R2_ISCRR Futures Initiative Long Report 220811

The futures of safety, compensation and recovery:

Final report on the Futures Research Initiative

Fawkes S, Palmer J, Inayatullah S, Burke R, Miller M, Worland P, Ellis N

Institute for Safety, Compensation

and Recovery Research Futures Workshop

27 October 2010

Queens Hall, Parliament House, Melbourne

August 2011

Research Report # 0811-017-R2

Accompanying documents to this report

Title Report number

The futures of safety, compensation and recovery A brief report on the Futures Research Initiative

Research Report No. 0811-017-R1

Research Report No. 0811-017-R1 Page 2 of 105

TABLE OF CONTENTS

LIST OF FIGURES AND TABLES ....................................................................................... 5

1. EXECUTIVE SUMMARY .......................................................................................... 7

2. INTRODUCTION AND AIMS .................................................................................... 8

3. METHODOLOGY ..................................................................................................... 9

4. METHODS .............................................................................................................. 11

4.1 OVERVIEW 11

4.2 METHODS: HORIZON SCANNING PROJECT 12

4.2.1 DATA MINING 12

4.2.2 ANNOTATED BIBLIOGRAPHY 15

4.3 METHODS: STAKEHOLDER DIALOGUE PROJECT 15

4.3.1 WARM UP WORKSHOPS 15

4.3.2 ONLINE DISCUSSIONS (BLOGS) 15

4.3.3 FUTURES WORKSHOP: OVERVIEW 18

4.3.4 FUTURES WORKSHOP: INTRODUCTION 18

4.3.5 FUTURES WORKSHOP: EXPLANATION OF FUTURES THINKING 19

4.3.6 FUTURES WORKSHOP: VIDEO 19

4.3.7 FUTURES WORKSHOP: FISHBOWL 19

4.3.8 FUTURES WORKSHOP: REPORT ON ONLINE BLOG DISCUSSIONS 20

4.3.9 FUTURES WORKSHOP: FUTURES WHEEL EXERCISE, SCENARIO DEVELOPMENT AND BACKCASTING 20

4.3.10 FUTURES WORKSHOP: PRIORITY RESEARCH QUESTIONS 22

4.4 METHODS: ISCRR ANALYSIS AND REPORTS 23

5. RESULTS OF HORIZON SCANNING PROJECT ................................................. 23

5.1 DATA MINING 23

5.2 ANNOTATED BIBLIOGRAPHY 24


6.0 RESULTS OF STAKEHOLDER DIALOGUE PROJECT ....................................... 24

6.1 ONLINE DISCUSSIONS (BLOGS) 24

6.2 FUTURES WORKSHOP: FUTURES WHEELS AND SCENARIOS 26

6.2.1 GROUP 1: DIVERSITY IS EMBRACED, PEOPLE ARE MORE VALUABLE27

6.2.2 GROUP 2: NEW WAYS OF ASSESSING AND MANAGING RISKS 29

6.2.3 GROUP 3: GREATER FOCUS ON EMOTIONAL AND MENTAL NEEDS 32

6.2.4 GROUP 4: 30% OF SCHEME BUDGET IS PREVENTION 36

6.2.5 GROUP 5: BROADER WAYS OF MEASURING SUCCESS IN IMPROVING HEALTH OF SOCIETY 39

6.2.6 GROUP 6: UNIVERSAL CARE FOR SUPPORT AND DISABILITY 41

6.2.7 GROUP 7: EMPLOYMENT RELATIONSHIPS BASED ON TRUST 45

6.2.8 GROUP 8: NEW PARTNERSHIPS AND RELATIONSHIPS IN THE SYSTEM TARGETED PROVIDERS 49

6.3 EMERGING KNOWLEDGE NEEDS AND PRIORITY RESEARCH AREAS 52

6.3.1 INTERVENTION RESEARCH 52

6.3.2 INDICATORS AND MEASURES 53

6.3.3 SOCIAL RESEARCH 54

6.3.4 TRANSLATION RESEARCH 54

6.3.5 SYSTEM CAPACITY RESEARCH 54

6.3.6 SUMMARY 54

7. RESULTS OF ISCRR ANALYSIS AND DISCUSSION .......................................... 55

7.1 INTRODUCTION 55

7.2 ANALYSIS OF HORIZON SCANNING PROJECT 55

7.3 ANALYSIS OF ONLINE BLOG DISCUSSIONS 57

7.4 OVERVIEW OF STAKEHOLDER DIALOGUE SCENARIOS 58

7.5 BIG IDEAS EMERGING FROM SCENARIOS 59

7.6 PREVENTIVE VERSUS COMPENSATION FOCUS IN TIMES OF BOOM AND BUST 61

7.7 PARTNERSHIPS VERSUS GOVERNMENT LEADERSHIP IN TIMES OF BOOM AND BUST 63

7.8 FUTURES OF SAFETY, COMPENSATION AND RECOVERY IN A NATIONAL AND GLOBAL CONTEXT 66


8. FUTURES RESEARCH INITIATIVE: METHODOLOGY ASSESSMENT .............. 68

8.1 EVALUATION OF METHODOLOGY IN DEVELOPING NEW KNOWLEDGE 68

8.2 EVALUATION OF METHODOLOGY IN PROMOTING STAKEHOLDER ENGAGEMENT 70

9. CONCLUSION ........................................................................................................ 71

10. APPENDICES ......................................................................................................... 72

APPENDIX 1. METHODOLOGY USING THE SIX PILLARS OF STRATEGIC FORESIGHT 73

APPENDIX 2. EXAMPLE OF AN ONLINE DISCUSSION SCREEN (OHS BLOG) 76

APPENDIX 3. STRUCTURE FOR ONLINE DISCUSSIONS (BLOGS) SUMMARIES 77

APPENDIX 4. SYNOPSIS OF BLOGS 78

APPENDIX 5. FUTURES WORKSHOP PROGRAM 80

APPENDIX 6. LIST OF FUTURES WORKSHOP PARTICIPANTS 82

APPENDIX 7. WELCOME LETTER FROM ISCRR BOARD CHAIR 87

APPENDIX 8. PURPOSES OF SCENARIOS 88

APPENDIX 9. THREE SCENARIO METHODS 89

APPENDIX 10. STEPS IN CONSTRUCTING FUTURES WHEELS 91

APPENDIX 11. PARTICIPATION IN ONLINE DISCUSSIONS 92

APPENDIX 12. RESEARCH QUESTIONS IN ORDER OF VOTES RECEIVED 93

APPENDIX 13. RESEARCH QUESTIONS NOT PUT UP FOR VOTING 95

APPENDIX 14. RESEARCH QUESTIONS CLASSIFIED BY DOMAIN OF RESEARCH * 96

APPENDIX 15. FEEDBACK FORM - ISCRR FUTURES WORKSHOP 98

APPENDIX 16. SUMMARY OF ISCRR FUTURES WORKSHOP FEEDBACK 101


LIST OF FIGURES AND TABLES

FIGURE 1. METHODOLOGICAL SEQUENCE ................................................................................. 9

FIGURE 2. PATH OF KNOWLEGE FLOWS IN THE FUTURES RESEARCH INITIATIVE ............ 10

FIGURE 3. CONTINUUM OF FUTURES STUDIES METHODS .................................................... 11

FIGURE 4. OVERVIEW OF FUTURES RESEARCH INITIATIVE ACTIVITIES .............................. 12

TABLE 1. THOUGHT LEADERS FOR ONLINE DISCUSSIONS (BLOGS) .................................... 16

FIGURE 5. GROUP 1: FUTURES WHEEL ...................................................................................... 27

