Analysis of the Australian Healthcare System

Analysis of the Australian Healthcare System INTRODUCTION The health of people belonging to any nation is the prime topic of interest for the government of that very nation. On the same lines, it is very essential that the health system should be based on equity principle, such that no one is denied the right to utilize the benefits of the health care system. According to the National Health Reform Agreement, Australian Health care system is also founded on the concept of equity of access efficiency and effectiveness (Adityan2, 2013). It is found to be a world class system in terms of both effectiveness and efficiency. The population has a good health status, with the average life expectancy at birth of 81.4 years (women-83.7 and men- 79.2). This is the highest in the entire world. Still even with such statistics, there are certain groups like those of aboriginals and the Torres Islanders, who have a poor health status (AGDH, 2014). Australian government works under the scheme of medicare, which aims at providing help with high medical cost s and the hospital costs. Another scheme called the Pharmaceutical Benefits Scheme (PBS) has also been implemented so that the costs of most of the medicines is subsidized. This essay describes the current scenario that prevails in the Australian democracy, regarding the status of equity of access, its effectiveness and the efficiency of the healthcare system. Effectiveness in this regard focuses on the ratio of outputs to outcomes. These three components form the basis of an ideal health system. In other words, a health system that if effective and efficient, is able to yield estimated outcome, is able to generate profitable outputs and is easily accessible (widely distributed), is an ideal health system for any country (NHHRC, 2009). The aim of this essay is to discuss the postulates of equity of access, effectiveness and efficiency in the Australian health care system and also throw light on the interrelationships among these concepts. EQUITY According to the US health and human rights academics Braverman and Gruskinn equity is an ethical concept with the baseline of distributive justice. With respect to healthcare, equity aims to eliminate unequal opportunites that are provided, to be healthy. Such opportunities are not given to those who have membership of socially less privileged groups like the poor people, handicapped, disenfranchised racial, cultural or ethnic groups. Mostly the people living in the rural areas are treated this way. If equity has to be considered with respect to the health care practices, then all the disparities or discriminations based on races, castes, origin, etc, should be eliminated completely. Thus, equity aims at diverting the attention of authorities towards the less privileged people of the nation (Braverman et al., 2003). As depicted by this definition, the requirement for medical health care depends upon the medical and social situation of an individual. In Australia, indigenous populati on is the one suffering from denial from health care services. They are generally linked with the economical, social, educational and cultural causes. The World Health Organisation has described inequity as follows,† Inequities are the differences or discriminations that are unjust, unfair, unnecessary and avoidable, but still persist in our society. It is not that every inequity is unfair, but yes all inequities are a result of unfair differences among the people. In the field of healthcare, just refers to the access permission for those who are not able to pay large sums of money, but are in desperate need of medical aid. Inequity should be prevented in granting access to medical aids for such cases depending upon the needs of various groups †. Gavin Mooney has defined equity as â€Å"equal access to equal care for equal need† (Mooney G., 2003). It was surveyed and found that the current health care facilities do not cater to the special needs of the indigenous people. There are many barriers to equity of access like the cost of care is very high, the fees of the consumer is again high, there is low health literacy among the people, poor access to health service information by the patients living in the remote areas, timely unavailability of the doctors, prevalence of quality services only in the posh parts of the country and lastly, the discrimination in giving the treatments. The last point itself explains the loopholes in the health care system. Some of the major reasons for such inequity are as follows: Most of the shopkeepers have closed their outlet in remote and poorer areas because there is decline in bulk billing. Patients who are willing to pay some extra amount are treated well while the rest are just ignored and left to die. Generally there are no hospitals in the remote areas. But even if some are there, they are too old that they need replacement/ Access to high technology treatments is doubtful in such areas and for such population. Richardson has shown the data statistics saying that the treatment of heart disease is thrice as common as in the insured patients. Also the provision of timely surgery is not applicable for public patients, as they have to wait in long queue and are treated once all the private patients have been taken care of. Better access to high quality services like that in dentistry and ancillary healthcare are offered to only those who either belong to the privately insured group or belong to a rich class. The Australians belonging to the White society are given the best possible treatment available in the world. While on the contrary, people belonging to the indigenous (Aboriginals and Torres Islander) population do not even have the facility to disclose their problem to a medical practitioner, leave apart getting the correct treatment. Australian Council of social Service (COSS) has implemented various strategies to overcome this gap by supporting the closing the gap priorities and promoting aboriginal health. EFFECTIVENESS Effectiveness can be defined as the measure of accuracy of a therapeutic method of treatment or success of the treatment when conducting the medical practice in remote location, or in the areas where sufficient funds or facilities are not available. Use of information technology in conjugation with high speed internet, is a ray of hope for managing patient’s records, health, finances, work force, advancements in medical field and delivery of services (Imran Muhammed et al., 2012). In this context, in order to introduce positive medical reforms, the government of Australia has implemented Personally Controlled Electronic Health Record (PCEHR) as the e health solution in this country. Earlier, the records of the patients were stored electronically in an electronic health recorder (EHR) system. Such systems were managed by a health care official and it helped a lot in maintaining records of so many people and also provided safety of personal information. But the major drawback of this system was that it was limited to the institutional access. If the family or any other person wanted to look after the patient, he/ she didn’t have any access to these records (Perlin, Kolodner, Rosswell, 2004). To avoid this problem a more patient centered model of health care system was developed (Perlin et al., 2004). This new model was termed as electronic personal health record (PHR) systems. An example of this new technology is Australia’s Personally Controlled Electronic Health Record (PCEHR). PCEHR was introduced in July, 2012. PCEHR had the function of keeping all the key components of the patient’s health information in one database, in form electronic records. Only registered users and their medical service providers had the access to all the records and summary of the treatments and their medical history. The main aim of developing this kind of electronic database was to help the medical practitioners to take better decisions with respect to t he treatments to be given to the patients (Les Schumer, 2013). PCEHR has some basic postulates like voluntary participation, providing access under consumer (or patient’s) control and a source of authentic information. PCEHR is not a substitution for clinical records. Instead depending upon the interest of the patients, they can register themselves online and choose a health care provider to create and maintain their records. People can now view their very own medical history ranging from the time, type and duration of medications, allergies and adverse reactions as well (Les Schumer, 2013). EFFCIENCY Efficiency, when defined in relation to the healthcare, is a relative term. It can be used to refer to technical as well as productive efficiency or even social efficiency. The extent to which effort, cost and time can be used for the desired task or purpose, is the efficiency. It is the final stage of a logical process which comprises of three steps starting from efficacy to effectiveness and finally efficiency. Australian government aims in maximizing the health care outputs produced from a set of standard input and improving the input quality. Conversely, the government is incorporating some measures to ensure that the health care inputs in terms of cost are minimized. As mentioned there are basically three types of efficiencies that are considered in Australian health care system (James F. Burgess, 2011). Technical efficiency: It is measured by production of outputs by utilizing fewer inputs. The potential inefficiencies prevailing in the system are long duration of stay, drugs a nd IV fluids that have expired and unused CPOE system. Productive efficiency: It is measured by production of outputs at minimized cost. Some of the potential inefficiencies faced by Australia are the Positron emission tomography (PET) scan vs. standard imaging for Alzheimer’s diagnosis, high discharge cost and high cost of care. Social efficiency: It is measured by making an individual cope with the current ailment without harming any other person. Again the system is filled with potential inefficiencies like use of cardiac defibrillator in low risk patients and wrong scope and scale in hospitals. Palmer and Torgerson reported that efficiency is the realtion between resource inputs ( which can be costs arising from labour input, capital investment and equipments) and either intermediate outputs (number of patients treated, waiting time, etc) or final health outcomes (lives saved, life years gained, quality adjusted life years (QALYs)) with an ideal target on the final health outcomes. RELATIONSHIP BETWEEN EFFECTIVENESS AND EFFICIENCY Efficiency is not possible without efficacy and effectiveness because both describe the extent to which the goal can be reached (Stephen Leeder, 2003). Keeping in view the Healthcare system of Australia, it is evident that even though the government is trying to reinforce new reforms into the healthcare system every now and then, yet there is lack of equity of access. The aim of such reforms is to improve the healthcare system and help it emerge as the high quality system. For this it is essential to have effective and efficient functioning of the system. But this is not the case. As said before, the health of the people in a particular nation, determines the progress or economic status of the country. And the health of people is determined by how quickly the treatment facilities are available for the patients. The aboriginals and the Torres Islanders are unable to access the medical institutions because of the discrimination and their location (which is generally outside the main ci ty or it is a remote location). The average life span of indigenous Australians is between 10-17 years of age, which is quite lower as compared to that in the non indigenous populations. Also, the rate at which the new born babies die (in indigenous populations) is two times higher than the rate in non indigenous and they also experience frequent situations of illness as well. Thus, it is need of the hour to seal this gap between the two populations so that equal rights and equal opportunities are provided to both the classes of people, irrespective of their origin, race, tribe, etc. Thus, there is a deep connection between equity of access, effectiveness and efficiency. When all the populations, whether indigenous or non indigenous, have equal access to all the medical facilities, the ratio of healthy to ill will definitely rise and the statistics will improve. But this is only possible when the medical facilities are effectively organized and made available in the remote areas too . Further, the successful execution of all these agendas will determine the efficiency of the Health care system. Thus, all the three terms go hand in hand. Without one, the other two are meaningless. CURRENT SCENARIO Many clinicians and the analysts do not consider it appropriate to include economics (costs) inbetween the medical decisions as they consider this as unethical. But they are definitely mistaken as one of the main advantages of health economics is that everything is transparent and all the concepts of equity, effectiveness and efficiency are maintained. It has been reported that the richer countries use the public funds more in the field of healthcare as compared to those used by the underdeveloped countries (Stephen Leeder, 2003). Since the investment made in health care demonstrates a country’s economic strength and its democratic values, it is both desirable and essential for a government to invest in health care. Secondly, the salaries offered to the doctors or other medical officers are very less as