Write an essay on Federalism using a case study to support your discussion. Case Study to use INTERGOVERNMENTAL AGREEMENT

FOR A NATIONAL REGISTRATION AND ACCREDITATION SCHEME FOR THE HEALTH PROFESSIONS (http://www.ahwo.gov.au/documents/National%20Registration%20and%20Accreditation/NATREG%20-%20Intergovernmental%20Agreement.pdf)

The essay should illustrate, explore and expand on some of the issues raised and analysis provided in the Wanna reading (Wanna, J 2007, �Improving federalism: drivers of change, repair options and reform scenarios�, Australian Journal of Public Administration, vol. 66, no. 3, pp. 275 � 279).

The minimum issues you should cover are coordination between and within levels of government and diffusion of power between Commonwealth and other levels of government.

Notes for assistance to participants

1. Include:

i. A definition of �federalism�

ii. The impact of High Court decisions and international agreements/agencies if relevant to your case.

2. This case study is about federalism. The case should illustrate coordination (or lack of it, in which case there is conflict and confusion) between levels of government and the question of which level is responsible. Don�t just �tell a story� or describe the case situation. You have to analyse the situation in terms of issues around federalism.

3. It should be about managing relationships between levels of government and within levels. Therefore the case you choose needs to include national, state/territory and, if possible and relevant, local governments.

4. Examples could include health, aged care, water conservation on the Murray river, other services or issues such as homelessness in Western Australia, the NT intervention etc where a range of agencies are involved but people still fall through the cracks, and so on.

5. If possible make your case relevant to your own workplace or political environment; however you can choose any case that illustrates the levels and issues. Questions that might be useful here are how does your job fit into federalism? Do relations between levels of government work well in your area?

6. Where the case is relevant to your work or political environment, identify your role and section/agency. Put this in the introduction � e.g. the writer is employed as X in Y section of Department Z.

7. Some people have the view that we are over governed in Australia with the states being a product of Australia�s history rather than a necessary level of government. However, the states are an irrevocable part of the constitutional makeup of the federation, so acknowledge the advantages of the diffusion of power inherent in the democratic process, as they apply to your case study.

8. If you have a lot of case material and description, it should be summarised and/or appended. The essay should focus on analysis and exploring dilemmas and issues, not case details.

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9. Be precise with evidence and analytical support from the literature (program materials, readings, other references) on the issues.

10. It will not be possible to discuss all the issues in an essay of this size. You need to discuss at least some of those listed in the topic. You may then choose to discuss additional issues. It is better to choose a few issues and discuss and analyse them in depth and detail, rather than skating over the surface of too many issues.

11. The key is to not just describe the case study/situation but analyse it. Describing the case study/situation is like telling a story about what happened. Analysing the case study is questioning the story, asking why things in the story happened the way they did, with what consequences, how could the story have turned out differently, what do other people think about the story, are there different versions of the events in the story and so on. (Refer to Section 5.3 of this guide for more ideas on �analysis�).

12. Ensure that your arguments and conclusion are supported with evidence rather than being a product of a particular ideology.

13. Your case should build on your work in the minor assignment by extending and deepening the analysis.

14. Make sure you act on any feedback or corrections from the minor assignment.

15. Use essay format with headings � see Section 5.5.2 of this guide.

16. Use a number and range of references, including reference to the academic literature on the topic (text books, journal articles etc); ten on your list would be a guide.

Consideration for Assessors

Discussion of additional issues, other than those in the set topic may attract more marks, so long as the issues are discussed, not simply listed or described and provided there is quality rather than just quantity.

Introduction

Federalism involves sharing of power between the federal government and its constituent states and it provides sovereignty to the states and territories of a federation. The agreement among the Australian nations to create a national registration and accreditation of its medical professionals has an objective of including the registered professionals in the national scheme. The implementation of the national scheme involves all states in presenting medical bills on health issues which makes them sovereign from the federal government. In this essay the Commonwealth has been described as exerting authority over the states of the federation due to its economic and political powers. Moreover the conflict in jurisdiction and power between the federal government and the states has been discussed in relation to health issues unique to the states and territories. This essay analyses the international agreement on the national medical scheme of Australia in comparison with the policies of federalism.

Federalism

Federalism is a government system in which the constitution allows for division of sovereignty between a central government and the political divisions such as states, provinces and local authorities. A federal system of government is based on rules of democracy in which power is shared between national and state governments. Federalists are proponents of a federation or federal government. The Australian nation emerged as a federation in 1901 when all colonies voted in support of the federation. The federation began as Commonwealth Australia, a model of federal governance that adheres to the United States’ original model of federalism.

 

 

Objectives of the National Medical Scheme

The objectives of a federal government involve equal treatment of all states so that problems that arise within the states are handled accordingly. The objectives of the federation and those of the state governments may vary depending on their roles in handling national, local and municipal challenges (Brown, 2007). The national medical scheme should have an objective of ensuring registration of all medical professionals so that their regulation by the national agencies and state committees, management of human resource and funds would be made effective. The role of the registration is to help the federation account for the medical professionals within its states and territories so that national policies on funding would be implemented. The medical problems of the various states within the Australian federation vary hence distribution of resources and management of the medical professionals would be possible if goals and objectives are properly laid down.

