged under both the University of Melbourne and Monash University, the Burnet has (like the Doherty Institute) very active epidemiology and laboratory-based research programs looking at HIV/AIDS and malaria. But it also brings in a major area of expertise that we lack. Globally, the Burnet is best known for its work on harm reduction which is, of course, based in the social sciences. Over the decades, the Burnet has been contracted by governments in Asia and Africa to help develop appropriate policy and public health responses to several pandemics, especially the continuing AIDS Pandemic. Locally, they have focused on the spectrum of sexually transmitted diseases.
I first became acutely aware of the centrality of the behavioural and social sciences in pandemic responsiveness during the early 1980s, when HIV/AIDS came out of nowhere.
When it comes to human behaviour and COVID-19,a minority of loud and counterproductive responses to vaccination, mask wearing and so forth – substantially fuelled via social media – have become too familiar to most of us. Clearly, the dissection of what is happening here is in the realm of the social and behavioural sciences. And it is also a major challenge for science communicators. That community needs the help of the behavioural scientists as they try to develop approaches that involve and interest marginalised groups.
My sense all along with COVID-19 has been that, as various nation states responded with somewhat different public health strategies and outcomes, we have a unique opportunity to “interrogate” the mass of quantitative and other data that has accumulated with the intent of developing optimal approaches for dealing with future pandemics. That requires, I believe, that we fund academics in economics, the social and behavioural sciences and, of course, the medical sciences to do rigorous, in-depth analysis and publish well documented data sets and conclusions. With challenge comes opportunity. The clear need is to“seize the day” that COVID-19 has opened to us.
Laureate Professor Peter Doherty AC shared the Nobel Prize in Physiology or Medicine in 1996 with Rolf Zinkernagel for their discovery of how the immune system recognises virus-infected cells. He was Australian of the Year in 1997. Professor Doherty is now patron of the Peter Doherty Institute for Infection and Immunity, a joint venture between the University of Melbourne and the Royal Melbourne Hospital, and the Michael F Tamer Chair of Biomedical Research at St Jude Children’s Research Hospital in Memphis.
Caption: A mobile testing site in the car park of Chadstone shopping centre in Melbourne, Australia (DLMcK/iStock)
Almost all the materials used for electrification are finite. Waste recycling should play a major role in the transition to a decarbonised economy.
Recovering critical and valuable materials from waste has a vital role to play in electrifying the world as we transition towards renewable energy and decarbonisation.
However, many of the commodities and critical materials needed for this electrification are subject to record prices. And many are simply dug up from the ground, while at the same time we are landfilling waste.
With growth in electric vehicles, wind turbines, and domestic solar systems, and an uptick in demand for batteries – including for electronics such as phones and computers – it is often overlooked that almost all of the materials needed to electrify our world are finite.
This is where waste recycling in Australia can play a major role, and rightly our nation has various strategies and policies addressing this critical issue.
Often this waste is exported and the value derived from the extraction and recovery of the embedded materials is lost to Australia.
We need a change of mindset that values our materials and challenges our throw-away mentality.
Technologies developed, and being developed, by the SMaRT Centre can also recycle and reform many of the materials from electronic waste that contain copper, manganese, zinc, gold and various rare earth elements.
And in a new announcement, the Centre’s research shows that waste coffee grounds and hydrogen derived from other wastes can be used as part of its Green Steel® Polymer Injection Technology.
Wastes from plastic, coffee grounds and rubber tyres are now used as alternative sources of coke and coal for steelmaking.
These methods of introducing hydrogen to the manufacturing process for steel demonstrate vast improvements in efficiency and the amount of energy required.
This means that waste itself can, and should, be seen as a resource if we want to electrify the world and boost sustainability in our economy.
Using “microrecycling”-based techniques to turn waste into value-added materials means we can also accelerate our sovereign manufacturing capability: more important than ever in our COVID-affected and supply chain-constrained world.
For instance, in the past five years, the volume of discarded smartphones, laptops, printers and many other electronic devices reaching their end of life jumped by 21 per cent.
This e-waste reached a record 53.6 million metric tonnes in 2019, an average of 7.3 kilograms per person, and has become the fastest-growing domestic waste stream. Global e-waste will reach a staggering 74 million metric tonnes by 2030, with most ending up in landfill, stockpiles or incinerated.