compared to what actually should be offered. Moreover, the funds given to the health care systems are not enough to procure the most appropriate treatments and thus this causes problems. Also since the funds are not sufficient, proper medical instruments are also not available for the treatment of chronic disorders. For an instance, there is no provision of NSAIDs which have an anitinflammatory effect on the disease. According to the Canadian social commenter John Ralston Saul, the governments that believe in corporatism, rationalism and cost reduction, as a means to improve the efficiency, become the main reason for the failure of the publically funded health care facilities (Stephen Leeder, 2003). The second scenario prevalent in Australian democracy is that even though the governments provide enough funds for the health care institutions, yet they do not guarantee equity of access. The big private sectors are generally biased and divert all the contribution from the government towards the richer institutions. CONCLUSION In order to place equity on the agenda of the health care policies of the Australian government, it is important to generate awareness about what Medicare and other public agencies actually fund for healthcare. It is also necessary to take the initiative and make the government realize that the topmost priority of any healthcare system should be to provide equity of access, as only then can the policies or treatments be implemented effectively and efficiently. The Australian Bureau of statistics health insurance survey and AXA/ National Mutual Data for NSW (1998), Spencer quoted that around $300 million of the public funds were used for dental care and allied health professional services (Stephen Leeder, 2003). Since dental care is not a luxury, but treatment of chronic illness is, therefore, the basic dental services for all the Australians should be subsidized. Secondly, the salaries received by the doctors from the bulk billed vs. the non bulk billed patients, should be redressed. Third, (hypothetically) a new body say National Council for Equity in Healthcare should be formed, so that it is directly answerable to the Australian Parliament and aim at making the Australian Health care more equitable (Stephen Leeder, 2003). Therefore, as discussed, it is very important to reform the current medical practices so that there is efficiency in the functioning of the health care department of Australia.

Global Environmental Issues Essay

As the third world countries struggle with famines poverty wars and population growth, the communities in the third world countries are discovering the potential impacts of these problems in the form of increased water, air and land pollution. In most of third world countries pollution is almost unchecked and developed nations dump untreated sewage flows and toxic wastes in to rivers. At many times the choice of third world countries is between poison or poverty and basic needs like clothing shelter and food takes the precedence (Murphy, 73). On the other hand forming and enforcing environmental policies in the third world countries becomes economically disastrous and therefore most environmental issues are therefore not addressed by the governments of the poor countries (Murphy, 73). The health of the environment in third world countries is exacerbated by developed nations which take the advantage of the third world countries dilemma. Developed nations dump hazardous wastes in developing nations (Murphy, 73). Industrialized nations also built industrial premises in developing nation to avoid environmental regulations which they would face at their home countries. Transnational corporations that produce chemicals that are deemed dangerous in developed nation find their market in third word countries. In third world countries the government cannot restrict the use of these chemical because it would be very costly for the citizens in the third world countries in trying to make a living (Murphy, 73). In addition to the problems created by industrialization and development third world countries also suffer environmental difficulties that are caused by war and poverty among other causes. Third world environmental issues are such as air pollution, water pollution, desertification, soil erosion, deforestation and environmental poisoning. Environmental pollution both from developed nations and third world countries come from multiple sources and therefore reduction of this problem has to be tackled by international government, corporations, non governmental organizations and individuals alike (Murphy, 73). The largest single role must be played by the respective governments which will involve regulation and enforcement of anti pollution measures. These decisions are not simple as there may be balance struck between disruption of commerce and reduction of environmental pollution and between ambitious spending programs and conservative fiscal policies. Best intentions in third world countries sometimes lead to contradictory result. For example hoy no circular programs in Mexico was intended to reduce traffic by forbidding driving one day per every week depending on the number of licenses but the program was subverted and may be the result of the increased vehicle sales in this country (Magraw, 82). On the other hand there is no country that can effectively protects its environment and solve the numerous environmental problems on its own (Magraw, 84). No matter how the country is advanced in technology and science or how it is perfect on its means of implementation of the environmental law or how perfect it is in its means of legislation, an independent efforts to reduce environmental problems are not enough (Magraw, 86). Therefore it requires global efforts to reduce environmental problems. Moreover there is no country that can be able to pay costs of environmental degradation on its own including the ever increasing costs of the new technologies that are being developed to remedy environmental pollution (Magraw, 87). Since we share the same environment globally and given that international community is an organic whole we can argue that man endeavors to solve the global environmental issue can not be accomplished and will be to no avail if they fail to bring into play all the positive factors and unite the available forces. Bibliography: Rajan M: Global Environmental Politics: India and the North-South Politics of Global Environmental Issues, 1997. ISBN 0195640489, Oxford University Press. Pickering K & Owen L: An Introduction to Global Environmental Issues: Instructors’ Manua. 1997. ISBN 0415166640, Routledge. Harris F: Global Environmental Issues. 2004. ISBN 0470845619, John Wiley and Sons. Diaz A & West S: Environmental Issues in Latin America and the Caribbean. 2005. ISBN 1402037732, Springer.

