Robert Griew | University of Melbourne (original) (raw)
Papers by Robert Griew
Smith. We were helped in our work by the support and involvement of the Indigenous Higher Educati... more Smith. We were helped in our work by the support and involvement of the Indigenous Higher Education Advisory Council, particularly Professor Aileen Moreton-Robinson. We were also greatly assisted by Mr Frank Gafa, who liaised with the National Union of Students and ensured that we gave strong consideration to the views of students, and Professor Peter Lee who liaised with Universities Australia and ensured that we understood the perspective of the sector as we developed our thinking and recommendations. A review of this size and complexity is not possible without a strong and dedicated secretariat. Thank you to the Review Secretariat team headed by Jasmin Fielder and supported by senior staff including, over the period, Catherine Vandermark, Lisa Schofield and Craig Ritchie. Thank you, Minister, for giving us all the opportunity to work on and contribute to the Review.
In 1995, an innovative model of Aboriginal involvement in health care began in the far west of NS... more In 1995, an innovative model of Aboriginal involvement in health care began in the far west of NSW. The local Aboriginal leaders interested in establishing peak health council for the far west of NSW decided not to establish a parallel service structure but to engage with the mainstream Area Health Services. An Agreement was signed between the new organisation, which later became Maari Ma, and the Far West Area Health Service, under which Maari Ma provided a management service for remote health services that would remain Area services. This Review was commissioned to evaluate the Agreement, through its various iterations, ten years on, and to make recommendations for the future. The Agreement was due to come to an end at 31 December 2006 and its parties wanted to know what has been achieved and seek recommendations about any future agreement. There had been several changes in the institutional structures surrounding the Agreement over the last ten years. There was no longer any shared sense of clarity about the purpose of the Agreement. The Review took place in two phases. The first phase, timed to provide advice for the decision that Maari Ma and GWAHS needed to make at the end of 2006, involved an extensive exploration of the historical record and in depth interviewing with key players from the inception of the Agreement and since. The aim was to provide to new players a clear understanding of what the Agreement had been trying to achieve, both in health service reform and in response to the political aspirations of local Aboriginal leaders. Thus the first phase of the Review produced an analysis of the implicit governance model. Also included in the first phase of the Review was an evaluation of results achieved under the Agreement based on documentary and file searches, interviewing and visits and the analysis of health information that could be accessed during the necessarily compressed timeframe. An evaluation framework was adopted that assessed results under the Agreement against a tiered set of objectives from a Health Performance Framework previously endorsed by the Australian Health Ministers’ Council. The tiers included: • Financial and management obligations; • Aboriginal workforce development; • Access to services for Indigenous and non-Indigenous residents; • Improved Aboriginal community engagement in health; • Health service reform; and • Health outcomes. The first Report was accepted by Maari Ma and GWAHS in late 2006. At a briefing of the Director-General of NSW Health at that time she agreed that it would be useful for further, more rigorous, analysis to be undertaken of the last objective relating to health outcomes. This would use data not available at the time, with the support of the Centre for Epidemiology and Research in NSW Health. The second stage of the evaluation of health outcomes has been undertaken during 2007. To achieve this four sources of potential data were considered, including: health behaviour from the NSW Health Surveys (which turned out not to be useful); pregnancy related indicators from the Midwives Collection; and mortality and hospitalisation data from administrative collections. Data were compared for the specific LGAs served under the Agreement with Indigenous and non-Indigenous comparator populations in a selected group of similar LGAs in neighbouring parts of NSW. A more detailed data analysis allowed a number of useful results to be added to the first phase analysis. Significant improvements have been achieved in both access to antenatal care in the first 20 weeks of pregnancy and for vaccine preventable hospitalisations for the Indigenous population covered by the Agreement. Encouraging trends were also identified for premature and low birth weights, and in the rate of acute ambulatory care preventable hospitalizations, for Indigenous people covered by the Agreement. The Review Team concluded that the Agreement has been effectively implemented and has been an essential part of an impressive and encouraging record of health reform in the Remote Cluster, over ten years. It recommended a new Agreement be negotiated. The Review also considered a number of key issues arising for the parties to the Agreement in the negotiation of any new Agreement and made a number of recommendations as a result.
12 Drawing on powerful practitioner-based knowledge to drive policy development, implementation a... more 12 Drawing on powerful practitioner-based knowledge to drive policy development, implementation and evaluation
ABSTRACT This paper reviews the effectiveness of Aboriginal health care programs, and identifies ... more ABSTRACT This paper reviews the effectiveness of Aboriginal health care programs, and identifies the programs and strategies that appear to work. The authors use a process of literature review and a focus on specific projects in each Australian jurisdiction to achieve their aim. Although much of the literature is found to be inconclusive and key health indicators appear to show little improvement in the health of Indigenous Australians, the paper identifies improvements in underlying health infrastructure and an encouraging increase in government commitment to dealing with the problem. The paper recommends longer program funding cycles and more rigorous evaluation of program data as ways of improving organisational stability and program outcomes.
New Zealand bioethics journal, 2003
In this paper we overview the findings of a literature review that was undertaken to guide the re... more In this paper we overview the findings of a literature review that was undertaken to guide the revision of the Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research (NH&MRC, 1991). The literature reviewed, in general, supported the development of specific research guidelines for Aboriginal and Torres Strait Islander contexts. The findings of this review were analysed thematically, and a number of key issues were identified for consideration in the review process. We present a summary of these key issues. In the final section of the paper we consider in more detail two of the key issues raised in the review process (the assessment of relevance or benefit of proposed research; and the process of consultation and negotiation of collective consent) in order to critically consider how these issue should be engaged in revised guidelines. On the basis of this analysis, it is our contention that specific guidelines on key issues are limited to the extent to ...