FIGURE 6. GROUP 1: FUTURES OF THE SAFETY, COMPENSATION AND RECOVERY SYSTEM - EMBRACING DIVERSITY ............................................................................................. 28


FIGURE 8. GROUP 2: FUTURES OF ASSESSING AND MANAGING RISKS .............................. 31


FIGURE 10. GROUP 3: FUTURES OF EMOTIONAL AND MENTAL NEEDS IN SAFETY, COMPENSATION AND RECOVERY SYSTEMS ............................................................................. 35

FIGURE 11. GROUP 3: BACKCASTING - EMBRACING EMOTIONAL AND MENTAL NEEDS IN COMPENSATION BY 2035 .............................................................................................................. 36

FIGURE 12. GROUP 4: FUTURES WHEEL .................................................................................... 37

FIGURE 13. GROUP 4: FUTURES OF THE COMPENSATION SCHEME BUDGET FOR PREVENTION ................................................................................................................................... 38


FIGURE 15. GROUP 5: FUTURES OF MEASUREMENT OF SUCCESS IN IMPROVING HEALTH OF SOCIETY ..................................................................................................................................... 41


FIGURE 17. GROUP 6: FUTURES OF UNIVERSAL CARE FOR SUPPORT AND DISABILITY .. 43


FIGURE 19. GROUP 7: FUTURES OF EMPLOYMENT RELATIONSHIPS BASED ON TRUST .. 47

FIGURE 20. GROUP 7: FUTURES OF EMPLOYMENT RELATIONSHIPS BASED ON TRUST .. 47

FIGURE 21. GROUP 7: FUTURES OF EMPLOYMENT RELATIONSHIPS BASED ON TRUST: A DAY IN THE LIFE .............................................................................................................................. 48


FIGURE 23. GROUP 8: FUTURES OF PARTNERSHIPS AND RELATIONSHIPS IN THE SYSTEM ........................................................................................................................................................... 51

FIGURE 24. GROUP 8: BACKCASTING ......................................................................................... 52


FIGURE 25. GLOBAL FUTURES: PROACTIVE VERSUS REACTIVE .......................................... 56

FIGURE 26. GLOBAL FUTURES: COOPERATIVE VERSUS INTERESTS-BASED ..................... 56

FIGURE 27. GLOBAL FUTURES AND BLOG THEMES................................................................. 57

FIGURE 28. BEST AND WORST CASE SCENARIOS ................................................................... 58

FIGURE 29. SAFETY, COMPENSATION AND RECOVERY FUTURES: PREVENTIVE VERSUS REACTIVE ......................................................................................................................................... 63

FIGURE 30. SAFETY, COMPENSATION AND RECOVERY FUTURES: PARTNERSHIP VERSUS GOVERNMENT-LED ........................................................................................................................ 65

FIGURE 31. PREVENTIVE PARTNERSHIPS AND BLOG THEMES ............................................. 66

FIGURE 32. INTERSECTION OF PREFERRED GLOBAL FUTURES AND SAFETY, COMPENSATION AND RECOVERY FUTURES AT BLOG THEMES ............................................ 67

FIGURE 33: PATHWAY FROM UNSHARED KNOWLEDGE TO CONSTRUCTED KNOWLEDGE EMBEDDED IN SCENARIO BUILDING ........................................................................................... 69


1. EXECUTIVE SUMMARY

The ISCRR Futures Research Initiative has been designed to provide a rich information context and opportunity for debate for its stakeholders about knowledge needs in safety, compensation and recovery over the next 25 years.

Information on national and global trends and futures writing across 11 areas of interest was generated by a Horizon Scanning Project. From over a million references, this project selected 183 articles which considered trends and possible futures and factors which shape them, including the underlying worldviews and myths.

The 183 articles became the catalyst for the first stage in the Stakeholder Dialogue project - 11 online discussions (blogs) involving invited contributors. The outcomes of these discussions were analyzed by ISCRR and generated themes of critical significance to the future of safety, compensation and recovery. These themes seeded discussions at a Futures Workshop among a wide range of stakeholders, and the production of both optimistic and pessimistic scenarios for the future of health and safety.

The Futures Workshop then addressed itself to the critical paths required to achieve the scenarios preferred by participants, in which prevention was the focus and partnership was the operating model. This process of backcasting laid the groundwork for developing research questions to address the knowledge needs of a preferred future. Voting by Workshop participants on the research questions they had generated showed a clear priority for research on improving intervention policies and programs, ahead of developing new indicators of health, identifying future social issues, translating research more effectively and increasing capacity of systems in research and program delivery.

This report draws together the outcomes of the Horizon Scanning Project and the Stakeholder Dialogue Project. ISCRR analysis of the Horizon Scanning Project is presented within the framework of those global prospects most commonly considered in the articles environmental crisis and hi-tech new world and the underlying drivers most commonly identified - global cooperation versus pursuit of sectoral interests and proactive versus reactive approaches to the future. In the Stakeholder Dialogue Project the future context was generally characterised by participants as one of economic flux; thus the scenarios generated in the Futures Workshop have been analyzed by ISCRR within the framework of economic boom and bust, together with and the underlying drivers identified in the Workshop preventive approach versus reactive/compensation focus, and a partnerships model versus government leadership.

The ISCRR analysis points to the intersection between alternative global futures and the forces shaping them, and Futures Workshop participants' preferred futures of safety, compensation and recovery and the means of achieving them. It is this intersection across the nine themes which emerged from the blog discussions and which seeded the Stakeholder Dialogue project that the Futures Research Initiative has opened up as the context in which knowledge needs and research questions can be considered. The report concludes that, in each of these nine areas, there will be opportunities for developments at the global level and those in Australian safety, compensation and recovery to inform and engage with each other.


This report is a technical report, intended to be a repository of information about the methodology and key results from the Initiative as a whole. It is not intended that it be read by the audience for this work, but rather as a reference for future projects and those interested in futures studies.

A number of other outputs have been produced for the audience for this work. These are:

ISCRR Futures Research Annotated Bibliography, October 2010 http://www.iscrr.com.au/files/news/Annotated_bibliography_21102010.pdf

Ellis N and Fawkes S. Drivers for futures in SCR: themes from blogs. Presentation at ISCRR Futures Workshop, 27 October 2010, Parliament House, Melbourne http://www.iscrr.com.au/futures_bibliog_pres.html

Past, present and future of WorkSafe Victoria and TAC, video presented at ISCRR Futures Workshop, 27 October 2010

Horizon Scanning Project technical review, ISCRR Research Brief No: 1010-011-R1B

Fawkes S, Palmer J, Inayatullah S, Burke R, Miller M, Worland P, Ellis N. The futures of safety, compensation and recovery: A brief report on the Futures Research Initiative, ISCRR, August 2011

Stylianou M. To strike a balance: A history of Victorias workers compensation scheme, 1985 2010. School of Philosophical, Historical and International Studies, Faculty of Arts, Monash University, ISCRR Research Report No: 0611-018-R1B

2. INTRODUCTION AND AIMS

ISCRR aims to maximize the potential impact of its research on safety, compensation and recovery scheme performance by:

optimizing engagement with stakeholders in setting the research agenda; conducting research; and translating research into policy and practice.