Describe Two or More Psychological Explanations of...

Describe two or more psychological explanations of schizophrenia 8+16 marks A01 A02 Sociocultural AO2 Cognitive Introducing Biology The cognitive explanation acknowledges the role of biological factors in schizophrenia, suggesting that the basis of the condition is abnormal brain activity producing visual and auditory hallucinations. Further features of the disorder emerge as people try to make sense of the hallucinations. When schizophrenics first experience voices and other worrying sensory experiences, they turn to others to confirm the validity of what they are experiencing. Other people fail to confirm the reality of these experiences, so the schizophrenic comes to believe that others must be hiding the truth. They begin to†¦show more content†¦The intention is to show schizophrenics that their hallucinations are not real. As yet, however, there is no evidence that this will provide a successful treatment. The research by Brown and Birley was a retrospective study where data is collected after events have occurred. In other words, once a person had developed schizophrenia they were asked about events leading up to the onset. It is quite likely that recall would be negatively affected by the events surrounding the onset of schizophrenia so such evidence may be unreliable. Prospective studies are preferable, where people are studied after the onset of the disorder. Hirsch et al followed 71 schizophrenic patients over a 48-week period. It was clear that life events made a significant cumulative (increasing) contribution in the 12 months preceding relapse rather than immediately prior to the schizophrenic episode. This does support the retrospective research. However, not all research supports the importance of life stressors. For example, Van Os et al reported no link between life events and the onset of schizophrenia. 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David Humes Anti Miracle Belief Essay - 1577 Words

The problem of miracles is an ancient one that has persisted for most of human history, but that has been addressed with some depth only in the last few centuries. The great empiricist philosopher David Hume was one of the first to present an analysis of miracles that tried to explain why they are created (by human beings themselves, in Hume’s opinion) and why people are so ready to believe in them. This is an important field of study, as with greater knowledge of the character of physical law, one finds more and more (rather than less) accounts of miracles being touted as exceptions to natural laws. Hume’s ideas on the matter are extremely illuminating and amazingly enough, are fairly universal in their applicability as regards†¦show more content†¦Ã¢â‚¬ËœSection X: Of Miracles’ pp.534- 543. Note: All references to Hume will be to this text unless otherwise noted. 2 fact, that is what we must consider when we think about miracles. This experience can be our own or be the testimony of someone else. However, as Hume notes, experience sometimes leads us to uncertain conclusions. As an important example, causes and effects may not rigidly adhere to each other all the time, so that there is an inherent uncertainty about such relationships. Also, testimony can be quite untrustworthy at times and there must be sufficient reason for considering it as proper evidence. It is for this reason that Hume proposes a method whereby one might possess degrees of belief about phenomena based on the evidence. The belief in a conclusion, according to Hume, must be proportional to the evidence in its favor (p.534). This method, to which I shall henceforth allude to as The Arithmetic of Doubt, consists of first collecting all the evidence (for or against) relevant to the point in question and based on which evidence is greater; deciding which side of the argument is the more probable one. Finally, the strength of this probability is proportional to the (qualitative) difference between the forces of the two competing sets of evidence (p.535). This, Hume maintains, is the way to understand, with some degree of accuracy, the degree of truth or falsity of a proposition that does not have an absolute conclusionShow MoreRelatedBy Definition Miracles Do Not Occur Essay1398 Words   |  6 PagesBy Definition Miracles Do Not Occur Even in this modern age, belief in the miraculous is widespread and is a feature of many world religions, including the Christian faith where miracles have played a significant role. It is important attempt to define what a miracle is, as this in itself is a source for debate. Today the term ‘miracle’ in many different ways and the idea is open to many interpretations. A miracle can be defined in a number of ways, firstly asRead MoreSources of Ethics20199 Words   |  81 Pagessuch changes should be brought about by identifying environmental policies with Islamic teachings. To do this, the public education system will have to supplement the scientific approach to environmental education with serious attention to Islamic belief and environmental awareness. 2.14- Ethics And Other Religion: Anyone who is able to overcome infant indoctrination and consider theistic religions objectively has no trouble in judging them to be completely false and simply the product of

Globalization of Yesterday and Today - 461 Words

