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Relationship‐based practice refers to approaches within human services which centralise inter‐personal relationships—either those between clients and workers or between clients and their own network—as a way to achieve positive service outcomes. Relationship‐based practice is increasingly recognised as a critical component in many areas of human services, particularly youth services. Despite increasing policy intentions for programs to adopt a relationship‐based approach, it is not always clear how services can implement this in practice. While relationship‐based skill training can be offered to individual workers, a question remains as to what can be done at an organisational and policy level to cultivate relationship‐based practice. Within this context, this paper explores how programs can be designed to foster relationship‐based practice. The paper draws on the evaluation of an intensive and tailored service for addressing long‐term youth unemployment in Australia: the your job your way pilot program run by yourtown. A key success of the program was strong relationship‐based practice, and this paper explores five features of the program's design that enabled this: (1) small caseloads, (2) intensive support, (3) staff with complementary skills and a professional and 'youth friendly' demeanour, (4) staff discretion about some aspects of program implementation, and (5) support delivered through social and group activities. The paper draws implications for how service provider organisations and governments can cultivate relationship‐based practice in human services. [ABSTRACT FROM AUTHOR]

Nearly a decade ago, the Australian Federal Government introduced a Digital Service Standard (DSS) for new and redesigned government services. This was an opportunity to encourage digital services and disruptive innovations to help the government improve citizens outcomes, and indeed there was a significant uptake in the digital services assessments offered by the program with key government agencies across health, human services, taxation, and education on board. However, by the 2020s the number of publicly visible assessments had significantly reduced. The initial broad adoption and recent reduction in numbers present an opportunity to explore the effectiveness of this government innovation management program that was ahead of its time. This paper reviews the impact of the DSS in fostering public service innovation and presents lessons learnt from the program. To perform this analysis, this research evaluates to what extent the DSS applied common private sector innovation management approaches of Innovation Process Management and Innovation Portfolio Management in the public sector. It also looks at the impact of these programs in encouraging specific types of modern digital innovations. The analysis draws on DSS assessments from 2015 to 2021 and considers how the program demonstrated public sector innovation leadership. This paper proposes a framework to improve the DSS by tailoring its approach for new and existing services, adopting specific standards to encourage incremental and disruptive innovations, and promoting more transparent reporting and funding of innovation management programs. This evaluation found that the DSS exemplifies Innovation Process Management in its use of stages and gates, and Innovation Portfolio Management in its use of targeted assessment criteria across innovation portfolios of various government agencies. The analysis also identified design limitations in the DSS as a whole of government innovation management approach due to its limited uptake in multiple large agencies and lack of specific standards to encourage different types of innovation. The impact of this research is to increase the adoption of the DSS and increase the innovation outcomes delivered by this government program. We conclude by reflecting some of the unique considerations in applying private sector innovation management practices in the public sector. Points for practitioners: Innovation management techniques are emerging but remain immature in the public sector.Australia has shown leadership in Government Innovation Process and Portfolio Management.Government must remain committed to innovation management programs and sharing the outputs of these programs.Government Innovation Management Programs should build in flexibility to encourage different types of innovation. [ABSTRACT FROM AUTHOR]

Contemporary manifestations of race are dynamic and elusive in the forms and shapes they take. "Colourblind" racism is effective at drawing on seemingly objective and race‐neutral discourses to obfuscate racialized forms of structural exclusion. Framed by Critical Race Theory and Critical Narrative Analysis this paper presents an example from the Australian context that examines the relationships between a grassroots initiative developed by creatives from the African diaspora and two not‐for‐profit human services organizations, to illustrate how ideologies of race are enacted and obscured by managerialist ideologies and discourses of risk. Specifically, it shows how harmful dominant cultural narratives of deficit and danger transforms racialized Africans in Australia into "risky subjects." In a managerialist organization, risk must be controlled, and thus risk becomes the rationality for the control of racialized and risky subjects. Resistance to control by those subjects produces forms of organizational defensiveness that are mobilized through managerialist discourses and practices that work to structurally exclude. These findings illustrate the ways ideologies of race work alongside and through other ideological discourses and practices which render racialized dynamics of oppression race‐neutral. Highlights: Contemporary and color‐blind manifestations of racism are evasive.Ideologies of race are obscured by discourses of risk.Risk discourses contribute to racialized forms of control and structural exclusion. [ABSTRACT FROM AUTHOR]