Yet recycling is not keeping pace with the global growth of e-waste – just 17.4 per cent of e-waste in 2019 was collected and recycled. Incredibly, this means the amount of e-waste could easily become equal to or bigger than plastics.
The European Electronics Recyclers Association states that 60-95 per cent of e-waste can be recycled. According to the UN, the value of raw materials in the e-waste generated in 2019 was about $57 billion USD, yet just $10 billion was recovered through recycling. What’s more, electric vehicle sales rose 40 per cent to 3.1 million units in 2020 and are predicted to grow to 30-40 million units by 2030.
Yet across the world there is a growing willingness within communities to embrace the many and considerable issues we face in the management of our materials sustainability, not just in cleaner energy.
The right value for our waste
We need a change of mindset that values our materials and challenges our throw-away mentality.
New government policies pleasingly include rare earths (such as neodymium found in computer hard drives) as a national priority. A renewed focus across all levels of government to better manage our waste, recycling and manufacturing resources is also welcome.
Even the International Energy Agency, in its recently released “Net Zero by 2050” report, is calling for more advanced recycling capability, noting that 40 per cent of emissions saving in 2030 will come from improvements in materials efficiency and increased recycling by business.
Recycling not only brings obvious benefits to society, but delivers reduced energy needs and environmental impacts by overcoming the energy-intensive extraction and processing required of natural resources.
The Federal Government’s National Waste Report 2020 shows that Australia’s national waste has increased to 74 million tonnes a year. Of that, about 60 per cent is estimated to be recycled. This is below the national resource recovery target of 80 per cent by 2030, which was set in the 2019 National Waste Policy Action Plan. Moreover, Australia’s new waste export bans coming into effect from this year are expected to reduce the rate of recycling.
Infrastructure Australia recently found that constraints on the collection and processing of recyclable waste, including product design and low demand, have led to recyclable waste ending up in landfill.
That report highlights the urgent need for new waste and recycling infrastructure, and has listed as the highest priority the need for the nation to retool itself in this area.
That is why I see a huge opportunity to adopt and create new technologies that lead to new supply chains and jobs to address these challenges.
My vision is for Australia to have decentralised and modernised manufacturing and recycling sectors, with both working closely together in sync. This will help us give greater value to our materials while striving for better material sustainability.
Enabling onshore, sophisticated waste processing, recycling and the reforming of waste as a resource will be central to global electrification and Australia’s ongoing prosperity.
Professor Veena Sahajwalla is an internationally recognised materials scientist, engineer, and inventor revolutionising recycling science. She is the Director of the UNSW Sustainable Materials Research and Technology (SMaRT) Centre, and the inventor of polymer injection technology, known as Green SteelTM, an eco-friendly process for using recycled tyres and other wastes in steel production. In 2018, Veena launched the world’s first of her MICROfactories® and she is the Director of the ARC Microrecycling Research Hub, as well as Leader of the new national Sustainable Communities and Waste Hub. Veena was also named the 2022 NSW Australian of the Year.
High-quality mental health care is possible. But it will demand structural reform, effective accountability, and the will to make it a reality.
Although 2022 is the 30th anniversary of Australia’s national mental health strategy, and after five previous five-year federal-state agreements, we are faced with the reality that affordable access to high-quality care remains out of reach to many of those in greatest need. As with aged care, the COVID pandemic has now highlighted to the wider public those major structural flaws that had been neglected for decades. Contrary to much popular and political belief, these major service problems are tractable in wealthy countries like Australia.
While our nine governments have just agreed another “landmark” mental health agreement on the eve of the 2022 federal election, the majority of the key recommendations of the 2014 National Mental Health Commission and 2020 Productivity Commission reviews have not yet been enacted. These structural reforms are the necessary actions that now need to precede investments of significant new monies.
More likely, however, is the announcement of many more small program funds, distributed across a wide variety of well-known “brands” and service providers with little attention to the reality that this piece meal approach has perpetuated the very poor experiences of care that have been documented by various commissions over the last 20 years, for example the Mental Health Council and the Victorian Royal Commission.
So, three questions must be addressed if we are ever to make serious progress. First, what are the key structural reforms that have not been implemented? Second, who will be held accountable for the implementation of these reforms? To use the phrase of the age, we must know “who does hold the hose?”. Third, given the longstanding and bipartisan political commitment to progress, what are the major political or social forces that perpetuate this public policy failure?