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The term Globalization has emerged more prominently in the 1990s, but the concept of globalization and references thereto are not entirely new and it has been frequently associated with interdependency (Keohane; 2000). However, the distinction between the two terms is that interdependence is a condition, whereas globalization is a process. This implies that globalization is in a developmental state rather a comprehensive term. For instance, two states can be interdependent economically or militarily with reciprocal effect, but hardly called globalized e.g. Australia and USA. Globalization today is notShow MoreRelatedThe Impact Of Globalization On The Society1114 Words   |  5 Pages The Impact of Globalization 3 Introduction The effects of globalization are visible everywhere. The mixing of cultures and races throughout our society is everywhere. It’s on television, in our homes and woven into our workplace. 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What Americans fail to comprehend is that slavery is not

Assignment Devry Free Essays

While genetic engineering is only being applied at crops at the moment, one has to wonder how long it will be before humans are unethically engineered and what will be the implication of such actions. An analysis of science fiction films, where genetic engineering is applied could provide a view Into the Implications of genetic engineer of humans on society. The popular science fiction film Cataract Is a perfect film to show the possible affects human genetic engineer could have on society. We will write a custom essay sample on Assignment Devry or any similar topic only for you Order Now In Cattle the technology to engineer people to near perfection has been made possible and the fate of everyone is known at the very moment of birth. The number of genetically enhanced humans is far rater than the number of natural born people, which has lead to a new form of social segregation. The film follows the life of one of the few of the natural born humans, named Vincent. Being a natural born, Vincent does not have many options and even worse he is diagnosed with a severe heart condition. From the start, it would seem that society (even Vincent own farther) would not consider him worthy of their attention. The only person that actually seemed to care about Vincent was his mother, who actually seemed to disapprove of the genetic engineer being done. One as to feel bad for Vincent and others like him, because nobody seemed to want anything to do with him. The schools would not accept him, because of his heart condition and his own farther did not consider Vincent worthy to care his name. Vincent parents eventually have another child who Is genetically altered: this son would be superior to Vincent in every way possible and the father would consider him worthy of his name. The film presents several important and very symbolic scenes, where Vincent and his brother Anton compete in swimming. Throughout their childhood, Anton would always win without ever having to give any effort. One day something Impossible happened Vincent the Imperfect natural born beat his perfectly genetically engineered brother. Years later, Vincent and Anton compete once more and when Vincent wins, he says he is able to do it, because he never saves anything for the swim back. One could view the swimming scenes as a metaphor for life. In life people have to compete against the forces of nature and others. Some people seem to be given everything on a silver platter, while others are given nothing. Just because mom people are given everything, It does not mean that those less fortunate cannot succeed. Violent Is a perfect example AT ten previous example; even tongs Nils brother is genetically superior, Vincent is able to beat his brother by training and working for his goals every day. Another interesting point of the film is the character Irene. Even with societies great technology there is still the possibility of errors and Irene is the best example of this statement. Irene is one of the many â€Å"perfect† beings except for one minor flaw, she has a heart murmur. This heart murmur proves that regardless of all of the advances made in technology cannot guarantee perfection 100% of the time. One has to feel for Irene, because despite being genetically engineered to near perfection she is not accepted by her fellow genetically altered brothers and sisters. The last significant character in the film is Jerome. Jerome is another one of the perfectly genetically engineered people, but he is described as being the best of the best. Unfortunately for Jerome, being perfectly engineered does not mean he would be successful at everything or that he would live a perfect life. Jerome had apparently laced second place once, which apparently demoralized him to the extent of attempting suicide. Groomer’s attempt of suicide was unsuccessful and it resulted in him becoming paralyzed, which would make him the perfect partner for Vincent. Groomer’s final action in the film is interesting, but not surprising. Jerome had tried to kill himself once before and it would only be a matter of time before he would try again. The ending of the film was the most informative and fascinating part of the whole film. When Vincent is his heading for the space shuttle he is given a surprise gene inspection by the doctor. Vincent does not have any of Groomer’s blood/urine samples and so it would seem that he is caught. Surprisingly, the doctor who conducted all of the testing on Vincent knew he was an In-Valid the entire time. The doctor let Vincent pass, because he had a son that apparently was an In-valid. In conclusion, it is apparent that Andrew Niccole, the director of Cattle, does not approve of genetic engineering. Niccole uses his film to paint the bleak picture of the future of genetic engineering. Now some people may doubt the relevance a film may eave on real world situations, but there are plenty of writers, scientist, and even scholars who would disapprove of genetic engineering. Victor Mafia wrote that genetic engineer would create a risk that the information discovered from genetic engineering would create a