Smith. We were helped in our work by the support and involvement of the Indigenous Higher Educati... more Smith. We were helped in our work by the support and involvement of the Indigenous Higher Education Advisory Council, particularly Professor Aileen Moreton-Robinson. We were also greatly assisted by Mr Frank Gafa, who liaised with the National Union of Students and ensured that we gave strong consideration to the views of students, and Professor Peter Lee who liaised with Universities Australia and ensured that we understood the perspective of the sector as we developed our thinking and recommendations. A review of this size and complexity is not possible without a strong and dedicated secretariat. Thank you to the Review Secretariat team headed by Jasmin Fielder and supported by senior staff including, over the period, Catherine Vandermark, Lisa Schofield and Craig Ritchie. Thank you, Minister, for giving us all the opportunity to work on and contribute to the Review.
In 1995, an innovative model of Aboriginal involvement in health care began in the far west of NS... more In 1995, an innovative model of Aboriginal involvement in health care began in the far west of NSW. The local Aboriginal leaders interested in establishing peak health council for the far west of NSW decided not to establish a parallel service structure but to engage with the mainstream Area Health Services. An Agreement was signed between the new organisation, which later became Maari Ma, and the Far West Area Health Service, under which Maari Ma provided a management service for remote health services that would remain Area services. This Review was commissioned to evaluate the Agreement, through its various iterations, ten years on, and to make recommendations for the future. The Agreement was due to come to an end at 31 December 2006 and its parties wanted to know what has been achieved and seek recommendations about any future agreement. There had been several changes in the institutional structures surrounding the Agreement over the last ten years. There was no longer any shared sense of clarity about the purpose of the Agreement. The Review took place in two phases. The first phase, timed to provide advice for the decision that Maari Ma and GWAHS needed to make at the end of 2006, involved an extensive exploration of the historical record and in depth interviewing with key players from the inception of the Agreement and since. The aim was to provide to new players a clear understanding of what the Agreement had been trying to achieve, both in health service reform and in response to the political aspirations of local Aboriginal leaders. Thus the first phase of the Review produced an analysis of the implicit governance model. Also included in the first phase of the Review was an evaluation of results achieved under the Agreement based on documentary and file searches, interviewing and visits and the analysis of health information that could be accessed during the necessarily compressed timeframe. An evaluation framework was adopted that assessed results under the Agreement against a tiered set of objectives from a Health Performance Framework previously endorsed by the Australian Health Ministers’ Council. The tiers included: • Financial and management obligations; • Aboriginal workforce development; • Access to services for Indigenous and non-Indigenous residents; • Improved Aboriginal community engagement in health; • Health service reform; and • Health outcomes. The first Report was accepted by Maari Ma and GWAHS in late 2006. At a briefing of the Director-General of NSW Health at that time she agreed that it would be useful for further, more rigorous, analysis to be undertaken of the last objective relating to health outcomes. This would use data not available at the time, with the support of the Centre for Epidemiology and Research in NSW Health. The second stage of the evaluation of health outcomes has been undertaken during 2007. To achieve this four sources of potential data were considered, including: health behaviour from the NSW Health Surveys (which turned out not to be useful); pregnancy related indicators from the Midwives Collection; and mortality and hospitalisation data from administrative collections. Data were compared for the specific LGAs served under the Agreement with Indigenous and non-Indigenous comparator populations in a selected group of similar LGAs in neighbouring parts of NSW. A more detailed data analysis allowed a number of useful results to be added to the first phase analysis. Significant improvements have been achieved in both access to antenatal care in the first 20 weeks of pregnancy and for vaccine preventable hospitalisations for the Indigenous population covered by the Agreement. Encouraging trends were also identified for premature and low birth weights, and in the rate of acute ambulatory care preventable hospitalizations, for Indigenous people covered by the Agreement. The Review Team concluded that the Agreement has been effectively implemented and has been an essential part of an impressive and encouraging record of health reform in the Remote Cluster, over ten years. It recommended a new Agreement be negotiated. The Review also considered a number of key issues arising for the parties to the Agreement in the negotiation of any new Agreement and made a number of recommendations as a result.
12 Drawing on powerful practitioner-based knowledge to drive policy development, implementation a... more 12 Drawing on powerful practitioner-based knowledge to drive policy development, implementation and evaluation
ABSTRACT This paper reviews the effectiveness of Aboriginal health care programs, and identifies ... more ABSTRACT This paper reviews the effectiveness of Aboriginal health care programs, and identifies the programs and strategies that appear to work. The authors use a process of literature review and a focus on specific projects in each Australian jurisdiction to achieve their aim. Although much of the literature is found to be inconclusive and key health indicators appear to show little improvement in the health of Indigenous Australians, the paper identifies improvements in underlying health infrastructure and an encouraging increase in government commitment to dealing with the problem. The paper recommends longer program funding cycles and more rigorous evaluation of program data as ways of improving organisational stability and program outcomes.
New Zealand bioethics journal, 2003
In this paper we overview the findings of a literature review that was undertaken to guide the re... more In this paper we overview the findings of a literature review that was undertaken to guide the revision of the Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research (NH&MRC, 1991). The literature reviewed, in general, supported the development of specific research guidelines for Aboriginal and Torres Strait Islander contexts. The findings of this review were analysed thematically, and a number of key issues were identified for consideration in the review process. We present a summary of these key issues. In the final section of the paper we consider in more detail two of the key issues raised in the review process (the assessment of relevance or benefit of proposed research; and the process of consultation and negotiation of collective consent) in order to critically consider how these issue should be engaged in revised guidelines. On the basis of this analysis, it is our contention that specific guidelines on key issues are limited to the extent to ...