Disability support is often provided at the interface with other human services such as health, education, and employment agencies. This can present many organisational problems for people receiving support and the organisations that provide it. Individualised funding is one attempt to ease problems of fragmentation and unmet needs, but perversely, it introduces further interface complexities as organisations consider how to manage their service provision and financial structures. Drawing on interviews with 28 managers, the focus in this paper is on organisational and interface changes and challenges following the introduction of the National Disability Insurance Scheme (NDIS) in Australia, and the adaptive strategies of organisations to provide individualised and coordinated supports. The three themes derived from the thematic analysis, adopting a commercial mindset, finding a business niche, and working across complex interfaces, epitomise the benefits, constraints, and consequences of new market mechanisms for the delivery of supports, and how organisations are adjusting to a more commercial‐orientated sector while also creatively negotiating multiple funding and governance systems. The findings contribute to understandings of how individualisation is creating new dynamics of local disability support governance and collaboration in service provision. Whereas much of the literature on individualised funding has focused on the fragmentation of services, this study of organisation managers contributes to understandings of how individualisation also generates new dynamics of collaboration and tension in local disability support governance and service provision. [ABSTRACT FROM AUTHOR]

Infestation of the head louse Pediculus humanus var capitis DeGeer (Phthiraptera: Pediculidae) is an important public health problem in Australia, with up to a third of children infested in some primary schools. Insecticide resistance and inadequate attention to the application instructions of topical pediculicides are common reasons for treatment failure. This study evaluated six popular Australian over-the-counter products against head lice, primarily comprised of different botanical extracts, and compared them with permethrin 1% (Quellada®) and a non-treatment control in order to assess their in vitro efficacy. We also assessed commonly used criteria for evaluating pediculicide efficacy in vitro. All tested products failed to demonstrate high levels of efficacy with the exception of Tea Tree Gel®, which outperformed 1% permethrin. Permethrin had a high level of efficacy, but using stringent criteria 18% of lice were not dead at 3 h, indicating some resistance to Quellada®. Commonly used less stringent criteria were shown to overestimate mortality of head lice as a result of the protective phenomenon of stasis or sham death observed in exposed lice that may recover after some time. Using two different levels of stringency resulted in different rankings of efficacy for most products, with the exception of the first ranked product, Tea Tree Gel®. Rankings of efficacy also varied over time, even within the different assessment criteria. Government regulatory agencies should require standard in vitro tests using stringent mortality criteria, with an observation period of ≥ 6 h, to determine the efficacy of new pediculicides, and only products that cause a minimum mortality rate (e.g. 80%) in head lice collected from the target population should be licensed for sale. [ABSTRACT FROM AUTHOR]

This paper examines the question of optimal duration of maternity leave through the lens of Australian mothers' perceptions of satisfaction with their leave: specifically, whether and why they returned to work earlier than they would have liked. Analysis of The Parental Leave in Australia Survey identifies financial need and limited access to paid maternity leave as the most common reasons for returning 'early'. Mothers taking leave for less than 9 months were significantly more likely than those taking longer periods to report that they had returned earlier than they wanted to, although leave periods over 12 months were not consistently associated with further declines in dissatisfaction with duration. Overall, the analysis highlights the financial pressures underpinning women's decisions, and suggests that enhanced availability of paid leave is more likely to be welcomed than further extension of leave duration. [ABSTRACT FROM AUTHOR]

The paper defines the state's apparatus as a site of power and contestation. This view enables contingency in the realm of government to be taken seriously. Accordingly, the paper takes a critical view of the idea of neoliberalism as a general global process. The paper reviews Paul du Gay's history of the state's apparatus, including his nostalgia for bureaucracy and his disdain for entrepreneurship. The paper contrasts du Gay's stylised take with a study of shifts in institutional structures and behaviours in Australia's state apparatus since the mid 1970s leading to the present period of Howard neoliberalism. The paper positions these shifts in the context of Coombs-led institutional reform in Australia; it examines the potential for institutional resistances and responses; and draws implications for how we view institutions as having agency in the political processes of state apparatus reform. [ABSTRACT FROM AUTHOR]

This paper examines the implications of welfare reform for the meaning of social citizenship in Australia. Australian welfare reform has been under way since the late 1980s, and reflects the themes of activity and participation that are shaping social policy in many advanced industrial nations. The paper suggests that Australian welfare reform is following a liberal trajectory of change which places a continuing emphasis on market and family as the preferred institutions for social support with a newly salient appeal to moral ideas about the responsibility of citizens to be self-sustaining. The paper argues that welfare is being transformed from a limited social right to support provided on condition, and from treating the claimant as a sovereign individual to a subject of paternalistic supervision. Together, these changes are redefining the meaning of equality in Australian social citizenship. [ABSTRACT FROM AUTHOR]

This paper reports on the results of the first year of a four-year study of the relationship between indigenous' people and the welfare system in two communities: Kuranda in North Queensland and Yuendumu in Central Australia. The work has been conducted by a group of researchers at the Centre for Aboriginal Economic Policy Research at the Australian National University and partially funded by the Commonwealth Department of Family and Community Services. The broad objective of the research has been to document the nature and extent of the relationship between indigenous people and the welfare system and to draw out the implications for family welfare policy and for the delivery of welfare services. A fuller discussion of the methodology and results is available in the monograph "Indigenous Families and the Welfare System: Two Community Case Studies" edited by Diane Smith.