The objective of the agreement provides for beginning with only the nine medical professionals that are registered within the Australian states. This illustrates that key medical professionals such as pediatrics, ophthalmology and oncology are not covered by an objective at the beginning of this agreement. For a federal policy to be successful, all institutions must be included (Nahan, 2005). The inclusion of all institutions helps to ensure that critical functions of the sectors of a federation are not left out. The agreement objectives should have covered all medical professionals including those that are yet to be registered within the states because of their equal importance in the medical practice. The neglect of the unregistered professionals from the objectives of the agreement is that such professionals would not be protected by the national scheme. The objective was biased to those professionals that are registered within the states and the territories.

Implementation of the Scheme

The role of federalism in division and limiting of power (France, 2008) is evident in this case study because the states and territories are mandated to pass respective legislation that relate to the national medical scheme. The implementation provisions of the agreement give the territories and states of the federation the mandate to present medical bills to their respective legislatures that will effect implementation of the national scheme for the nine groups of the registered professionals. The federal government is not responsible for creation of legislature for all its states. This is importance for any federation because every state or territory has problems unique to itself. Medical issues such as care of the aged, sanitation and public health have uniqueness specific for every Australian state and thus federalism’s role of dividing power ensures that relevant legislation that relate to medical professionals are passed by the state legislative bodies.

Institutions of federal governments are structured to ensure that roles and responsibilities of stakeholders are clearly defined (Greer & Jacobson, 2010). This is a way of ensuring that jurisdiction issues are well understood so that the roles of the federal government will be distinguished with the responsibilities of the state governments and international agreement organizations. In the implementation of the regulatory framework of the Australian national medical scheme, the legislation that is to be enacted on the registered medical professionals will provide the structure and functions of the professionals.  Defining roles and duties will prevent conflict in the federal and state medical practices in Australia.

The implementation of the national medical scheme for registration and accreditation that is focused on state and role participation proves the fact that federalism plays an important role in customization of policies and regulations. Federalism enables tailoring of services and policies in a way that meets the needs of the communities which are directly affected (Rosen, Gurr & Fanning, 2010). Differences in medical needs of individuals from the various states and territories in Australia means that the medical approaches need to be custom made to suit the varying needs and capabilities of citizens on issues of health. Thus it is true that federalism promotes democracy by accommodating differences among states and therefore allowing them to participate in making decisions on issues that affect them (Mallat, 2003).

A federation must avoid centralized control of laws or policies. The power must be shared between the federal government and the territories (Brown, 2007). The case in the national scheme for registration and accreditation of medical professionals seems to be different from the policies of a federation. The agreement gives the state of Queensland a go ahead to be the leader state in enactment of the primary legislation for the establishment of the national scheme for the medical professionals. According to the implementation plan of the agreement, the Queensland legislation would be applied in the national jurisdictions of the states of Western Australia, Victoria, New South West and the Australian Capital Territory. This gives the state of Queensland a central position in controlling legislation that goes beyond its boundaries.

Funding

In Australia, the Commonwealth controls a large portion of funding to the states and territories (Wanna, 2007). The financial and political power of the Commonwealth within the Australian federation makes it to be the major contributor of funding for the states hence the center of influence. The recent trends of federalism in Australia have seen the Commonwealth intervening on state and territorial matters hence creating a conflict of responsibilities (Tiernan, 2008). The agreement lists the resources of the national medical scheme as registration fee of the professionals, fees from accreditation functions, the current commonwealth, territory and state contributions. According to the agreement, the subsidies and contribution of the commonwealth to the scheme are not to be reduced for the initial two years of operation.

The national scheme for medical professionals would be a way of promoting diversity among the member states. Federalism gives its citizens a wide range of choices or variety (Greer & Jacobson, 2010). The national medical scheme as provided by the agreement will enable registered medical professionals to work in any state in Australia. Citizens can also choose to seek health care anywhere within the federation.

Cooperation among the states of the Australian federation in matters of health care will be enhanced by the national medical scheme. The problem is that the state of Queensland seems to be given more jurisdiction powers in terms of enacting the legislation of the national medical scheme. A federal government acts to promote cooperation among sates in political, economic social and health issues (Tiernan, 2008). The national medical scheme in the case study is to promote cooperation among states in health issues that affect them.

According to the agreement every medical professional will pay a registration fee as provided by a single national agency. The fees are to be set in a way that it would be transparent and equitable to all professionals. The policies of federalism provide for financial provisions that are not biased against any of the institutions of the federation (Wanna, 2007). Conflict to the policies of federalism in the case study would arise if there was unequal payment of the fees. The funding of the national scheme by the states however should be considerate to the sates with less economic power. This is because some states face more medical challenges yet they do not have adequate state funding to cater for the health issues specific to them. Issues such as homelessness in Western Australia would need more funding to solve the crises compared to other states that have less challenges on matters related to health care.