A priority for ISCRR at present is to establish an agenda for research which will meet the short and longer term knowledge needs of the Transport Accident Commission (TAC) and WorkSafe Victoria (WorkSafe).

ISCRR's approach to achieving the above objectives has been to embark on the development of the organisation as an international centre of excellence for futures studies in safety, compensation and recovery, exemplified in the 2010-2011 Futures Research Initiative.

This report on the Futures Research Initiative explains the exploration of global long-term futures through the Horizon Scanning Project and the engagement of ISCRR stakeholders in a Stakeholder Dialogue Project. The aim of the Initiative was to identify possible health


and safety futures within a wider context, and the knowledge needs for realizing a preferred future.

3. METHODOLOGY

The methodology of the Futures Research Initiative was consistent with general approaches to futures studies projects. These involve gathering inputs (data and information); undertaking (using selected futures studies methods) the linked processes of analysis, interpretation and prospection; accompanied by futures studies 'products' such as reports, presentations, workshop and multimedia (Voros, 2003)1.

Hence the ISCRR Futures Research Initiative is an integration of three components:

A Horizon Scanning Project to identify national and global trends relevant to the future of safety, compensation and recovery

A Stakeholder Dialogue Project to engage key stakeholders and opinion leaders in reviewing these broad trends and identifying trend drivers (causes, worldviews and underlying myths), then exploring possible futures for the safety, compensation and recovery sector over the next 25 years and the knowledge needs of a preferred future.

Analysis and reports of these data by ISCRR. The chronological sequence of these three components is illustrated in the following diagram:

FIGURE 1. METHODOLOGICAL SEQUENCE

However the three main components are much more closely integrated than this sequence suggests. At the heart of the methodology is an analysis and report to stakeholders following a series of online (blog) discussions about the Horizon Scanning Project. This analysis is the critical link which connects the Horizon Scanning Project and the Stakeholder Dialogue Project in two ways:

by seeding discussions in the Stakeholder Dialogue process (nine blog themes presented to the Futures Workshop)

1Voros,J.(2003).Agenericforesightprocessframework.Foresight5(3),1021


through synthesising, at the end of the Futures Research Initiative, the outputs from both the Horizon Scanning Project and the Stakeholder Dialogue Project (the analysis presented in this Report).

The path of knowledge flows through the Initiative is shown in the following diagram, and provides the framework for the analysis in this Report.

FIGURE 2. PATH OF KNOWLEGE FLOWS IN THE FUTURES RESEARCH INITIATIVE

The methodology for stakeholder engagement was designed by Professor Sohail Inayatullah and Dr Robert Burke (in close association with ISCRR) using Inayatullah's approach to strategic foresight2. This was based on the six pillars approach and 'linked methodologies (see Appendix 1) to enable a systematic examination of drivers, trends and indicators, the articulation of alternative possible futures and the pathways to achieving preferred futures.

One of the key ideas underpinning the methodology was that the techniques should allow participants to delve beyond the 'official public description' of an issue (such as how a compensation scheme works and how its effectiveness is assessed). Ideally, the methodology would assist participants to recognise and describe structures and processes in the system that directly shape performance and then go beyond this to questioning why the system is structured and managed in this way. This last phase involves uncovering the worldviews of those associated with creating and sustaining the system and at a deeper level, the notions embedded in society - 'metaphors and myths' - that support these worldviews.

2Inayatullah,S.2008,'Sixpillars:futuresthinkingfortransforming',Foresight,vol.10,no.1,pp.421,


4. METHODS

4.1 OVERVIEW

Methods were selected to provide and information-rich context for dialogue between stakeholders responsible for decision making at a number of levels. The aim was to explore uncertainties (and thus reveal potential areas for research) rather than try to identify certainties. The methods included:

a horizon scanning data search and expert review to provide context a series of participatory exercises with stakeholders and experts which

included online blog discussions, and a Futures Workshop with expert presentations and discussion, mind mapping using the futures wheel, and scenario development and backcasting.

Each of these methods had a specific purpose related to the production of some form of required knowledge on Ling's (2003) continuum (Figure 3) from 'soft' (intuitive/learning) expertise to the hard analytical expertise.

FIGURE 3. CONTINUUM OF FUTURES STUDIES METHODS 3

ISCRR analysis and reports throughout the Initiative enabled the transitions between each stage and the synthesis present in this Final Report.

An overview of the methods used in the Futures Research Initiative is represented in Figure 4 below.

3Ling,T.(2003).ExAnteEvaluationandtheChangingPublicAuditFunction:TheScenarioPlanning

Approach.Evaluation,9(4),p447


FIGURE 4. OVERVIEW OF FUTURES RESEARCH INITIATIVE ACTIVITIES

The methods used in each part of the Futures Research Initiative are briefly described below.

4.2 METHODS: HORIZON SCANNING PROJECT

4.2.1 DATA MINING

The Horizon Scanning Project posed the following questions in a data search:

What are the global future trends in social, technological/scientific, economic, environment, political, legal and ethical (STEEPLE) areas, and in health, work, transport, safety, compensation, recovery and knowledge transfer fields? (so-called 'PUSH' factors)

What is the current status of health, work, transport, safety, compensation, recovery and knowledge transfer fields? ('WEIGHT' factors)

What are the preferred futures in health, work, transport, safety, compensation, recovery and knowledge transfer fields? (PULL' factors)


The criteria for selecting documents in the data search were deliberately broad, to ensure all trends were captured which could impact on this sector. The broad criteria were as follows:

Topics related to STEEPLE, health, work, transport, safety, compensation, recovery and knowledge transfer.

English language only All countries 2006-current Any data source (e.g. peer-reviewed articles, newspaper, websites, blogs) Related to humans.

Ideas are said to follow a developmental path - from the seed, where few people are talking about the idea and it may be discounted as radical, to where it becomes accepted and implemented into practice. The aim of the sources strategies was to include sources from these different stages in the development of ideas. These strategies were as follows.

Database search Scopus is the largest abstract and citation database of research literature and quality web sources covering nearly 18,000 titles from more than 5,000 publishers. This database searches a number of different sources which are associated with different stages in idea development.

Search terms used were related to (1) STEEPLE, health, work, transport, safety, compensation, recovery and knowledge transfer; and (2) PUSH, PULL, WEIGHT factors.

Expanding and refining the terms was an iterative process. Initially relevant terms were listed. These were expanded by feedback from experts. A list of related/associated terms and synonyms was then generated using WordNet. The user group to assess the usefulness/appropriateness of each potential expanded term and selected a small number of additional terms. Terms were combined in a number of ways. Initially all the STEEPLE and other terms were combined with the Boolean operator OR. Then all the all PUSH, PULL WEIGHT terms where combined with the Boolean operator OR. The collection of STEEPLE etc terms were limited (Boolean operator AND) with the PUSH, PULL, WEIGHT terms. This combination has limited by the years 2006, 2009 and 2010. This produced nearly one million references. As it was only possible to download a maximum of 2,000 references, smaller searches where then conducted. Again the STEEPLE and other terms were limited by the PUSH, PULL, WEIGHT terms.