form of discrimination in the workforce (Mafia, 2001, p. 83). This fact is evident from the film Cattle. Discrimination in the workforce has always been a problem in the past and it would seem like the problem may evolve if genetic engineering becomes possible. Elizabeth Fenton, a philosopher, believes that genetic engineering will lead to the reaction of a new sub-species of humans and that the differences between the two species would lead one species to enslave or destroy the other (Fenton , 2008, p. 8). While in the film the enhanced beings never directly enslaved or destroyed the naturals, the naturals would never be more than lower class individuals. While there are plenty of people who argue against genetic engineering, there are still a few people who say that genetic engineering can have a place in the world. Clifton E. How to cite Assignment Devry, Papers

Old Melbourne Goal as a Cultural Heritage Site-Sample for Students

Question: Discuss about the Old Melbourne Goal as a Cultural Heritage Site. Answer: Introduction The Old Melbourne Gaol Museum is one of the most important heritage places in Australia which attracts lots of tourists on the regular basis. Recently, the importance of saving the heritage culture in Australia is increasing which has raised many concerns in order to protect these sites. This particular report has been made on The Old Melbourne Gaol Museum by analysing the relationship between different stakeholders, conservations principles applied to save the place, visitor statistics, marketing activities used, and sustainability principles applied. At, the end, proper recommendations are made in order to increase the customer and also the sustainable tourism. Main body Analysis of ownership and stakeholders and the current stage of relationship between heritage and tourism management at the site The Old Melbourne Gaol Museum is one of the biggest historical places in Australia which is visited by millions of tourists every year. It was once filled with the criminals, mentally disabled people and others who committed crimes (Donohoe, 2012). However, later, it was changed to the museum but still some artefacts of that time and also the gallows, where the prisoners were hanged are still in place. The building is currently owned and managed by the National Trust of Australia and it is its biggest stakeholders. Other than that, the tourists, central government, local communities are also its stakeholders. National Trust of Australia is a national peak body which is committed to preserve and promote Australias indigenous, natural and historic heritage. The Old Melbourne Gaol Museum is also managed by this trust only and it makes sure that the building is continuously managed by doing construction on the regular basis, maintaining the halls, gall ways, gardens, etc. the trust makes sure that the building is well preserved and because of that it takes care of the proper security so that people do not come and destroy the place. All the artefacts are well preserved by this trust in terms of their cleaning, care, maintenance so that it can attract lots of tourists on the regular basis (Duval and Smith, 2013) Other than this, the trust is also responsible for the appropriate promotion of this place so that lots of tourists can visit this place and learn about the past of Australias heritage. They make sure that all the tourists not only international but also the domestic one can understand the value of this place and visit it. The trust is doing great work in terms of attracting the tourists, etc. However, there are various things which are still unlooked like facilities for visitors, maintenance of the building, nearby areas, etc. The central government of Australia is also one of its stakeholders as they are responsible to provide the proper funds to NTA (National Trust of Australia) so that they can protect the Old Melbourne Gaol Museum in an effective manner. The government also selects the board of NTA and gives them the instructions to manage the heritage. The local community as a shareholder is also very important as they also have the responsibility to protect the local monument because it provides them with work opportunities as tourists guides, local sellers, hotels, etc. They have to make sure that the tourists do not harm the heritage and get home with lots of knowledge about the place. Tourists are also one of the important stakeholders of the heritage as these are the people who provide income to the local population, government, etc. These people may be local or international but are responsible to visit these places and get knowledge about them (Bramwell and Lane, 2012) The tourism management and cultural heritage management (CHM) often have a very awkward relationship. The CHM is directly responsible for the provision as well for the conservation of cultural heritage assets while the tourism management handles the role of product development and promotion role. There is always tension between these two bodies at The Old Melbourne Gaol Museum because the CHM argues that cultural values are being compromised for the commercial gains while tourism management says that tourism values are being compromised when a management attitude exists that any touristification has a corrupting influence. CHM says that they are trying their best to reintroduce people to their cultural roots and are also reinvigorating peoples interest in history and culture while tourism management argues that they are the one who promotes the place and aware people about the places like this (Alberti and Giusti, 2012). With this relationship, it can be said that it is important for NTA to interfere and make both the parties well aware of their roles and increase their collaborations. Conservation principles