The politics of midwifery education and training in New South Wales during the last decades of the 19th Century

This paper focuses on the introduction and development of midwifery education and training in Sydney during the last decades of the 19th century. The aim of the training, it is argued, was to displace the lay midwives by trained midwifery nurses who would work under medical control. The lay midwives were one of the largest occupational groups among women and two-thirds of births in NSW were being delivered by them in the late 19th century. It was a period of professionalisation of medicine and medical men laid claim to midwifery as a legitimate sphere of their practice and saw it as the gateway for establishing a family practice. The lay midwife stood in the way of their claim. The training programs were established purportedly to control maternal mortality. From the beginning in 1887 medical men were in control of midwifery nurse training. In addition to training at the Benevolent Society Asylum, three more women's hospitals were established in the 1890s in Sydney making it possible to train a stream of midwifery nurses. The midwifery nurses were charged exorbitant fees for their training; the fees contributed substantially towards running the new hospitals that delivered birth services to the poor and destitute women mostly in their homes. The midwifery nurses worked hard in miserable conditions under the guise of clinical experience required for training. When a critical mass of poorly trained midwifery nurses were in the offing, a Bill was introduced into the Parliament in 1895, restricting registration to midwifery nurses and this would have eliminated the lay midwife if passed. It took more than two decades to get a Registration Bill passed in the NSW Parliament.     

Australia's Individualised Disability Funding Packages: When Do They Provide Greater Choice and Opportunity?

Australia's new National Disability Insurance Scheme (NDIS) uses individualised funding packages instead of traditional block‐funded disability services to support people with disability. The NDIS works with the person and their family to assess the person's needs and develop a plan that determines their funding allocation. Funding can be used to purchase support from a disability service or from the open market. People can purchase support that suits their cultural and personal preferences. This paper examined whether individual funding packages met their aims in Western Australia, where they had been the primary mechanism of disability support for over 25 years. An exploratory case study was conducted consisting of face‐to‐face, in‐depth interviews with 11 key participants: people with disability, senior government administrators, service provider managers, and a support worker. Complex systems theory was used to review the data and findings showed that individualised funding packages did not automatically result in more choice and greater opportunities. People needed information to make informed decisions; supportive and creative support from social workers and other professionals; and welcoming communities. The findings can inform policies and assist social workers facilitate maximum choice and opportunities for people with disability and their families.     

Balancing Qualified Staff Requirements with Shortage of Recruits in Child Care – The NSW Experience

In Australia and many other countries, government regulations require that children's services, such as long day care centres and preschools, employ certain numbers of qualified early childhood teachers. This recognises that training and experience of staff are the most significant factors determining the quality of care. At the same time Australia is facing a shortage of qualified early childhood teachers, and governments are grappling with how staff requirements can be met. In this article we examine the New South Wales Government approach, which waives temporarily the requirement to employ qualified teachers if children's services providers can show that they have made all reasonable effort at recruiting the required staff. We consider the impact of the temporary waiver on quality of care, and whether it is necessary to compromise government standards in this way. Our research concludes that most providers committed to good quality care do not resort to using the temporary waiver.     

From Assistance to Prevention: Categorizing Young Carer Support Services in Australia,and International Implications

Young people who provide unpaid care for a relative with chronic illness or disability are a growing focus of public policy and research in Australia and internationally. Support services for these young carers have emerged, but not enough is known about their effectiveness. This article develops an analytical framework that categorizes young carer support services according to their goals and the types of intervention provided. The analytical framework is based on Australian data. It is applied to young carer support services available in Australia but may be applicable to other countries. The aim of the framework is to provide a structure for assessing the effectiveness of current services in supporting young carers by clarifying service goals and identifying gaps in existing service provision. The framework contributes to conceptual discussions about young carer supports, and it can be used to guide future policy development. The article draws on Australian and international literature as well as findings from a recent Australian study on young carers. The proposed framework groups young carer support services according to three overarching goals: assisting young people who provide care; mitigating the care‐giving responsibility; and preventing the entrenchment of a young person's caring role. The framework is applied to an audit of Australian support services for young carers, illustrating how it can be used to assess existing supports for young carers and inform future policy development. The findings suggest that most services in Australia fall into the categories of assistance and mitigation, while few contain preventative elements.     

Does partnership funding improve coordination and collaboration among early childhood services? – Experiences from the Communities for Children programme

Partnerships among service providers are an important aspect of human service delivery, including in the early childhood and family service sector. There is extensive international literature on factors contributing to partnerships – also termed service coordination, collaboration or integration – but little evidence of partnership outcomes exists where partnerships are a funded and mandatory component of large‐scale programmes. This paper reports findings from an evaluation of the Australian Government's Communities for Children (CfC) programme. Under CfC, partnerships were mandated and funded, and the evaluation findings show that the programme resulted in an increased number of agencies working together to support families with young children (0–5 years) and that working relationships between agencies improved. The effectiveness of these partnerships depended on funding for partnership activities and on organisational and practical factors.     

Effective personalised housing support for people with disabilities – case study analysis

International policy trends favour personalised approaches to housing support for people with disabilities. Previous research is inconclusive about whether these approaches are effective compared to group home support in the way they use government resources and benefit clients, partly because it does not usually consider the experiences of people who use the support. In this research we compared six new, innovative case studies of personalised housing support to previous research about group home support. We included qualitative data about client experiences, in particular regarding social networks, decision making, community service use and participation in domestic tasks. We found that client outcomes were positive in all four categories, while the financial costs to clients and government were similar to group home support. The results offer evidence that current, personalised approaches to housing support can be an effective policy option that allows people with disabilities to make choices about how to live and participate in their communities, without increasing the cost to government.