Google A Google search was also conducted using the same search terms. Topic models and prototypical documents were also produced from the resulting corpus and submitted for review by the panel of experts.

Journal searches


Futures journals, and occupational, health and safety journals were searched manually for articles related to the three questions being asked. Future journals were searched for articles related to STEEPLE, health, work, transport, safety, compensation, recovery and knowledge transfer; occupational, health and safety journals were searched for articles related to PUSH, PULL and WEIGHT.

Futures websites Futures websites were manually searched for articles related to STEEPLE, health, work, transport, safety, compensation, recovery and knowledge transfer.

Serendipity Documents which were identified by associates or by people working on the project were also included if appropriate.

Similarity search As a result of the above processes, a corpus of potential documents was assembled. The SCOPUS and Google corpuses were then scanned using TFIDF techniques to identify documents that were similar to the documents that had been selected to date. These were then submitted to the reference panel and further potential documents identified.

Gap search A review by the reference panel of the documents found through this process identified a number of gap areas that were not covered. A number of more specific Scopus and Google searches were conducted to locate these specific areas.

For some of these searches the above computer technique was used to select key documents for submission to the reference panel. For a number of searches that returned small numbers of results, manual review was used to select documents for review.

To obtain the final set of articles, more than 600 documents were found by the above strategies and were presented to experts at ISCRR for review. Out of this number, nearly 200 were selected for potential inclusion on the short list. These were generally chosen independently by two reviewers and any discrepancies were resolved by discussion. This collection of documents was subjected to topic modelling using the MALLET software with models for 8, 10 and 12 topics considered. Topic descriptors (words which appeared frequently in the documents) were identified for each topic. A discussion was held regarding which words and topics best suited the objectives of the exercise. Informed by these inputs, 11 topics were finally identified:

1. The future of disability and rehabilitation service delivery models 2. The future of health 3. The future of work 4. The future of individual responsibility versus the welfare state 5. The future of occupational health and safety 6. The future of technology 7. The future of sustainability 8. The future of corporate social responsibility 9. The future of avoiding unintended harm in compensation systems


10. The future of at risk sub groups 11. The future of transport.

Documents in these topics were further short listed. These documents were chosen to select the most relevant that is, relating to local issues, recent, well-written, interesting and thought-provoking. There was also the aim of balancing academic articles with more controversial articles. Synopses of the articles were prepared. Licensing and copyright issues were addressed, applying for permission where necessary. On the Think Tank blog, weblinks were provided for full text articles, or abstracts of the articles. For those few articles unavailable as full text or abstract, a summary of the article was written.

4.2.2 ANNOTATED BIBLIOGRAPHY

An annotated bibliography of 183 articles selected from the Horizon Scan was prepared by ISCRR for use in the online blog discussions and at the Futures Workshop.

4.3 METHODS: STAKEHOLDER DIALOGUE PROJECT

4.3.1 WARM UP WORKSHOPS

Three warm up workshops were held to introduce key individuals to the Initiatives aims and futures studies-based methodology. These were held for TAC, WorkSafe and Monash University in order to:

provide staff in partner organisations with the opportunity to gain an understanding of futures thinking

inform staff about the program recruit interested staff to participate in the stakeholder dialogue.

4.3.2 ONLINE DISCUSSIONS (BLOGS)

Blogs focussing on the 11 topic areas identified through horizon scanning were set up on the ISCRR Futures Research website. The blog sites were designed to facilitate participation by contributors. 'Thought Leaders' engaged to introduce the blogs and to participate in discussion as a way of ensuring the initiative in general and the online discussion were selected for their ability to think broadly and inspire others.


The Thought Leaders are listed in Table 1 below.

Online Discussion Theme Thought Leader Position

Health Prof Stephen Leeder Director of the Menzies Centre for Health Policy, University of Sydney

Work Greg Tweedly CEO, WorkSafe

Occupational Health and Safety Dr Ben Amick Adjunct Scientist, Institute of Work and Health

Technology Prof Jim Falk Director, Australian Centre for Science, Innovation and Society, University of Melbourne

Sustainability Kathleen Townsend Managing Director, Kathleen Townsend Executive Solutions Pty Ltd

Transport David Anderson CEO, Ports Australia

At Risk Sub-groups Janet Dore CEO, Transport Accident Commission

Disability and Rehabilitation Services Anna Booth

Non-Executive Chair, Slater & Gordon Lawyers - Specialist in workplace relations

Avoiding Unintended Harm in Compensation Systems

Prof Arno J Akkermans

Professor of Private Law, University of Amsterdam

Corporate Social Responsibility Richard Price Senior Principal, Natural Resources Group, Macquarie Capital Advisers Ltd

Individual Responsibility versus the Welfare State

Prof Edwina Cornish

Deputy Vice-Chancellor (Research), Monash University

TABLE 1. THOUGHT LEADERS FOR ONLINE DISCUSSIONS (BLOGS)

Potential contributors were identified and personally invited by email or telephone to access the site and take part in the blog discussion. They were emailed details for accessing the site and instructions on how to comment. 'Bloggers' names and comments were both visible on the blogs.

The blogs were structured as follows:

Welcome message by the Thought Leader of the specific theme area Background to the project Summary of four stimulus articles identified through horizon scanning Links to each of the articles Instructions on how to participate in the blog Stimulus questions


o What today is impossible to do in OH&S but if it could be done would fundamentally change it for the better?

o Why is it impossible? o What would make it possible? o How can you make it possible?

Video of Professor Niki Ellis, ISCRR, presenting an overview of the ISCRR Futures Research Initiative

Video of Dr Robert Burke, Mt Eliza Business School, Monash University, presenting an overview of futures thinking

Additional resources. A screen-shot of one blog site (Occupational Health and Safety) is shown in Appendix 2.

The blogs remained open from September to October 2010. Two weeks prior to the Futures Workshop, all online discussions were analyzed to identify key themes within each blog. The approach used to analyze each blog comprised a sequence of steps:

Collate all blog postings Read and clean data for spelling and clarity Code data for sub-themes:

o What is impossible?

o Why is it impossible?

o What would make it possible?

o Issues/ Barriers

o Visions/Projections/ Trends

o Examples of policy, practice, programs

o Other themes emerging

Organize and present data. The structure used for each blog summary is shown in Appendix 3. The summaries (see Appendix 4) were provided in draft form to Thought Leaders and the ISCRR team in advance of the Futures Workshop to inform their thinking and preparation.

An early analysis was also undertaken by the ISCRR team to identify themes across the blogs, which may indicate key areas for research, change or development. This was presented at the Futures Workshop and incorporated in the Powerpoint presentation by Professor Ellis (see Appendix 4).


