• Identify and discuss two key influences that have shaped healthcare and/or healthcare access in contemporary Australian society. (The two influences must be from 2 different influencing categories, i.e. not 2 historical issues or 2 cultural issues) 
• Identify and describe how each influence has shaped healthcare and/or healthcare access  Discuss how each influence might continue to impact healthcare and the RN role.  

Introduction

The healthcare system consists of the patient and clinical care at two points with numerous settings in between, such as diagnostic tests, treatment modalities and restorative care and certain arrangements of the legislative, regulatory and monetary matters (Hall, 2015). According to the Australian Institute of Health and Family Welfare (2017), initially most of the people visit the general practitioner when ill. They are then referred to a specialist for the diagnosis, tests, prescription or higher treatment methods (Australian Institute of Health and Family Welfare, 2017). The evolution of the specialist treatment dates back to the 1960s, which has contributed to the progress and continues to influence the Australian of healthcare system in a constructive manner. Similar to this, certain other factors are also involved in shaping the healthcare in the contemporary Australian society under the historical, political and socio-cultural influences. This essay discusses two key influences, one each in the historical and cultural factors and their contribution in healthcare access, and impact on the present system. It also presents the role of registered nurses (RN) in shaping the healthcare in context with both the influencing factors.

Historical influence: Influence of general practice on Australian healthcare system

The Australian healthcare is known to deliver cost-effective, better health services. The influence on general practice was based on the needs and expectations of the population (Hall, 2015). One of the marked changes that took place since the 1960s is specialization of services from general practitioners, who became the first-line contact for patients with different health problems. The decrease in general practice was notably from the Second World War, when the cases of mortality and morbidity increased due to infectious diseases, injuries, and chronic diseases. Such conditions caused an overload on the GPs and the importance of the specialist services was recognized (Harris & Zwar, 2014). 

Various medico-political issues ensued, which included the independence of the GPs, cost effectiveness, the role of alternative practitioners versus GPs, sufficiency of medical services in the rural areas, and the connection between hospital and community. These issues led to few remarkable developments during the period. It included the establishment of the Australian College of General Practitioners in 1958, opening of Royal Australian College of General Practitioners (RACGP) exam in 1968, Family Medicine Program from 1973-2002, the establishment of academic departments of general practice in the university medical schools from 1974 to 1990, introduction to registration in 1989, establishment of the First Divisions of GP in 1992 to 2011, recognition of GP as specialty by federal government in 1996 to 2002, and the commencement of accreditation in 1998. The number of GPs has increased since 1960. The women practitioners increased from 19% in 1991 to 35% in 2003 to 41% in 2012 (Harris & Zwar, 2014). 

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