and concepts applied NTA has described different conservation principles, policies and guidance which are all been stated to preserve The Old Melbourne Gaol Museum. The first principle states that the historic environment is a shared resource which means that the people should value this heritage as a part of their culture and natural heritage because it reflects the knowledge, beliefs and traditions of the diverse communities. The heritage value represents the public interest, regardless of the ownership of NTA (Prideaux, Timothy and Chon, 2013). The use of different laws, public policy and public investment are justified in order to protect the interest of the public. There should be proper advice and assistance from public sources in order to help the owners sustain he heritage. The second principle states that everyone should be able to participate in sustaining the environment of The Old Melbourne Gaol Museum. People can freely contribute their knowledge in order to protect the place. Tourists should be able to learn to sustain the historic environment of the place and experts should encourage the other to learn about the place. The third principle states that understanding the significance of the place is very vital because it contains the diverse culture and natural heritage values that people get associated with. As per the fourth principle, The Old Melbourne Gaol Museum should be managed to sustain its value. Proper actions should be taken to counter the harmful effects of natural change or to minimise the risk of a disaster on time and in terms of severity and likelihood of identified consequences and sustainability (Briassoulis and Van der Straaten, 2013). There should be asperity in quality of design and execution so that it can be valued now and also in future. As per the fifth principle, the decision about change must be reasonable, transparent and consistent and should be done under expertise, experience judgement, etc. The last principle states that documenting and learning from decisions is essential in order to maintain the cumulative account of things that happened to The Old Melbourne Gaol Museum and the ways in which the significance of place got altered. Application and critical analysis of the Market Appeal Robusticity Matrix Market Appeal Robusticity Matrix is an assessment tool to be applied in a pro-active way in order to assess potential and determine issues that require resolution. It has two axis namely Market Appeal and Robusticity in which Market Appeal is focused on experiential and product values while Robusticity is focused on issues linked to physical and cultural values. Figure 1: Market appeal/ Robusticity matrix of Old Melbourne Gaol Museum The Old Melbourne Gaol was raised in the phases from 1851 to 1864 via Department of Public Works of the Victorian colony; the credit of design was given to the Chief Architect (Henry Ginn). The eldest remaining section which was the Second Cell Block between 1851 to 1853 that served as a museum and included a large block along with 3 cell tiers ending in the central hall in 1860 at the scaffold site. The block of the cell is properly preserved to give a complete understanding of the circumstances continued by the prisoners. Well, maintenance was provided to Chapel and entrance buildings, as these were the main focus to complex buildings. They have been changed on the inside; however, almost the work is convertible. The Old Melbourne Gaol Museum, Entrance buildings, and courtyard area of intellectual, artistic, architectural, technical and significant to the Victoria state. The site of the original gaol multifaceted and has archaeological significance to the State of Victoria. The building complex is significant in past for its major role in the oldest existing gaol in Melbourne, further the Remand, Debtors and woman prisons for the city area for much of its operational life where the prisoners were executed of original funerals of them at the gaol, inclusive of Ned Kelly. Above description shows that Old Melbourne Gaol has high Robusticity and medium Market appeal Cultural tourist visitor analysis and marketing activities attracting these types of tourists Cultural tourism in Australia is increasing day by day and the government is also trying their best to attract the customers with different marketing activities. There were total of 746, 100 visitors arrival during June in Australia and out of those 9% of the total people visited The Old Melbourne Gaol Museum which is a good number (Welch, 2013). However, the numbers are much less as compared to the other popular sites but still the places associated with death, ghost hoax, etc. are visited by less people (Jamal and Camargo, 2014). There was increase of 4% in the number of tourists since last year. In order to increase the number of visitors to The Old Melbourne Gaol Museum, the NTA is doing lots of initiatives so that more and more people can visit this place. The NTA organizes an annual fest in which the people are invited with different costumes and lots of competitions are held (Welch, 2017). People from all over the world are invited in the event via website of historical place and also via the Australian tourism website (Witcomb, 2013). Other than this, lots of promotions are done on the social media platforms with paid advertising so that people can learn about the place and generate the curiosity. The place is given on rent to various film and television makers so that its visibility can be increased on the national and international screens and people can be called with the increase in craze (Park, 2013). Analysis of current sustainability concepts and strategies applied at the site There are different kinds of sustainability initiatives and strategies that are adopted by NTA