4.3.3 FUTURES WORKSHOP: OVERVIEW

The workshop was designed to bring together key experts and stakeholders from TAC, WorkSafe, Monash University and related organisations and fields to identify priority research questions that would help to shape ISCRR's research agenda. Effort was made to ensure the workshop was information rich and structured to stimulate interaction, open discussion and debate among participants. The opening addresses to the workshop were designed to establish the authority, relevance, significance and expectations of the workshop.

The program for the Futures Workshop is shown in Appendix 5, and a list of participants at Appendix 6.

The process elements of the workshop program, and a brief description of them, are as follows.

4.3.4 FUTURES WORKSHOP: INTRODUCTION

At the opening section of the workshop, guests and participants were welcomed by ISCRR Chief Executive Professor Niki Ellis, who provided background on the workshop and its development, aims and structure.

The Hon Tim Holding, Minister for Water, Finance, Tourism and Major Events then welcomed participants to the workshop on behalf of the State Government. He stressed the record of achievement by TAC and WorkSafe in Victoria and the opportunity to build on them, through research, to further improve safety, recovery and compensation performance in the state. He invited participants to bring an open mindedness to the workshop deliberations.

The Chair of the ISCRR board, Mr James MacKenzie, welcomed participants in a pre-taped video presentation. (See Appendix 7 for the welcome letter from Mr MacKenzie to the participants). He noted that TAC and WorkSafe had emerged as world leaders in the way they help people recover who are injured at work or on the roads, and in their approach to compensation. Both organisations have high public visibility through their advertising campaigns on safety on the roads and at work. He stressed the importance of ISCRR planning well for the future and understanding challenges such as those emerging from the ageing of the population and workforce. He saw the input from stakeholders represented at the workshop as very important in helping ISCRR understand the issues and how these will shape safety, compensation and recovery systems.


4.3.5 FUTURES WORKSHOP: EXPLANATION OF FUTURES THINKING

Professor Inayatullah provided an overview of the field of futures studies combined with some key trends and ideas that are shaping our common futures. He outlined how futures studies had enabled private and public organisations and sectors gain a long range strategic perspective on their social role and operations.

Professor Inayatullah then scoped the workshop process for participants: the use of futures wheels to explore the key issues shaping safety, recovery and compensation systems identified from the horizon scanning and online discussions; the formulation of scenarios, using these ideas, to depict alternative futures; linking narratives underpinning these different scenarios to organisational or sector strategy; backcasting from a selected scenario to the present day; and identifying the research which needs to be undertaken in order to realise the longer term scenario. Excerpts from Professor Inayatullahs presentation are shown in Appendix 8 and Appendix 9.

4.3.6 FUTURES WORKSHOP: VIDEO

Timing the future is a pillar in Inayatullahs methodology. By looking back participants can gain a sense of the pace and scope of change which can assist to push participants into the future. To assist with this ISCRR commissioned a video, Past, present and future of WorkSafe Victoria and TAC. Subsequently the interviews undertaken for the video became a source of information for a written history of WorkSafe Victoria, also undertaken by ISCRR.

4.3.7 FUTURES WORKSHOP: FISHBOWL

The 'fishbowl' was a facilitated panel comprising the 11 blog Thought Leaders or their representatives of each online discussion theme. The lead workshop facilitator interviewed each Thought Leader/ representative in turn, noting and remarking on key ideas and themes.

Issues discussed included the changing makeup of the workforce and implications of this for operating transport and health care systems and the way work is organized, located and managed. Another issue discussed was equity and the role of workplaces as well as transport and compensation systems to progress health and social equity objectives for social and economic reasons.


4.3.8 FUTURES WORKSHOP: REPORT ON ONLINE BLOG DISCUSSIONS

Feedback prepared by ISCRR on the online discussions was included in the workshop to provide an overview to participants of the blog postings. A synopsis of the online discussions was presented by Professor Ellis (see Appendix 4). She noted statistics on participation in the blogs and identified nine key cross-blog themes that emerged from the early analysis of the blogs:

1. Universal care and support for disability 2. Greater focus on non-financial needs, especially emotional, to reduce

unintended harm of compensation schemes 3. Increased engagement with workers through the employment relationship

and with clients through consumer empowerment in care systems 4. Broader ways of measuring success in improving health of society, needs an

evidence base 5. New ways of assessing and managing risks dealing with emerging risks 6. New relationships (partnerships and collaborations): governments, NGOs,

business, unions, workers, communities, including globally 7. Technological change paced by social change: reclaiming humanity 8. Diversity as the norm equity as the challenge 9. System integration.

4.3.9 FUTURES WORKSHOP: FUTURES WHEEL EXERCISE, SCENARIO DEVELOPMENT AND BACKCASTING

Pre-designated groups were seated at tables to undertake a sequence of futures exercises. They were asked to select a topic from a list (two groups could not do the same topic). The topics were derived from the nine blog themes and represented important strategic challenges for the compensation system.

Instructions on using the three futures methods to be used by the groups - futures wheel exercise, scenario development, and backcasting - were set out in a guide prepared by futurist and workshop facilitator Professor Sohail Inayatullah (Scenario and Research Implications) and supplied for use in the workshop.

Futures Wheel

In the first futures studies exercise, groups created a futures wheel. A futures wheel is an exercise in mind-mapping the impacts of an issue. An issue is placed at the centre of the wheel and produces a radial pattern of primary/secondary/tertiary impacts. It provides a structured way of exploring futures related to a topic or theme, and of organizing thinking and questioning.

An issue, trend or event was selected by each group, which then responded to the question - what are the impacts of this issue/trend/event? The group then responded to the question - what are the secondary impacts of these impacts? Further questions identified the tertiary and more far reaching impacts of impacts. (See Appendix 10 for more detail and diagrams on this process).


Scenario development

The groups then embarked on a scenario development exercise, drawing on the ideas generated in the futures wheel exercise.

Scenarios are internally consistent portrayals of future states, integrate trends across a range of fields and have multiple purposes including understanding the views of different stakeholders and perspectives; finding new areas of growth, products, processes, people, possibilities; and helping clarify often hidden assumptions about the future (see Appendix 8). Scenario development exercises take a range of forms and can be adapted for particular uses and settings. Sophisticated scenario development initiatives have become well established in the private sector as part of advanced, longer term strategy development and are apparently increasingly being adopted for use in the public sector as the need increases to understand interactions between trends 4.

Three different scenario methods were described in the Futures Workshop workbook: double variable method, multivariable scenario technique and organisation scenario technique (see Appendix 9). Groups were invited to choose whichever technique appealed to them and made sense for their topic, and then to apply it to develop four different future scenarios.

Groups were then asked to deepen their insights into one of the scenarios by discussing and responding to the following four questions:

What is the core strategy in this scenario? What are the narratives, stories, metaphors, that can help realise this

scenario?

What are the narratives, stories and metaphors that can prevent the realisation of this scenario?

In what ways can you re-script the narrative so the scenario has a greater possibility of being realised or avoided?

Backcasting

Backcasting (sometimes portrayed as the opposite of forecasting) involves selecting a scenario (a desired future state) then working back in time to identify the necessary stages, events or innovations leading from the present day to the desired future. In a sense, it tells the story of the factors that brought about one particular, preferred, future state. It reveals areas where research and development would be needed in order for particular innovations or decisions to come to fruition.

