The decision made by the Prime Minister of the day undermined the precepts of the National Medicines Policy and
Kingdon’s model is helpful to gain an understanding of how this came about.
In the early 1980’s Kingdon described the multiple-streams policy agenda setting framework based on observations and interviews with people involved in health and transport decision making within the US federal government (Kingdon 1995). He aimed to provide a framework that explains what it is that makes some issues important to decision makers and become part of a government’s agenda while others that may appear equally important do not gain serious attention. Kingdon’s model involves processes and participants. Three process streams run side by side, problems, policies and politics. The list of problems known to government is long and their relative importance to decision makers rise and fall. Sometimes problems become apparent suddenly, following a crisis, or are gradually realised through changes in indicators. Alternative policy solutions to problems are many and varied and are suggested by a range of participants from academics to bureaucrats (Travis & Zahariadis 2002). Only a selection of the possible policy approaches …show more content…
The introduction of the HPV vaccination program was a major policy shift. Since 1991 Australia had relied on the biennial cytology based, National
Cervical Screening Program (NSCP) to detect cervical cancer (Kulsingam et al 2007). This had resulted in significant reductions in cervical cancer incidence and mortality (Garland et al.
2008). Despite the success of this program the availability of a preventative vaccine came to be understood by the public as a necessity, driven by media statements using words such as
‘miracle’, ‘lifesaver’ and ‘Vaccine will save women’( Roughead et al 2008). The dialogue and narrative of what Kingdon called ‘visible participants’ (Kingdon 1995 p199) was unanimous in its support of the reversal of the PBAC decision. CSL the Australian developer of the vaccine, launched an emotive appeal that suggested any delay in the introduction of the vaccine would place thousands of women at risk for HPV infection (Roughead et al 2008).
Added to this, political opinion from state and federal members of parliament was strongly in favour of implementing the vaccination program despite the PBAC decision.