Building effective governance

Sarah L Larkins
Med J Aust 2012; 197 (10): 585. || doi: 10.5694/mja12.11344
Published online: 11 November 2012
Health workforce governance: improved access, good regulatory practice, safer patients.
Stephanie D Short, Fiona McDonald, editors. Farnham, UK: Ashgate Publishing, 2012 (xix + 272 pp, $110). ISBN 9781409429210.

ENSURING THAT we produce a health workforce that is well trained, “fit for purpose”, equitably distributed, and that delivers effective and safe health care is a key responsibility of all those involved in medical education, health governance and health policy making. Various health scandals have drawn the attention of the public to failures in health governance, and raised considerable doubt about the ability of the health professions (and in particular doctors) to self-regulate in a way that will protect the public.

This ambitious academic text seeks to link the “three pillars” of health workforce governance: access to health services; regulation of health service providers; and patient safety and quality of care. The book is edited by experienced Australian academics with backgrounds in health economics and law, respectively, and its scholarly tone reflects this. Contributors have been deliberately selected by the editors from a wide range of disciplines, and comprise academics, regulators and health professionals from Australia, Canada and Indonesia, both well known and less well known.

While the major focus of the text is Australian, some chapters describe examples drawn from the Indonesian and Canadian contexts — these would have been more useful if their relevance to health workforce governance in the Australian context had been made more explicit or, alternatively, if the whole text had a more clearly articulated global focus.

Although this disciplinary variability is promoted as a strength, it does produce chapters that vary dramatically in approach and relevance. The book is divided between chapters that are a pleasure to read (and take notes from) and those that focus on describing micro-policy changes and leave the reader with a sense of frustration and many questions unanswered. While this is a book of great relevance to scholars interested in health workforce and governance and there are some outstanding chapters, the patchy quality overall and lack of a coherent narrative linking the chapters limits its relevance for a broader audience.

  • Sarah L Larkins

  • General Practice and Rural Medicine James Cook University, Townsville, QLD



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