The structural reforms required have been well-documented and include:
Expanding services to provide effective care for up to 15 per cent of the population in any year. This includes about 3-5 per cent who require hospital-based or emergency services and another 5 per cent of people do receive primary-care based or specialist services for various less complex anxiety or depressive disorders, but with high reliance on capacity to meet out-of-pocket costs. However, at least another 5 per cent of people, typically described as the “missing middle”, do not receive affordable or effective care. In this group, there is an over-representation of children, young people, those disadvantaged by geography or socio-economic status and those with more complex mental health needs.
Shifting the balance of service funding (and specialist service provision) from hospital-focused and activity-based to community-focused and outcomes-based reimbursement.
Moving the clinical service system from predominantly a late-intervention and chronic disease focus to prevention and early intervention. As 75 per cent of disorders have their onset before 25 years of age, and 50 per cent before 15 years, this means services need to be directed increasingly at children and young people.
The catch cry for such services should be “Right care, first time, where you live”. Responding effectively to the challenges of “place” (“where you live”) requires the recognition of the importance of socioeconomic and geographic regions, each with their own demographic and cultural challenges. In Australia, we have 52 recognised regions where mental health services need to operate in synchrony with other human services.
Provision of quality care that is based on highly-personalised assessment, multidisciplinary delivery of care and active use of measurement-based outcome tools. As our current public (activity-based for restricted services) and private (largely government-insured with large out-of-pocket costs) funding models respond poorly to these challenges, alternative and more equitable funding arrangements are urgently required, including: competitive, innovative funding pools; incentives to provide new specialist and multidisciplinary services for more complex care; and, other novel population-based models.
Active use of population-based and other planning tools at the regional level that not only recognise the social and economic context of mental ill-health, but also engage the relevant local authorities and community leaders in collaborative decision-making with a commitment to long-term implementation.
Responding urgently to the opportunities created by new digital technologies, not just for the delivery of low-cost, high-quality services to disadvantaged people, but also for the effective coordination of service delivery to empower the primary users of those services. This is likely to support better clinical outcomes. Internationally, the “uberisation” of mental health services is rapidly developing and this will inevitably disrupt the current business models of “bricks-and-mortar” based clinics.
Recognising the need for real innovation in the delivery of psychosocial services that promote social and functional recovery at all stages of illness. This now means serious reform of the National Disability Insurance Scheme (NDIS), and the acceptance that while at least 90,000 Australians will require the highest level of individual financial support, at least another 250,000 require significant psychosocial services.
Insisting that while suicide prevention at the population level is strongly influenced by major economic (e.g., employment, financial security) and social (e.g., social connection and cohesion) factors, mental health services have a key role to play in ensuring safety and reducing risk in those who present for care.
Acting to reduce the premature death, and high rates of physical ill-health, in those living with major mental illness. As modifiable risk factors (most notably cigarette smoking) and lack of access to physical health care largely account for these poor outcomes, provision of effective physical health care by multidisciplinary and skilled teams is required.
Development of smart data systems, that provide real-time information on key user concerns (waiting times, out-of-pocket costs, experiences of care), service access and affordability, individual-level outcomes, resource distribution and population-level outcomes.
Support for regionally-based accountability frameworks, so that it is clear who is responsible for the planning, funding and commissioning functions for the full spectrum of services within each region.
The second key question is: who will be held accountable for promoting, funding and implementing these key reforms? Our 30-year history is that each level of government simply retreats to being responsible only for that part under its direct control. So, the states retreat to public hospitals and acute services, while the Commonwealth funds the activity without direct responsibility for the resulting services. At best, we have been left “half-pregnant”.
Both the Productivity Commission and the previous National Review emphasised the need to move to a system of regionally-based accountability, but recognised that this is only possible if the funding and commissioning functions are devolved to the regional level. A solution is therefore at hand if the respective governments agreed to cooperate and implement change at the regional level.
Given the conceptual consensus to shift to regionally-based planning, funding and service delivery, and the recognition of the key structural reforms required, why is there the lack of substantive progress? Many would argue that the funding never moves to match the rhetoric. The proportion of health spending on mental health and suicide prevention has remained static at 7.5 per cent over the last three decades. Given the burden due to mental ill-health is at least 14 per cent of total illness burden, and that suicide remains the major cause of productive years of life lost in Australia, the level of financial investment is grossly inadequate.