The workshop facilitators undertook a backcasting exercise in plenary to show how it was done. The results of this were printed out from the electronic whiteboard and given to each group for reference.

4Fawkes,S(2009).Howandwhyfuturesstudiesareusedinhealthpolicymaking.UnpublishedPhDthesis.LaTrobeUniversity.


Groups were then invited to apply this method to their choice of one of the scenarios. Questions they were asked to use to develop their backcasting process were:

What events and trends transpired to make the scenario a reality? List at least three.

What are some strategic pathways? The groups were encouraged to develop a timeline representing their backcasting work and reflect on its implications for research.

4.3.10 FUTURES WORKSHOP: PRIORITY RESEARCH QUESTIONS

Groups were then asked to scope the research questions that were evident from or suggested through the scenario work and backcasting, and write these up on large sheets of paper. These sheets were then placed at the front of the room and all participants were asked to move to the front and nominate, by placing sticky dots, the five questions that in their view were priority questions to address through research. Questions with the most dots next to them were understood to be those that participants, as a whole group, regarded as being most important to capture in the ISCRR research agenda.

At the conclusion of the workshop, ISCRR staff took photographs of the sheets of paper on which the small groups documented their work during the day, for the purposes of analysing the workshop and its outcomes.


4.4 METHODS: ISCRR ANALYSIS AND REPORTS

ISCRR analyses, presentations and reports enabled transitions between the various stages of the Futures Research Initiative, culminating in this Report which synthesizes the outputs of the Initiative. ISCRRs activities included:

Review and cataloguing of Horizon Scan data into 11 topic areas by an expert panel

Preparation and publication of the Annotated Bibliography of selected Horizon Scan articles

The analysis of blog postings and development of nine emerging themes which was presented to the Futures Workshop

The synthesis of outputs from both the Stakeholder Dialogue Project and the Horizon Scanning Project which is presented in this Report

A summary of feedback received on the Futures Research Initiative, presented later in this Report

Preparation of technical and other reports on the Futures Research Initiative listed at the end of this Report

This Report builds on the outputs of the Horizon Scanning Project and the Stakeholder Dialogue Project. It highlights the dominant themes in writings on global/national futures and in the safety, compensation and recovery futures canvassed by stakeholders, then draws attention to important connections between them.

5. RESULTS OF HORIZON SCANNING PROJECT

5.1 DATA MINING

As noted above, the ISCRR panel shortlisted 183 articles across 11 areas of interest:

1. The future of disability and rehabilitation service delivery models

2. The future of health

3. The future of work

4. The future of individual responsibility versus the welfare state

5. The future of occupational health and safety

6. The future of technology

7. The future of sustainability

8. The future of corporate social responsibility

9. The future of avoiding unintended harm in compensation systems

10. The future of at risk sub groups


11. The future of transport.

The innovative data text mining methodology used in the Horizon Scanning Project has been written up in a separate report Horizon Scanning Project technical review, ISCRR Research Brief No: 1010-011-R1B.

5.2 ANNOTATED BIBLIOGRAPHY

The annotated bibliography was written so that the reader could understand not only the focus of the article but also the character (eg research report) or tone (eg speculative) of the article. It was posted on the 11 blog sites, and provided to participants in the Futures Workshop.

6.0 RESULTS OF STAKEHOLDER DIALOGUE PROJECT

6.1 ONLINE DISCUSSIONS (BLOGS)

Participation in the blogs is tabulated in Appendix 11. A target of blogs of 100 postings was set at the start of the project, and a total of 105 postings resulted from the contribution of 73 individuals (excluding Thought Leaders). Three blogs had twelve postings - Occupational Health and Safety, Disability and Rehabilitation, and Health and Health Care. Two blogs had eleven postings - Avoiding Unintended Harm in Compensation Systems and Work. The blogs with the lowest number of postings were 'at risk' sub-groups (7 postings) and Individual responsibility vs. the Welfare State (6). Participants' postings provided a range of insights reflecting their professional expertise and experience as well as personal values. They proposed trends that operate to push circumstances and systems forward; visions that work to pull circumstances and systems towards futures; and the past that that serves to create a weight that makes circumstances and systems resistant to change.

Trends identified by bloggers were diverse in scope, indicating the complex context of safety, compensation and recovery. Demographic trends noted included increasing population size, ageing of the population and diversification of the working and work capable - population. Bloggers noted broad social trends such as towards the adoption of active transport which enables exercise, mobility and social connectedness; participation by and increasing power of groups previously excluded from the workforce including women, people with disabilities and migrants. Numerous trends that will shape work futures were either assumed or identified. As the Victorian workforce contracts and stagnates because of reducing availability of labour (in turn related to the ageing of the population), workplaces will need to respond to the requirements and characteristics of the population groups who will comprise the workforce. These will include people who have been underrepresented in the past such as women and from more diverse backgrounds. The prevention of systemic discrimination (discrimination that is serious and impacts on a whole group of people in a similar way) and promotion of equal opportunity will become prominent as a consequence of this shift in workforce makeup. Motivation of this workforce will be key as the scarcity of labour increases. A slowing down of new workforce entrants will have an impact on areas including the economy, industry, the typical career path and perhaps the standards of education that many will aspire to achieve before entering the workforce and during their career.


Technology trends are also reshaping work, including where and what work can be conducted, introducing new challenges for occupational health and safety, performance management and work/life balance for individuals and families. Broad technological trends identified by bloggers included the development of innovations that serve the interests of energy efficiency and sustainability objectives such as alternative vehicle and fuel technologies; advances that enable more efficient ways of doing things, such as computerization of technical processes, but which are at the same time serving the interests of a culture of instant gratification. Trends in specific sectors are also reshaping work, injury patterns, potential for prevention and demands on the compensation system. Where trends in health care such as the availability of prevention technologies meet increasing consumer demand for personalized care, demand will increase for injury and disease prevention based on biological, social and psychological factors.

The visions and aspirations portrayed by bloggers gave voice to attributes they want to see develop in the safety, compensation and recovery fields as well as society and sectors. Some of the simplest visions had enormous implications for leadership and harnessing social and technological innovation. For example, every journey is a safe one; 'a society that marshals the capability, effort and funding (its adequacy and duration) more efficiently, effectively and sustainably around prevention of the problem', in order to reduce the number of citizens we add to the long term cohort (of people who are disabled or unemployed for instance) each year'; and 'As a 21st century society, we aspire to a situation where no-one should expect that their loved ones will be injured, maimed, diseased or worse as a consequence of their work. And, should they be, that they will have an assured entitlement to expert treatment and rehabilitation - and fair and just compensation.'

Some visions were coherent representations of the ways in which workplaces should function for example: [w]orkplaces will promote participation by all (at-risk ) groups in the community including mothers, people with a disability, older workers, CALD workers by having equal opportunity for people to demonstrate their capacity and ability; and providing a work environment in which people feel confident to speak up where there are issues or problems and make a complaint without being frightened of victimization or consequences. Some visions of health were expansive but in line with recent research and advocacy efforts: 'All new health investments are directed to wellness approaches based on an understanding of what the major determinants of health or wellness are (such as employment, good housing, clean air and water).' Others focused on the role of individuals in preventing injury and disease, such as 'patients take full responsibility for their health care needs to prevent illness & disease to prevent hospital admissions, and to follow recommended rehabilitation/recovery guidelines to prevent re-admissions'.