The proposals on the funding of the federal government are to come from institutions of a state and directed to the state government and not directly at the federal government (Hills, 2001). This illustrates jurisdiction boundaries of the federal government in imparting control of its member states. Funding of the health interventions of the states and territories of the Australian federation has restrictions on the roles played by the federal government in solving local matters.

Legislation Amendments

All institutions of a federal government must have a contribution in amending policy matters on issues that affect the federation in general (Bellamy, 2010). According to the agreement of the case study, amendments to the legislation that affects the national medical scheme are to be made upon proposals by any parties within the states or territories. The amendments to the scheme will be an avenue for states with critical medical problems to give proposals that would increase funding by the federal government to enable them to meet their medical challenges. The proposals would be on policy issues or legislation such as regulation of private medical practice, medical insurance and the role of the federal government upon its states and territories.

In Australia, there has been a trend towards centralization of power as opposed to federalism especially in areas such as water resources, health care and the pharmaceutical industry (Mallat, 2003). This is directly in contrast to the federal policies of decentralization of power. Murray River water conservation issue for example has faced a centralized influence as opposed to the policies of federalism that should promote a decentralized approach in control of state and territorial issues. The federal government should only support the states in terms of finances but not imparting direct authority over issues that should be handled within the state boundaries.

The funding of federal projects should be controlled by state governments even if the financial resources emanate from the federal government. The financial help from the federal government should be directed through the state and territorial governments instead of the federal government funding state projects directly (Brown, 2007). According to the agreement in the case study, the funding of the Advisory Council is to come directly from the state governments. The ministerial Council is to consider proposals for the amendment of the scheme before it would agree to the amendments it sees to be fit.

The state of Queensland is being used by the federation as a pacesetter of the amendments of the national medical scheme. This shows that the state of Queensland is going across boundaries and therefore influencing other states on matters of amendments to the legislation. This is a characteristic of a centralized government and not a federation. A federal government allows states and territories within the federation to solve their local challenges through giving proposals that are relevant to issues specific to its states (Tiernan, 2008).

The national medical agency

Agencies of a federal government should be nationalized so that matters of control are determined. The role of the federal government and the state agencies are to be defined so that there is no conflict of power between the states and the federal government (Wanna, 2007). According to the agreement in the case study, the structure of the national medical scheme has the national agency at the top with the responsibility of administering the scheme under the governance of a management committee. The management committees under the national agency show decentralization of powers. The committees are to make decisions that affect specific state issues. Sub committees could be necessary to take care of health challenges at the municipal level.

According to the provisions of the agreement, the role of the national agency is to maintain national lists of registered practitioners and administer the funds of the scheme. This is a role of the national agency in management of the human resource s in the health sector that fall under their jurisdiction. The national agency also plays a role of managing the funds of the states that fall under its jurisdiction and control. This prevents the federal government from direct control of medical professionals within the states.

Conclusion

State governments in the Australian federation should share responsibilities in matters national medical scheme to make the federal system work better through decentralization of responsibilities. The objectives of the national medical scheme should be accommodative to all medical professionals and lay a strategy of ensuring that registration of all medical professionals within a set period. The implementation of a federation is possible if roles of the federation, states, international agreements, territories and municipalities are clearly defined so that jurisdiction boundaries do not arise. The economic and political powers of the Commonwealth have caused new trends of power that is more centralized because of the influence of the international agreement on the Australian states. The funding of the states and territories of the Australian federation is to be managed by a national agency so that direct control of medical funding by the federal government is avoided. Amendments of the national medical scheme are to be implemented through contributions of parties from any state to ensure equality within the federation.

 

References

Bellamy, J. A. (2010). In the shadow of federalism: Dilemmas of institutional design in

Australian rural and remote regional governance. Australasian Journal of Regional Studies, 16(2), 151-151-181.

Brown, A. J. (2007). Reshaping Australia’s federation: The choices for regional Australia.

Australasian Journal of Regional Studies, 13(3), 235-235-253.

France, G. (2008). The Form and Context of Federalism: Meanings for Health Care Financing.

Journal of Health Politics, Policy & Law, 33(4), 649-705

Greer, S. L., & Jacobson, P. D. (2010). Health Care Reform and Federalism. Journal of Health

Politics, Policy & Law, 35(2), 203-226

Hills, R. M., (2001). The political economy of cooperative federalism: Why state autonomy

makes sense and €œdual sovereignty€ doesn’t. Michigan Law Review, 96(4), 813-813-944.

Mallat, C. (2003). Federalism in the middle east and Europe. Case Western Reserve Journal of

International Law, 35(1), 1-1-14.

Nahan, M. (2005). Federalism, national competition policy and the way forward. Review €“

Institute of Public Affairs, 57(2), 22-22-23.

Rosen, A., Gurr, R., & Fanning, P. (2010). The future of community-centered health services in

Australia: Lessons from the mental health sector (A). Australian Health Review, 34(1), 106-106-15

Tiernan, A. (2008). The Council for the Australian Federation: A New Structure of Australian

Federalism. Australian Journal of Public Administration, 67(2), 122-134

Wanna, J (2007), €œImproving federalism: drivers of change, repair options and reform

scenarios€, Australian Journal of Public Administration, vol. 66, no. 3, pp. 275-279

 

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