Advocacy coalitions in health policy

In this paper, Paul Sabatier's Advocacy Coalition Framework (ACF) is used to understand the timing and direction of change in Tasmanian health policy and, in particular, the structure and governance of public hospital services, The Tasmanian Government has had a defining role in determining these organisational parameters. Legislation ratified the legal status of colonial hospital boards (1878), before bringing them under state control (1918) and eventually abolishing them in favour of regional boards (1991). Regional boards were, in turn, abolished in favour of statewide governance structures (1997). The recent (2008) introduction of Area health management structures now is occurring within these statewide structures, The ACF provides a synthesis of contemporary policy theory that allows for a longitudinal approach to analysing public policy in the field. While most often applied to environmental policy in the United States, here it is used to show how conflict between health policy stakeholders is shaped by local conditions in one Australian state, as well as by political and economic structures.