Focuses on the issue concerning the viability of social support from the Australian government for old people in the future. Effect of demographic change on government social outlays; Projections in the Intergenerational Report of the Australian Treasury; Introduction of the living standards trade-off between young and old people.

This multiple‐case study examines the adoption of a case management system (CMS) across two community organisations in Australia using organizational routines as a theoretical lens. Both the adopters and the vendor were interviewed to explore how the CMS was instituted in the adopting organisations. Many of the concerns or problems associated with a CMS as reported in the literature were not supported in this study. Although the two cases differed significantly in terms of size and resources, the findings show that the adoption of CMS led to new ostensive and performative routines around data collection and service delivery in both organisations. This had implications for accountability and organisational learning. In particular, better access to data improved visibility and reporting on the provision of services and subsequently supported fundraising. This study also highlights some of the situational factors that facilitate or impede the transition to a CMS such as the critical role of the CMS administrator and the way the change is managed in adopting organisations. Overall, this study contributes to the discourse on CMS by providing some evidence to support a more nuanced view of CMS including as 'systems of accountability' or even a 'necessity' of the digital age rather than merely as 'instruments of neoliberal policy' and enablers of bureaucratisation of social work. [ABSTRACT FROM AUTHOR]

We show how policy discourses construct consumer choice, performance measurement and quality standards as key technologies in the marketisation of disability services and aged care in Australia. The emergence of performance outcome measurement and increased consumer access to these through diverse consumer facing and interactive platforms enables the state to "govern at a distance" through the management and shaping of outcome indicators rather than delivery of services. The state does this by creating market competition and establishing outcomes which reflect the construction people using services as informed and rational consumers rather than citizens. This construction and operationalisation frame marketisation as a rational solution to broken systems, assume choice is unproblematic and ignore diverse capacities to access and use information, resource differentials and contextual variables such as market maturity and service availability. The benign marketisation of human services thus discriminates against those who are already marginalised and disadvantaged unless equity strategies are clearly in place. [ABSTRACT FROM AUTHOR]

We use survey and archival data from 271 fee‐generating not‐for‐profit human service organisations in Australia to examine how the use of performance measurement systems affects those organisations' client performance. Using Simons' levers of control, we find that interactive and diagnostic uses of performance measurement systems are positively related to client performance. We also find beliefs control to positively moderate the relation between diagnostic use of performance measurement systems and client performance, and boundary control to negatively moderate the relation between interactive use of performance measurement systems and client performance. The findings have implications for research and practice. [ABSTRACT FROM AUTHOR]

Background Over recent decades, a couple of interesting trends have occurred in regard to human services practices in Australia. First, there has been a significant shift from practices that previously have intentionally responded to emerging and continuing human need within communities to practices that are now managed within a context of managerialism and influenced by market forces. Second, in such a changing context, increasingly, organisations have added the suffix ‘care’ to their organisational name. One is therefore left to consider why this latter change has occurred, and how is care being considered, particularly in organisations supporting people with intellectual disability (ID). Method A conceptual-theoretical analysis is undertaken to explore the characteristics of human services that embrace managerialism. The moral constructions of personhood in regard to people with ID within this service context are investigated; and the implications of how care is practised are considered. Results An immoral-amoral binary of personhood within an underpinning neo-liberal context is identified and analysed. Further analysis reveals a more insidious independent–dependent binary for people with an ID linked to a dominating Ethic of Normalcy. This latter binary suggests that care seemingly becomes neither ethically relevant nor legitimate for people with ID in managerialist service contexts. Conclusions Ethical transformation in regard to care is needed for contemporary human services practice for people with ID. The underpinning Ethic of Normalcy is challenged for an Ethic of Engagement; whereby a deep understanding of care as a moral concept needs to be at the core of practice, rather than merely attached in an organisational name. [ABSTRACT FROM AUTHOR]

Demand responsiveness is an established principle in the efficient operation of markets. The principle has been applied to government services in international development overseas, and mainstream government service delivery in Australia, but only recently to Indigenous settlements. Shifting the balance in services from supply to demand is seen to have the potential to improve access, outcomes, and sustainability of services. In Indigenous settlements, an important relationship between demand and supply of services does exist, but a deeper analysis is necessary beyond the economic model to account for the complex sociopolitical geographies involved. Further research is required to develop a framework to explain the interactions that occur in practice, to determine the conditions which permit productive relationships to develop between consumers and service providers. The article presents an analytical framework through which to proceed, structured around five proposed research questions. [ABSTRACT FROM AUTHOR]

