Healthy infrastructure: Australian National Broadband Network policy implementation and its importance to health equity

ABSTRACT

Critical social and economic resources, such as employment, education, and health services, increasingly require online access, highlighting the growing need to address equity of access to high-speed broadband telecommunications. Ensuring access to broadband requires the necessary infrastructure which, in Australia, is the National Broadband Network (NBN). In this paper, we use policy implementation theory to examine the translation of the government’s NBN policy into service delivery, specifically in relation to the choice of policy instruments to install the broadband infrastructure, the associated barriers and enablers to their implementation, and the equity considerations that are emerging as the policy is implemented. We conducted a rapid review of NBN policy documents and academic and grey literature to map the NBN policy instruments and to examine how key contextual, political, and technical aspects of NBN policy implementation are likely to affect equity. Our findings indicate a range of equity concerns in the implementation of NBN policy. The instrument choice of a public–private ‘hybrid’ organisation to implement NBN policy has created a fertile ground for competing political, social, and commercial priorities, thereby affecting how the policy is implemented and thus increasing the risks to equity as it competes with other priorities. As these mixed public–private instruments become more prevalent as policy tools to deliver major infrastructure, determining the best means to safeguard equity is a vital consideration to ensure the benefits are distributed fairly.

KEYWORDS:

• Digital divide
• digital equity
• digital inclusion
• policy implementation

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Toby Freeman is a Senior Research Fellow at the Southgate Institute for Health, Society and Equity, Flinders University, joining the Institute in 2009. He has over 14 years’ experience in research in health equity and social determinants of health research [e-mail: [email protected]].

Matthew Fisher is a Research Fellow at the Southgate Institute for Health, Society and Equity, Flinders University. He has managed several projects examining links between public policy, social determinants of health and health equity [email: [email protected]].

Fran Baum (AO) is a Matthew Flinders Distinguished Professor of Public Health and Director of the Southgate Institute of Health, Society and Equity at Flinders University. Professor Baum is a Fellow of the Academy of the Social Sciences in Australia, and one of Australia’s leading researchers on the social and economic determinants of health [e-mail: [email protected]].

Sharon Friel is Director of the School of Regulation and Global Governance (RegNet), Director of the Menzies Centre for Health Policy, Australian National University, and Professor of Health Equity. She is a Fellow of the Academy of Social Sciences Australia and has expertise in analysis of structural factors affecting health inequities, including trade and investment, urbanisation, food systems, and climate change; and policy and regulatory processes to address health inequities [e-mail: [email protected]].

ORCID

Toby Freeman http://orcid.org/0000-0002-2787-8580

Sharon Friel http://orcid.org/0000-0002-8345-5435

Additional information

Funding

This work was supported by the National Health and Medical Research Council Centre of Research Excellence on the Social Determinants of Health Equity: Policy research on the social determinants of health equity [APP1078046].