Lessons Learned: Health Reform Commissions in Australia, England, USA and Canada

Monday, 22 July 2013: 11:05 AM

Jill F. White, RN, RM, BEd, MEd, PhD
Sydney Nursing School,, University of Sydney, Australia, Camperdown, Australia
Mary Chiarella, RN, LLB, (Hons), PhD
Sydney Nursing School, University of Sydney, Sydney, Australia

Learning Objective 1: The learner will be able to understand the critical elements to positioning nursing contributions to health reform processes

Learning Objective 2: The learner will learn the lessons about nursing influence in the reform processes in the past five years in Australia, Canada, USA and England.


 The purpose of this paper is to share the lessons learned about nursing participation in health reform policy by analysing four key national health reform commission reports produced in four countries within the past five years.


There were two major methods employed in this study. The first was document analysis of the key health reform policy reports and the government responses to these commission reports. This was followed by an expert reference group critical appraisal of these documents and their outcomes for each country following their release.

Results: The similarities and differences across these documents will be discussed. These include the degree of nursing input to the commission processes, the degree to which non-nurse participation was present, the methods by which the reports were released to the public and the actions of nursing organisations following report release.


Each of the commission reports was consistent in seeinhg a major role for nursing in healthcare future scenarios; all indicated primary health care as the direction of health reform, each indicated aged care and chronic disease management in the community as essential. The effectiveness of the outcome was influenced by election timing and outcome, by nursing action both in informing the commission and mobilising on its release. The degree of political astuteness and maturity were significant features determining outcomes of reform processes. It was clear from this work that educational and experiential preparation of senior nurses to increase their level of political sophistication will enhance nursing input to and outcomes from reform processes.