Health policy and the nursing profession: a deafening silence

The Australian healthcare system, and those of many other Western countries are experiencing significant shifts in the development of health policy. Many of these shifts are directly related to economic factors that have contributed to the spiralling costs of health care. The trends in health policy appear to be embracing a 'market driven' approach to the distribution of resources and health services. Technology and medical developments have contributed to these current economic trends. Over the past 20 years nurses have been faced with significant shifts in the direction of health policy to the extent that many policies have significantly impacted upon their practice without their apparent contribution. Several theoretical positions exist about nurses' lack of policy participation. This paper examines some of the current health policy changes in Australia that are perceived to have had the greatest impact on the nursing practice, and identifies some of the barriers to the nursing profession's participation in the formulation of health policy.