South Australian politics has a long history of producing ideas and inspiration disproportionate to its size. But this power diminishes in the face of increasing globalization, competition and social change.
We used institutional theory to understand the extent to which the government’s neo-liberal economic policy orientations constrained and limited its ability to address equity as a policy idea. This was evident in our analysis of Change@SA and its 90-Day Projects.
The state’s economy
After a long period of stagnation, the South Australian economy has experienced strong growth in recent years. However, the latest Economic Briefing Report from the SA Centre for Economic Studies reveals that the state’s economy is expected to continue growing in 2023, but at a much slower pace. Cost of living pressures and tighter financial conditions are expected to slow household spending. In addition, the end of COVID-19-related border restrictions will mean that a declining rate of interstate migration will act as another drag on economic growth.
The State Government has a number of strategies to promote its economy and attract business investment. These include a new Hydrogen Jobs Act to provide successful proponents with a clear, efficient regulatory and licensing framework and a one window government process. The government also wants to boost housing supply and reduce the cost of energy bills for households and businesses. In addition, the State Government is looking to address the financial disincentive to work faced by Age Pensioners.
Despite the emphasis on these new initiatives, many challenges remain. The economic performance of South Australia is still lagging behind that of the rest of the country and the global economy. This is largely due to the lack of investment by foreign investors and a deteriorating national labour market. The State’s unemployment rate remains above the national average, and while there has been some recovery in aggregate household spending since the pandemic, it is hampered by rising mortgage rates, higher electricity prices and increased costs of living.
In order to understand the reasons for this, our research has analysed the key strategic policy documents that provided the direction for SA HiAP during the period of this study. We have compared these documents according to their level of problematisation of equity as a policy idea and their focus on intersectoral collaboration. We use institutional theory to argue that the dominant neo-liberal economic policy agenda closed down the small policy space available for addressing equity and constrained policy actors’ ability to consider or prioritize it over other policies. This, combined with a belief that economic concerns would lead to social concerns, meant that the state’s HiAP approach was never able to address equity explicitly.
The state’s politics
The South Australian state government is responsible for public education, hospitals, prisons and police, roads, water supply and land resources. It also provides substantial funding to community organisations and local governments and has de facto influence over many other policy areas through the provision of specific-purpose financial grants. The Commonwealth (federal) government has a broader role in defense, foreign affairs, trade and economic policy, welfare payments, immigration and shipping.
The aims of SA HiAP include improving population health and wellbeing, particularly by closing the gap for Aboriginal peoples, through an integrated approach across all sectors of government. This includes addressing policies that influence the health determinants of people’s lives, such as housing, incomes and education, rather than just those under the direct control of individual agencies. This requires an inter-agency approach involving cooperation between all government sectors and the development of sustainable mechanisms for this kind of cross sectoral policy work.
An important premise of the SA HiAP approach is that policy actors will see an equity dimension in their activities, whether or not these are explicitly articulated as such. However, this is problematic given the range of perceptions and definitions of equity and the contested nature of its significance for different policy actors [28]. The institutional constraints on the ability to focus on equity – particularly from a neo-liberal perspective that emphasises relationship maintenance over addressing complex problems – also limit the potential for the SA HiAP approach to have a positive impact on improving equity.
This has been evidenced by the drift away from an explicit focus on equity in key strategic policy documents that set whole of government priorities and agendas during the research period. This was most evident in the 7 Strategic Priorities for 2013–14 that reflected a shift towards a more general focus on economic improvement and which did not include an explicit reference to equity. However, the shift in priority was not as pronounced for the 10 Economic Priorities in 2014–15. These included a reference to the need for addressing inequality through broader economic development and raising incomes, but did not explicitly mention health equity in particular. The SA HiAP approach has nevertheless continued to operate within an overall context of a growing recognition that health inequalities are largely a product of social and economic factors and that they can only be reduced through intersectoral collaboration on complex policy problems.
The state’s society
South Australia is a state within the Commonwealth of Australia with a bicameral Parliament consisting of a House of Assembly and the Legislative Council. Its constitutional monarchy retains the power of the Crown, and its parliamentary democracy is Westminster-based. General elections are held every four years, and the current government is led by the Liberal Party of Australia.
The state’s economy is dominated by agriculture, mining and manufacturing. Its social capital is also strong, with a highly educated population and many volunteer organisations. The state is home to the University of South Australia and the three-campus Adelaide Institute of Technology, both of which are world-class. Public transport is limited in the major urban areas, and cars are the dominant mode of travel.
Like most states, South Australia faces a wide range of challenges in the 21st century including rising unemployment and climate change. It has limited natural resources compared to its size, and has struggled to generate the economic prosperity that other larger mainland states have experienced. Nevertheless, it has been a leader in areas such as regional development, land reform and Aboriginal reconciliation.
Despite South Australia’s relatively low level of population, its governments and political leadership face challenges that are not unique to the state. They share with counterparts across the country and around the globe a sense of insecurity brought on by globalisation, competition and social change. They are also struggling to cope with the fact that the state has a much lower tax base than its peers.
Historically, South Australian politicians have been important contributors to the federation movement and have fought for the rights of citizens in several legal battles, such as the right to predetermine medical treatment at the end of life and the right to choose a peaceful death. In 1995 the state enacted the Consent to Medical Treatment and Palliative Care Act, which granted the right of people to die at home with the assistance of doctors and nurses.
During the study period, the SA Government’s key strategic policy documents set out priorities for whole of government action and were analysed for evidence that they had an equity focus. Five were identified and are described below along with their problematisation of equity, emphasis on intersectoral work and focus on the role of government in achieving an equitable future.
The state’s future
South Australia shares many of the same challenges as its fellow mainland Australian states and territories. These include the need to cope with economic insecurity and competition and the challenges of social change. However, the state’s smaller population and relative lack of natural resources means it is particularly vulnerable to unforeseen external pressures.
In the face of such uncertainty, its government and political leadership needs to generate ideas and inspiration that can help to orient public policy for the future. It is these ideas and inspiration that can shape the state’s future and provide a pathway forward for the nation.
The key to generating such ideas is for the state to create spaces where the state can generate the knowledge and inspiration that is needed to guide policy developments towards a more inclusive, equitable future. The State’s ability to do this depends on its ability to build a culture of innovation within the state’s public sector. The state must be able to find ways to make it possible for policy makers to address complex problems that require cross-agency responses by finding innovative solutions through intersectoral collaboration.
One way the state could achieve this was to make intersectoral policy making a central part of its institutional cultural norms. It has to ensure that every decision is made in the context of the impact on health equity.
A guiding policy document for the state’s government is its Strategic Plan for South Australia (SASP). The SASP articulates the state’s government values, priorities and goals through an extensive consultative process. Initially, the SASP contained an equity focus that was evident in the targets of the 2007 and 2011 versions of the document.
However, as the SASP developed, a shift was made from an emphasis on equity as an outcome to an emphasis on intersectoral collaborative processes. The reason for this shift can be attributed to multiple factors. These include: the perception among policy actors that achieving equity is a complicated and challenging goal; the focus on co-benefits, which led to a silence on health inequities in SASP documents; and the strong interest of government agencies in developing joined up policy solutions through an intersectoral collaborative approach.