The counterpoint to visions was barriers to realizing them. Some barriers are enduring and obstinate factors that inhibit change in systems and the community. A fundamental issue is that the status quo across a variety of areas serves the interests of some parties and not others and change can be limited by vested interests and the scale of existing investments in how particular systems work. Commenting on the transport sector, for example, bloggers expressed visions related to how transport needs are addressed (eg a top down multimodal strategic approach) and what future transport systems would look like (eg integrated). The barriers to these visions lie in the entrenched mode silos, that is, where a car is a solution to a local problem of getting to work or shopping; and an airline is


a solution to the local, national or international problem of travelling intrastate, interstate or internationally.

Barriers to change in the occupational health and safety field related to issues including: perceptions of what OHS is, its relative importance in an organisation and associated issues such as the level of investment in OHS and where control of OHS sits; the balance between strong OHS programs and being competitive in an international context; the pace of change and the limits to proactive actions; lack of agreement about whose role it is to lead macro level change; and gaps in evidence needed for policy and practice and difficulty getting investments in research. Barriers to realizing preferred health and health care futures included the orientation of the values and investments of the health care system, lack of population health planning involving key non-health sectors, obstacles to creating incentives for 'healthy choices to be the easy choices' and resistance by or inability for people to assume more responsibility for health-related decisions. Health and health care futures are shaped by supply side (health system) factors and demand side (individuals and populations) factors. On the supply side, the funding models currently used for the health system are based on illness management. Investment returns in the health system come from ill health not good health.

6.2 FUTURES WORKSHOP: FUTURES WHEELS AND SCENARIOS

Futures Workshop groups selected from a range of propositions about the future which were based on the nine themes emerging from the blog discussions, as follows:

Group 1: Diversity is embraced by the scheme (people are more valuable)

Group 2: New ways of assessing and managing risks, especially emerging risks eg nanotechnology and genomics

Group 3: Greater focus on emotional and mental needs

Group 4: 30% of scheme budget is prevention

Group 5: Broader ways of measuring scheme success in improving the health of society

Group 6: Universal care and support for disability

Group 7: Employment based on trust

Group 8. New partnerships and relationships in the system.

Each group developed futures wheels and, using the ideas generated, formulated scenarios. Depictions of futures wheels and scenarios from all groups were gleaned from notes taken at the workshop by each group. The futures wheels and scenarios are presented in the following sections. The results of backcasting are also included. (Only two groups completed backcasting).


6.2.1 GROUP 1: DIVERSITY IS EMBRACED, PEOPLE ARE MORE VALUABLE

Futures Wheel

The futures wheel created by Group 1, shown in tabular form in Figure 5, scoped several implications for compensation systems from embracing diversity, then the implications of these factors. Practical implications were that employer attitudes to their workforce composition had to change and because of increasing cultural diversity, services for workers would need to be tailored through providing interpreters for example. At a macro level, the implications of embracing diversity were significant and included increased costs initially but reduced societal costs over time. The need to tap into communities to increase engagement by community members had wider social implications such as the potential to form partnerships and to create networks and communities where none existed before or strengthening these networks and communities.

Implications if diversity is embraced by the scheme and people are more valuable

Primary Secondary Tertiary

Diverse workforce skills Changing employer attitudes

Design of infrastructure Calculation of costs - long term

focus

Early prevention measures

Tailored services Access to interpreters

Initial cost factors Reduced societal costs

Success measures Societal impact measures

Tapping into communities to increase engagement Creating networks/ communities

Partnerships

Flexible work arrangements

FIGURE 5. GROUP 1: FUTURES WHEEL


Scenarios

Group 1 applied the Multiple Variable scenario to then explore futures associated with the challenge of the safety, compensation and recovery scheme (or system) embracing diversity. Participants identified four key drivers as differentiating one future scenario from another:

demography cost (financial and economic) technology social.

The four scenarios generated by Group 1 are presented in Figure 6.

2035 DIVERSITY

Driver: Demography Headline Workplaces embrace diversity Systemic causes/ characteristics - Workforce shortage Medical technology Legislation change High net migration Worldview No different Metaphor No different

Driver: Financial and economic Headline Centrelink goes broke Systemic causes/ characteristics - Mental health issues Increase in refugees Productivity decrease Structural shift in social support systems More self reliant Worldview Self reliance Metaphor Self reliance

Driver: Technology Headline First bionic person in Australia Systemic causes/ characteristics - Reduction in health costs Improved research costs and investment Nanotechnology implants Stem cell Remote working Telemedicine Worldview My battery never expires Metaphor Techno worker

Driver: Social Headline Victoria tops happiness scale Systemic causes/ characteristics - Lower working hours legislated Balanced lifestyle Work hubs Worldview Im connected to my community Metaphor Happy community

FIGURE 6. GROUP 1: FUTURES OF THE SAFETY, COMPENSATION AND RECOVERY SYSTEM -

EMBRACING DIVERSITY


6.2.2 GROUP 2: NEW WAYS OF ASSESSING AND MANAGING RISKS

Overview

Group 2 noted two major issues as having a significant influence on how emerging risks such as those associated with nanotechnology and genomics will be assessed and managed in future. Firstly, technology will play a significant role in better assessing risk. Secondly, the extent to which individuals will assume more personal responsibility for safety will play a role in how risks are assessed and managed. To be able to assume more responsibility however, individuals will require accurate perceptions of risk which is contingent on quality information being conveyed to them in ways they can understand and use. Group 2 used the analogy of driving safety to characterize what they meant by new ways that risk could be assessed and managed. While the speedometer on a vehicle instrument panel indicates what speed a driver is doing and therefore communicates a measure of risk, information about other factors impacting on safety such as blood alcohol level, fatigue, lighting, road conditions and the mood of driver, are important if an individual is to assess their actual level of risk.

New ways of assessing and managing risks contributing to safety will require sharing information about individuals risk profiles with government and relevant agencies, although this has significant implications for privacy. As in many areas of public health, such an assessment would need to balance absolute personal freedom (to injure oneself, but then also others) against curtailed personal freedoms in the public interest.

With the blurring of boundaries between home and work and the separation of the information systems of several agencies working on safety and reducing risks, Group 2 believed there is an argument for developing a combined system addressing universal health and safety not just workplace or vehicle safety.

Group 2 felt that there was a need for more research on how to stop things going wrong. For example, experiments to assess why an incident nearly happened, what was going on at the time, what piece or pieces of information was/ were not available/ understood/ applied that led to a near miss.

Futures Wheel

The futures wheel created by Group 2 is shown in tabular form in Figure 7. A key implication of the issue of new ways of assessing and managing risks was that these activities have ethical dimensions covering various aspects of data management (data security, what data is collected and how it is used and lack of data as a basis for decision making) and these need to be addressed in measuring the outcomes of the system. Another implication was that new risks are inherent in innovations and a preventive approach (perhaps along the lines of the prevention principle in public health) should be applied as innovations are developed and adopted.