in order to bring sustainability in The Old Melbourne Gaol Museum. One of the biggest initiatives that the organization has taken is that they have completely banned the polybags near the site so that there is pollution. All the shops nearby have been told to use only paper bags so that it can be recycled appropriately (Joshi, 2012). The lightings in the facility are completely fuelled by the solar power and it has helped to reduce the energy consumption a lot. Water management is also encouraged by the NTA in The Old Melbourne Gaol Museum as proper facilities are there which collects the rainwater and then it is recycled it to provide fresh water to all the tourists. Steps are also taken in order to increase the greenery around the museum so that the green environment can be promoted. Recommendations to improve the management of stakeholders and appropriate changes to existing or the introduction of new sustainability strategies It is very important to improve the management of the stakeholders in The Old Melbourne Gaol Museum so that everyone can work together and increase the tourism at this place. The first thing that can be done is to improve the relations between tourism management and cultural heritage management (Buckley, 2012). Both can work together where tourism management can work in terms of increasing the tourism in the place and cultural heritage can provide the knowledge so that people can learn about this place more and more. Other than that, efforts can be made in order to remove the hoaxes regarding ghost and other illegal activities so that interest of tourists can be increased at The Old Melbourne Gaol Museum (Smith, 2017). People can be told regarding the interesting stories about this place so that curiosity in their mindset can be increased and they get instigated to visit the palace. The local environment can also be m in terms of providing better staying and eating facilities to the tourists. The place can also be rearranged with proper restroom facilities, food cafeteria, and rest facilities so that people can visit (Smith, Waterton and Watson, 2012). In terms of sustainability, the transportation can be changed and green vehicles should be allowed near the site. People should be told to throw the waste material in the dustbin which further can be recycled by establishing the waste management facilities (Ross, 2012). More greenery can be increased near the place by planting the trees and maintain the garden nearby. All the artefacts should be protected with proper care and people should not be allowed to touch them (Cohen and Cohen, 2012). Conclusion In accordance with the present study, conclusion can be drawn that role of stakeholders is very important as they all have been responsible for maintenance and promotion of this site. The study shows that NTA is trying hard to apply different conservation principles for the same and it has helped to increase the tourism. However, there are still some measures that can be taken by the NTA like strengthening relations among each other, apply sustainable measures, etc References Alberti, F.G. Giusti, J.D., (2012). Cultural heritage, tourism and regional competitiveness: The Motor Valley cluster.City, culture and society,3(4), pp.261-273. Bramwell, B. Lane, B., (2012). Towards innovation in sustainable tourism research?. Briassoulis, H. Van der Straaten, J. eds., (2013).Tourism and the environment: regional, economic, cultural and policy issues(Vol. 6). Springer Science Business Media. Buckley, R., (2012). Sustainable tourism: Research and reality.Annals of Tourism Research,39(2), pp.528-546. Cohen, E. Cohen, S.A., (2012). Current sociological theories and issues in tourism.Annals of Tourism Research,39(4), pp.2177-2202. Donohoe, H.M., (2012). Sustainable heritage tourism marketing and Canada's Rideau Canal world heritage site.Journal of sustainable tourism,20(1), pp.121-142. Duval, M. Smith, B., (2013). Rock art tourism in the uKhahlamba/Drakensberg World Heritage Site: obstacles to the development of sustainable tourism.Journal of Sustainable Tourism,21(1), pp.134-153. Jamal, T. Camargo, B.A., (2014). Sustainable tourism, justice and an ethic of care: Toward the just destination.Journal of Sustainable Tourism,22(1), pp.11-30. Joshi, M.P.V., (2012). Planning Cultural-Heritage Tourism for Sustainable Development. Park, H.Y., (2013).Heritage tourism. Routledge. Prideaux, B., Timothy, D. Chon, K. eds., (2013).Cultural and heritage tourism in Asia and the Pacific. Routledge. Ross, J.I., (2012). Touring imprisonment: A descriptive statistical analysis of prison museums.Tourism Management Perspectives,4, pp.113-118. Smith, L., Waterton, E. Watson, S. eds., (2012). The Cultural moment in tourism. Routledge. The Old Melbourne Gaol Museum., (2017). History. [Online]. Available Through: https://www.oldmelbournegaol.com.au/history/. [Accessed on 5 October 2017]. Tourism Australia., (2017). International Visitors Arrival. Online]. Available Through: https://www.tourism.australia.com/en/markets-and-research/tourism-statistics/international-visitor-arrivals.html. [Accessed on 5 October 2017]. Welch, M., (2013). Penal tourism and a tale of four cities: Reflecting on the museum effect in London, Sydney, Melbourne, and Buenos Aires.Criminology Criminal Justice,13(5), pp.479-505. Witcomb, A., 2013. Using Immersive and Interactive Approaches to Interpreting Traumatic Experiences for Tourists.Heritage and Tourism: Place, Encounters, Engagement, pp.152-70. Smith, L., 2017. Explorations in Banality: Prison Tourism at the Old Melbourne Gaol. InThe Palgrave Handbook of Prison Tourism(pp. 763-786). Palgrave Macmillan. Welch, M., 2017. Penal Tourism and the Paradox of (In) Humane Punishment. InThe Palgrave Handbook of Prison Tourism(pp. 479-495). Palgrave Macmilla