Australian Health Policy Review
Table of Contents
Introduction. 3
Definition of policy. 3
Details of the search
strategy. 3
A description of each of
the key policy elements. 4
Ministerial forward. 4
Vision statement 4
Goals. 4
Objectives. 5
Strategies. 5
Application of Kingdons
multiple streams theory. 5
Problem stream.. 5
Policy stream.. 6
Political streams. 6
Policy entrepreneurs and
window of opportunity. 7
Evidence-based
recommendations. 7
Conclusion. 8
Reference List 9
The
policy can be explained as a constructive development of actions that are
informed by the data driven evidences and serves the purpose of mitigating the
identified societal issues and attain desired outcomes (Vargas-Hernandez et al., 2021). The policies
have been contributing significantly when it comes to influencing the
population health outcomes (Rozaqi
& Raharjo, 2023). The
policies asserts such influence in public health by driving proper resource
allocation and encouraging concerted effort across multiple sectors (Trein, 2017). The health policies
shares significant relevance to the context of mitigating preventable
conditions since the strategic interventions can significantly result in the
reduction of disease burden and improve quality of life (Wrede, 2020).
The
policy that is selected for this review is the NSW Skin Cancer Prevention
Strategy 2023 2030 (NSW, 2023). This has been established by the Cancer
Institute NSW. This policy has been chosen due to its relevance to the
significant public health risk that is illustrated by the skin cancer in
Australia. Australia has been identified as one of the critical nations that is
susceptible to high skin cancer incident rate. This is evidenced by the fact
that the patients who have been diagnosed with skin cancer has surged by 37% in
Australia (Cancer Australia, 2024). In
addition to that more than 60% of the Australian are expected to suffer from
skin cancer during their lifetime (Olsen
et al., 2022). This policy serves as a valuable asset for examining
how public health strategies can address the widespread and avoidable clinical
condition. In addition to that, the policy has also been chosen due to its
relevance in preventive health and its comprehensive multi sectoral framework.
The
selection of this policy has been adopted by a systematic search strategy. The
academic databases in the form of Google Scholar and Pubmed has been utlised to
relevant policies. The peer reviewed journals that has aimed at analysing the
policy with critical insights had been selected. It is then followed by the
collection of the policy document from the official government websites such as
NSW Health and Cancer Institute NSW. The key search terms are Australian
health policy , skin cancer prevention , public health strategy NSW and
cancer prevention policy. The inclusion criteria focused on policies that have
been integrated recently and have been established by government. In addition
to that, the inclusion criteria also included the fact that the policies should
be prevention oriented and should possess definitive goals with implementation
strategies. The NSW Skin Cancer Prevention Strategy has been selected since it
has met all the inclusion criteria.
The
ministerial foreword that is established by NSW Minister for Health establishes
the significance of skin cancer as a critical public health issue and
demonstrates the contribution of the UV radiation as the primary cause of the
disease. This has emphasised the importance of collaboration across the
government, private sectors and communities. This concerted effort has been
essential in reinforcing the commitment of the NSW Government to reduce the
skin cancer incidence through the sustained and coordinated efforts. The
foreword plays a crucial role in the legitimisation of the policy and
signalling politcal support for its implementation.
The
vision statement of the policy is to reduce the incidence of skin cancer
in NSW which reflects a key long term commitment in the prevention of
cancer and alignment with the NSW Cancer Plans objective of decreasing cancer
burden. This vision has provided a transparent and measurable direction for the
policy which focuses on the reduction of new cases instead of the solitary
objectives of managing the existing conditions.
The
policy has outlined three overarching goals. The first goal is to embed skin
cancer prevention across the public . private and community sectors. The second
objective is to improve access to quality shade at work, school, play
and in public spaces as part of a healthier built environment (NSW,
2023). The third goal is to increase the adoption of sun protection
behaviours among those with low sun protection behaviours, those at high risk
of skin cancer, and the broader community.
The
objective is to embed skin cancer prevention policy, procedures, programs and
campaigns, in all our priority settings
The
policy has outlined an array of strategies that are established to achieve its
three overarching goals through coordinated and evidence based actions. In an
attempt to address the first goal, the strategy has focused on developing
leadership and capacity within the private, public and community sectors. The
strategy has promoted the integration of evidence based sun protection policies
and has implemented the skin cancer prevention within the routine
organisational practices. In order to accomplish the second goal, the strategy
has been developed which focuses on enhancing access to quality shade and
engaging stakeholders such as local government and urban planners (NSW, 2023)..