The clear reservation of many in power, however, is that many more dollars into our highly dysfunctional system would not result in better outcomes. Despite the many plans, there has never been a move to dismantle the financial and structural underpinnings of this dysfunctional system. This compares poorly with the restructure of disability services under the NDIS. So, the end-result is an ongoing impasse.
A political breakthrough, therefore, is likely to depend on three factors. First, enhanced belief at the community level that these problems are actually tractable. We can fix them by focusing on resolving the issues with less top-down “one size fits all” and much more “bottom-up” one region at a time. Second, by empowering local leadership, capability and accountability at the regional level to drive this process. Third, by governments engaging with twenty-first century approaches to co-design, system modelling and use of smart technologies to empower service users to drive substantive improvement in their own care.
Professor Ian Hickie AM is a Professor of Psychiatry and the Co-Director of Health and Policy at the University of Sydney’s Brain and Mind Centre. He has led major public health and health services developments in Australia, particularly focusing on early intervention for young people with depression, suicidal thoughts and behaviours and complex mood disorders. He is active in the development through codesign, implementation and continuous evaluation of new health information and personal monitoring technologies to drive highly-personalised and measurement-based care.
Caption: Affordable access to high-quality care remains out of reach to many Australians (Photo by Courtneyk/iStock)
Policymakers help to design the future. Their challenge is to embrace a world of twenty-first century dynamic, complex systems.
Policymakers are futurists. In designing and implementing policies and programs that aim to prompt and foster particular behaviours, policymakers engineer future outcomes in society. In this sense, policymakers design the future. It is a daunting space to inhabit, and also a hopeful one.
There are many tools policymakers can use to glimpse the future and to design towards it. As the world continues to reel in response to systemic shocks, no tool for the future has more potential at this point in time than cybernetics.
As we reflect on the events of the past three years it is clear that we are still processing – individually and collectively – what has happened. And it is not over. We can’t yet know exactly how we have been changed – by the pandemic and other recent events – but what we do know is that these past three years have shaped and reshaped our bodies, our homes, our families, our daily lives, our communities, our schools, our companies, our cities and even our governments. These events have impacted our ideas about data, privacy, borders, danger, vaccinations, regulations and whom among our public figures is worthy of our trust.
We can learn a lot from how we have responded to all of this so far. But, even on the eve of a federal election, there remains a persistent lack of clarity about what the future could or should be.
This moment feels like an opportunity to do more. And if so, where do we start?
To start thinking about the future differently we can contemplate the perspective of Australia’s First Nations people. The concept of “always was, always will be” offers a through line from past to present to future and makes clear both persistence and responsibility. It directs us to meditate on the shape of the future, and think about the tools and approaches we might need to cultivate in order to succeed in it.
To help with this task, I often think of a quote by science fiction author, William Gibson: “the future is already here, it’s just unevenly distributed”. Gibson’s provocation suggests that the future is not a destination or an event yet to transpire, but rather is a collection of activities, encounters and even things that we can see, if we so choose. In this way, the future is knowable, even observable in our present, if we pay the right attention.
Paying attention to our world in 2022 and trying to observe the future, we see that the future is not a technology, or a set of behaviours or demographic patterns. It is clear that recent events – pandemic, bushfires, war – are not simple, single events. They are manifestations of complex adaptive systems; systems that encompass ecological, cultural, social, economic and technological dimensions. The challenges of designing the future in a world full of such systems feels acute.
Ordinarily, most systems remain invisible to the general public.
Prior to the pandemic, for instance, most of us didn’t spend a lot of time pondering global supply chains, or the complex dance of delivery services, or the interconnections of state and federal regulatory frameworks. But since the start of the pandemic, we have seen many systems rendered in plain sight, and implicated in our everyday lives. In part, the failure of these systems is what made them visible to the public: systems that delivered food to our grocery stores, systems that delivered educational content to our children, systems that made sense of viral loads and population epidemiology; systems to obtain, certify and distribute vaccines; systems that shut down our borders; systems that spread factual news; even the systems of electricity, telephony and the internet. We saw these systems because they stopped working.
…the future is knowable, even observable in our present, if we pay the right attention.