Aim: To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children.Methods: Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues.Results: During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal.Conclusion: We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing. [ABSTRACT FROM AUTHOR]

The transportation of convicts to the British penal colony at New South Wales in the late 18th and early 19th centuries was largely undertaken by private merchants under contract to government. In the early years, the outcomes of this system, as measured by mortality rates, were mixed, but by the turn of the century, public officials had refined its operation, resulting in a significant decline in convict deaths. Close study of the evolution of this system reveals that government officials were grappling with many of the same issues encountered by public service commissioners today - trade-offs between price and quality, the use of transactional versus relational contracting forms, and heavy reliance on financial incentives as opposed to intrinsic motivation. Government's success in reducing mortality on the convict ships highlights the importance of system design, effective monitoring and management when public services are delivered under contract. [ABSTRACT FROM AUTHOR]

Aim Although opioid substitution therapy (OST) immediately after prison release reduces mortality, the cost-effectiveness of treatment has not been examined. Therefore, we undertook a cost-effectiveness analysis of OST treatment upon prison release and the prevention of death in the first 6 months post-release. Design Population-based, retrospective data linkage study using records of OST entrants (1985-2010), charges and court appearances (1993-2011), prison episodes (2000-11) and death notifications (1985-2011). Setting New South Wales, Australia. Participants A cohort of 16 073 people with a history of opioid dependence released from prison for the first time between 1 January 2000 and 30 June 2011. Intervention OST treatment compared to no OST treatment at prison release. Measurements Mortality and costs (treatment, criminal justice system-court, penalties, prison-and the social costs of crime) were evaluated at 6 months post-release. Analyses included propensity score matching, bootstrapping and regression. Findings A total of 13 468 individuals were matched (6734 in each group). Twenty (0.3%) people released onto OST died, compared with 46 people (0.7%) not released onto OST. The final average costs were lower for the group that received OST post-release ($7206 versus $14 356). The incremental cost-effectiveness ratio showed that OST post-release was dominant, incurring lower costs and saving more lives. The probability that OST post-release is cost-effective per life-year saved is 96.7% at a willingness to pay of $500. Conclusion Opioid substitution treatment (compared with no such treatment), given on release from prison to people with a history of opioid dependence, is cost-effective in reducing mortality in the first 6 months of release. [ABSTRACT FROM AUTHOR]

Out-of-pocket health expenditures in Australia are high in international comparisons and have been growing at a faster rate than most other health costs in recent years. This raises concerns about the extent to which out-of-pocket costs have constrained access to health services for low income households. Using data from the ABS Household Expenditure Survey 2003–2004, we model the relationships between health expenditure shares and equivalised total expenditure for categories of out-of-pocket health expenditures and analyse the extent of protection given by concession cards. To allow for flexibility in the relationship we adopt Yatchew's semi-parametric estimation technique. This is the first detailed distributional analysis of household health expenditures in Australia. We find mixed evidence for the protection health concession cards give against high out-of-pocket health expenditures. Despite higher levels of subsidy, households with concession cards do not have lower out-of-pocket expenditures than non-cardholder households except for the highest expenditure quintile. Cards provide most protection for GP out-of-pocket expenditures. [ABSTRACT FROM AUTHOR]

Australia's Centrelink provides an unique experiment with the integration of a variety of social services through a single quasi-autonomous organisation. This multi-functional agency delivers services to a number of clients while subject to a range of external and internal imperatives. The case indicates the complexities in managing the interface between policy department and service delivery agency and the limitations of operating with purchaser-provider arrangements as a basis for relationships. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article focuses on Project Magellan, a program of the Family Court of Australia for the management of parenting disputes which involved allegations of child abuse. It states that the program, which is an example of judicial administration towards specialized court programs, involved 100 families and various human service organizations and state and federal agencies. Furthermore, the program's contribution to the development of knowledge on child abuse in parental separation is discussed.

This article discusses the theoretical rationale for outsourcing government human services and provides a short contextual history of outsourcing in Australian placement and labor market programs. Since the mid 1990's, there has been a steady growth in the propensity for government organizations to outsource their human welfare related services. The intensity of competition and the ownership structure of a market are related but not necessarily linked economic phenomena. However, most government funded activities are provided by the government and most government provided services have been protected from competitive market forces. However, there is also a large body of welfare-related services which are government funded and government provided and are also shielded from competition and market incentives. In Australia, these are mainly services that have been provided to guarantee minimum consumption levels across the population in accordance with community notions of economic justice and equality.

The author reflects on the article "Estimating Met Demand for Alcohol and Other Drug Treatment in Australia" by J. Chalmers, A. Ritter, and L. Berends which appears in the same issue of the journal. The challenges associated with estimating the number of people who receive alcohol and other drug (AOD) treatment in Australia are examined, along with the identification of potential data sources and primary research evidence. Health service system monitoring is assessed.