The strategy has also set monitoring and evaluation unit for assessing shade
availability in priority settings. In the context of attaining the third goal,
a strategy has been proposed by the policy which prioritises the public
education and behavioural change through the delivery of evidence supported and
consistent messages that are customised to the interests and understanding of
priority populations.
The
policy has identified skin cancer as a major health problem by providing empirical
evidences. One such evidence is that two out of three Australians are expected
to be diagnosed with skin cancer in their lifetime. In addition to that, the
policy has also highlighted that 95% of the skin cancer has been caused by UV
rays (NSW, 2023). This shares alignment with the problem stream since it
demands the illustration of the conditions with supporting evidence of their
indicators (Cairney & Jones, 2015).Therefore, the
problem stream is clearly defined in this case. In addition to that,
increasing melanoma incidence rates and the substantial economic burden on the
healthcare system has reinforced the urgency of the issue. The recognition of
the high risk groups in the form of outdoor workers and adolescents has been
shaping the problem definition through the demonstration of disparities that
have been persisting between the behaviour and exposure. Therefore, the problem
stream has been driven by statistical indicators and elevated public awareness
of sun exposure risks.
The
policy stream is defined by the presence of potential solutions that are
available for addressing the identified problem (Cairney, 2024). In this context, the NSW Skin Cancer
Prevention Strategy has drawn inferences from credible evidence base and has
built on previous strategies that has been integrated in NSW. The policy has
included feasible and evidence based interventions such as public education
campaigns, promotion of sun protection behaviours such as Slip, Slop and Slap
and structural modifications through access to shade in public and workplace
settings. The strategy has also worked on the creation of SunSmart and
ShadeSmart programs. These programs have been effective in testing the viable
solutions and refining the solutions for practical application. In addition to
that, the policy has been accountable for the integration of evaluation
mechanisms, which enhances the sustainability and credibility of the potential
solutions. Therefore, it is observed that the policy stream of NSW Skin Cancer
Prevention Strategy 2023 - 2030 is strong in terms of primary prevention,
however, the policy stream is weaker in the context of addressing secondary
prevention since it is only acknowledged briefly as an area of exploration.
The
political stream is characterised by the presence of wider political
environment which includes the stakeholder support, government policies and
public opinions (Herweg et al.,
2019). The strategy has reflected strong political commitment as it is
supported by the NSW Minister of Health and shares alignment with the wider
frameworks of NSW Cancer Plan and Future Health Strategy. The involvement of
multiple stakeholders which includes the government agencies, healthcare
providers and community groups suggests a high level of institutional support.
The combination of the preventative measures against skin cancer and public
concern about the skin cancer establishes a facilitative political environment
for intervention (Islam et al.,
2023). In addition to that, the political stream of NSW Skin Cancer
Prevention Strategy 2023 - 2030 is further intensified since the policys focus
on collaboration and shared responsibility share alignment with the
contemporary governance approaches.
The
policy entrepreneurs are characterised by the stakeholders who advocate for the
policy change and facilitate the coupling of the three streams (Battaglia, 2025). In the context
of this policy, the Cancer Institute NSW acts as a central policy entrepreneur
since this stakeholder is in charge of the creation, coordination and
implementation of the strategy. The firms such as Cancer Council NSW and
Melanoma Institute Australia have also contributed by offering expertise,
advocacy and program delivery support. The convergence of the problem, policy
and political streams establishes a window of opportunity for policy action. In
this case, the opportunity has been created by rising melanoma incidence rates
and growing awareness about the efficacy of preventive strategies.
One
of the key policy silences has been the limited operational focus on secondary
prevention in terms of early detection and screening. The policy acknowledges
the significance of the early detection, however, it only provides a primary
exploration of this area instead of providing concrete actions. The future policy
interventions should integrate structured screening interventions, targeted
skin checks for high risk populations and transparent integration with primary
healthcare services since early diagnosis enhances the skin cancer outcomes. In
addition to that, the absence of digital health and technological innovation
has also emerged as a gap in the policy of NSW Skin Cancer Prevention Strategy 2023
- 2030 . NSW Skin Cancer Prevention Strategy 2023 - 2030 has mentioned about
the implementation of public education campaigns, however, the policy fails to
leverage trending technologies in the form of mobile health application,
tele-dermatology. The integration of these digital platforms improves accessibility
and support the rural and remote populations for engaging with the sun
protection benefits. In the context of equity, the policy has identified
priority populations, however, the policy fails to provide extensive insight on
the culturally customised interventions. The explicit strategies are essential
in mitigating the needs of Aboriginal communities and CALD communities in the
context of health literacy and access to services. The approaches of
co-designing the interventions with these communities would improve the
effectiveness and relevancy. There is also a degree of misalignment that
persists between the implementation strategies and vision. This is because the
vision focuses on the reduction of incidence rates whereas the strategies focus
on behavioural changes instead of integrating regulatory interventions, which
does not coincide with the interests of the vision. The strengthening of policy
measures such as integrating shade requirements in urban planning regulations
and the mandating of workplace UV protection standards would be appropriate in addressing
wider social determinants of health.