This sudden knowledge of systems sits atop other knowledge that we gained in the bushfire season of 2019-20. That season made unforgettably visible a different set of systems – fire, water, rain, wind, smoke, firefighters and fire safety apps, and of course climate and climate change.
As we look to a future rich with ever more such systems, policymakers will need to imagine new models of engagement and governance, new kinds of critical thinking and critical doing, and new sorts of training. How do we teach ourselves to see these systems all the time, not just when they are broken?
This brings us back to cybernetics. In the 1940s, at a not dissimilar moment of upheaval and change, an approach to systems as a building block of the future emerged. That approach was called cybernetics. In close conversation with the rise in computing and technological innovation, and against the backdrop of the destructive power of nuclear weaponry, cybernetics was an intellectual wellspring for the twentieth century. Scratch the surface and somewhere there will be a link to cybernetics. It was more than just an approach to the future, it was also inspiration for a multiplicity of different futures and a toolkit to get you there.
One of the key concepts in cybernetics that has persisted is the idea of feedback – where the output of a system is also its future input. In cybernetics, feedback was married with circular causality, which focused on reciprocal relationships between the ecological, human and technical pieces of the system.
In a future rich in dynamic and adaptive systems, we will need to pay particular attention to feedback, feedback loops and reciprocities – to the ways that they are constituted and constitutive. We will need to see each system and its dynamics; not just its pieces but the ways in which they are assembled, and by whom. We will need to remember and be reminded that every system has a history and set of reasons it came to be that way. Knowing how to ask about the boundaries of a system, its interdependencies and affordances are critical skills; as is being able to determine who is erased or rendered mute or invisible in a system.
Our responsibility then is to ensure that as we contemplate future systems, we do so alive to the fact that they will embody a politic, and conscious of the fact that we can shape that self-same point of view. We should not adhere to the notion that technology is neutral and should instead encourage debate about the values in technology and the systems that would encompass them. This is as true for a regulatory framework managing electronic vehicle charging stations as it is for the next generation NBN network, or telehealth rebate schemes, among many, many other things. We will need to actively create spaces for such conversations and equip ourselves to have them.
When we launched a new School of Cybernetics at the Australian National University in January 2021, it was to deeply investigate all of this and more. It is the first school of cybernetics in Australia, and the first new school of cybernetics globally in two generations. And whilst much has been written about the theory of cybernetics, far less has been written about the organisations that do it well. So, we have been finding our way. And we have been doing so in close conversation with a range of people including policymakers, with a significant proportion of our graduates being current members of the public service.
Approaching future systems
The futures we design will require different models of leadership, critical thinking and critical doing, and different kinds of training experiences than those currently at hand. We need to fill this gap. We need to help citizens and organisations approach future systems, and to critically frame the role of government, industry, and civic and civil society in the creation, management, regulation, and security of such systems. Much like the cybernetic conversations of the 1940s, we need as many voices and points of view as we can gather together. In the School of Cybernetics, I like to believe we are doing some of that work. I hope others will join us.
Cybernetics is an important approach to the “systems-full” future, and it strikes me that there is an opportunity to reappraise and refit it for a world of twenty-first century dynamic, complex systems, and for the people who will regulate them. For policymakers, this is an invitation and a challenge. Cybernetics is an articulation of a system with dynamic feedback loops, which brings together humans, increasingly smart computing, and the broader ecological world. It is also an approach to building such complex systems that favours many voices, unfolding conversations, and the necessity to build new knowledge.
In 2021 Distinguished Professor Genevieve Bell was asked to deliver the Garran Oration. This piece draws on that speech.
Distinguished Professor Genevieve Bell AO FTSE FAHA is a renowned anthropologist, technologist, and futurist. Genevieve is currently the Director of the School of Cybernetics and the 3A Institute (3Ai) at the Australian National University and also remains a Vice President and Senior Fellow at Intel Corporation. She is also a non-executive director of the Commonwealth Bank of Australia.
Caption: The 2019-2020 bushfire season made a different set of systems visible – fire, water, rain, wind, smoke, firefighters and fire safety apps, and of course climate and climate change. (Photo by Stuart Shaw/iStock)
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A digital publication of the James Martin Institute for Public Policy. For more information please visit jmi.org.au or contact email@example.com For advertising and media enquiries please contact firstname.lastname@example.org