The
findings of the study indicate that the NSW Skin Cancer Prevention Strategy 2023
-2030 serves as a comprehensive and evidence based policy which aims at
decreasing the incidence of skin cancer through prevention, behavioural and
environmental strategies. The results of the study signifies that the
multisectoral approach of the NSW Skin Cancer Prevention Strategy 2023 - 2030
is one of its strength. The application of the Kingdoms Multiple Streams
theory in the context of NSW Skin Cancer Prevention Strategy suggest that the
policy has a strong convergence of problem identification, viable solutions and
political support. The outcomes from the study indicate that the lack of
exploration in the domains of secondary prevention surfaces as a critical gap
in NSW Skin Cancer Prevention Strategy 2023 - 2030.
Vargas-Hernandez, J., Noruzi, M. R.,
& Ali, I. F. N. H. (2021). What is policy, social policy and social policy
changing?. International Journal of Business and Social Science, 2(10),
287-291.
Trein, P. (2017). Coevolution of
policy sectors: A comparative analysis of healthcare and public health. Public
Administration, 95(3), 744-758. https://doi.org/10.1007/978-3-319-92381-9_19
Wrede, S. (2020). How country
matters: studying health policy in a comparative perspective. The Sage
Handbook of Qualitative Methods in Health Research. Los Angeles: Sage,
88-105.
NSW. (2023). Working together NSW
Skin Cancer Prevention Strategy 20232030. Retrieved from https://www.cancer.nsw.gov.au/getmedia/a41c0e1b-4514-44ab-b801-e70ea4fcdefa/SCTASK2783661-NSW-Skin-strategy-WR.pdf
Incidence and mortality: National Cancer
Prevention Policy Skin Cancer Statistics and Issues. Cancer Australia (2024). UV
Radiation Prevention Policy: Skin cancer incidence and mortality
Retrieved from https://www.cancer.org.au/about-us/policy-and-advocacy/prevention/uv-radiation/related-resources/skin-cancer-incidence-and-mortality
Olsen, C., Pandeya, N., Green, A.,
Ragaini, B., Venn, A., & Whiteman, D. (2022). Keratinocyte cancer incidence
in Australia: a review of population-based incidence trends and estimates of
lifetime risk. Public Health Research and Practice, 32(1),
e3212203. https://doi.org/10.17061/phrp3212203
Cairney, P., & Jones, M. D.
(2016). K ingdon's multiple streams approach: what is the empirical impact of
this universal theory?. Policy studies journal, 44(1),
37-58. https://doi.org/10.1111/psj.12111
Cairney, P. (2024). Kingdons
multiple streams framework: what happens next?. International Review of
Public Policy, 6(6: 3). https://doi.org/10.4000/13gg0
Islam, M. R., Akash, S., Rauf, A.,
& Sharma, R. (2023). Skin cancer from the perspective of public health
concerns: etiology, transmission, diagnosis, treatment, and
complicationscorrespondence. Annals of Medicine and Surgery, 85(5),
2266-2267. https://doi.org/10.1097/MS9.0000000000000662
Herweg, N., Zohlnhfer, R., &
Zahariadis, N. (2019). From policy theory to application: Best practices for
operationalizing the multiple streams framework. In of the
International Conference on Public Policy, Montreal, Canada. https://www.ippapublicpolicy.org/file/paper/5d1758597d0a6.pdf
Battaglia, F. (2025). Kingdon at 40:
multiple streams, multiple flaws. Journal of Policy Studies, 40(3),
25-42. https://doi.org/10.52372/jps.250204
Rozaqi, S. A., & Raharjo, P. S.
(2023, July). Definition, importance, and formulation of health policy and
financing. In Proceedings of the Youth International Conference for
Global Health 2022 (YICGH 2022) (p. 134). Springer Nature. https://doi.org/10.2991/978-94-6463-206-4_33
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