Implications of new ways of assessing and managing risks especially emerging risks

Primary impact Secondary impact Tertiary impact

Assess environmental impact

- criteria for approval

International implications World market

Utilizing technology to assess

Pick up risks earlier

Ethical implications Data security

What we collect and how we use data

Lack of data

Measurement of outcomes

Corporate responsibility

Technology Self health assessment

Benefits for society Government research body for new products

Need to assess from this perspective

Impact of technology and products eg IPad, Coca Cola New risks

Prevention

Broader support - all accidents

Fragmentation of safety knowledge

Rethink structures of today - VicPol, TAC, MFB, CFA

Broader definition of risk eg wellness Focus on prevention

Skills

Resources

Holistic view

Social implications

New issues Ageing population

Technology - IPods, hearing

Mental health impact Resilience



Scenarios

Group 2 applied the Double Variable technique to explore futures associated with new ways to assess and manage risks (especially those that are emerging). Participants identified two key variables as shaping the four futures scenarios: prevention/ compensation and universal coverage/Work and road injury coverage. Group 2 noted that to broaden the scope of compensation, there needed to be a shift to prevention and to increased individual responsibility. A number of tensions around the issue of assessing and managing risks (especially emerging risks) were identified by Group 2:

extent of coverage need for / role of compensation system individual responsibility versus state responsibility safety versus broad notion of holistic health prevention versus compensation.


Universal focus (health and safety)

Pre

vent

ion

Headline - Utopia Systemic causes/ characteristics - We know what health is (population level) Individuals are responsible and capable and knowledgeable Technology enabled Unhealthy behaviour incentives for healthy behaviour One agency - national Support based on need if desired Metaphor - Universal (health and safety)

Headline - Busting the Bank Systemic causes/ characteristics - No individual accountability All healthcare needs are met High taxation Income security Metaphor - Universal (health and safety)

Com

pens

atio

n Headline - Half way house Systemic causes/ characteristics - Education Targeted but effective prevention therefore decreased incidence of road and traffic accidents Businesses thrives Lawyers go bankrupt Fault-based system Metaphor - Prevention

Headline - Lawyers dream Systemic causes/ characteristics - Government led - no individual accountability Cause of injury-based, not needs based People with injuries who dont have access because not work or road injury Injury-based therefore health problems neglected Prevention under-developed Metaphor - Living in the past

Work and road injury focus

FIGURE 8. GROUP 2: FUTURES OF ASSESSING AND MANAGING RISKS

Group 2 deepened their exploration of the scenario Utopia by responding to the questions posed in the workbook. The key points made were as follows.

Group 2s core strategy was about broadening coverage to all health and safety matters (not just those associated with roads and work). The realisation of the strategy would involve:


Defining universal health and safety in terms of proper measures, standards and KPIs

A shift in the system focus to prevention Emphasizing physical, social and behavioral factors. Increasing individual accountability and support using knowledge and

technology from government, business, etc (individual empowerment)

Developing universal access to knowledge we model Developing an integrated system (national) Utilizing social innovation as a driver of technological development for

prevention

Encouraging innovation to solve the problems we dont yet have. Barriers to the realisation of the strategy were identified as the removal of individual freedom/ choice; and the predilection of humans to take risks.

Group 2 believed they learned that to broaden coverage requires a shift to prevention with greater emphasis on physical, social and behavioral factors.

6.2.3 GROUP 3: GREATER FOCUS ON EMOTIONAL AND MENTAL NEEDS

Overview

Group 3 had a vision of a greater focus on emotional and mental wellbeing. The metaphor of a jazz band playing harmoniously together was used as a way of emphasizing that while individuals are responsible for their own actions, we as a community have to play in harmony with each other. Embodied in the metaphor are values, for example, some instruments are equally important and all are valued; some musicians may have solos, but these are all part of the song; and working well together creates a beautiful whole harmony and listening to rest of band is vital.

The group felt that in the past, communities relied on institutions such as churches to reinforce community values, of the importance of sharing responsibility. As churches have lost their influence, a new approach is needed to take up this role and other institutions have sought to promote shared values. This is a role that is bigger than TAC, Worksafe and ISCRR's current agenda.

The significant trend which has a major influence on how they could realize the vision, was the effective use of social marketing/mass communication campaigns which had demonstrated positive outcomes Life be in it, the Gun Buy Back initiative, the TAC road safety campaigns and the Worksafe campaigns. Social marketing was thought to help convey ideas and encourage shared values in the community in the way that the churches or other major social institutions once did. The group discussed a QUIT type campaign aimed at achieving these goals. Media advertising to achieve such changes in behaviour and attitudes to life and responsibility for others was thought to be a long term, expensive project just as TAC and Worksafe programs were in their initial years. There appears to


have been a reduction in the budget for these programs and that this could explain the increase in accidents this year.

The backcasting process showed that the greatest challenge is the political will to invest in this approach - $30 million a year would be required which is huge by Victorian media campaign standards but not large when cost savings are considered. The group thought that the election of the new state government, and its stated policy on advertising, meant that this investment will be impossible to achieve without some other way of giving TAC/Worksafe/ ISCRR other income.

Lack of political will/timing was noted as a significant barrier to addressing this issue. The Port Arthur atrocity provided a context for the Liberal government to stand up to traditional conservative government support base (farmers/gun lobby) to introduce both the Gun Buyback scheme and tighter legislation governing gun ownership.


Futures Wheel

The futures wheel created by Group 3 is shown in tabular form in Figure 9. The implications of bringing a greater focus to emotional and mental needs at the third tier level were identified as: whether ISCRR is the right body to develop greater community awareness of these issues or whether another agency is better placed; promoting social inclusiveness, the interconnectedness of people and communities, is at the heart of bringing a greater focus to emotional and mental needs; and a stronger recognition of these areas of health and wellbeing has implications for workplaces in terms of expanding existing programs and services to cover these areas as well a physical health.

Implications of bringing a greater focus to emotional and mental needs


Greater community awareness of issues

What is the role of WorkSafe/ TAC in this?

Is there another agency?

Individual and community responsibility, social thinking to come to the fore

Social inclusiveness, interconnectedness of people and communities

Huge shift to prevention Changes to how we can engage/ support people through systems

What is the responsibility of employers to understand wellbeing needs/ emotional needs of workers

Prevention message spread throughout community in other areas

New including non-medical workforce to tackle issues with family/ community focus

Research project to understand workforce

Preventive issues focus on unemployment

Stop unemployment after 18 months and people feeling worthless

Greater acceptance and support

More open to what people need - young people/ emotional needs

Increase in number identifying as having mental health issues

Implications for workplace to treat mental health issues

More effective communication

What is media/ communication mode for next generations

Greater investment in mental health

Implications for funding models, government


Scenarios

Group 3 applied the Organisation Scenario technique to develop futures related to with bringing about a greater focus on emotional and mental needs in the area of safety, compensation and recovery. Participants identified factors that differentiated four different scenarios as worst, best, business as usual and outliers. The four scenarios generated by Group 3 are presented in Figure 10.


2035

Worst case Headline - Youre on your own > No-one cares Systemic causes/ characteristics - Reactive Demand >Supply from system Not viable Unfunded scheme Information/ knowledge poor Compensation dependent Impacting everything No health or social response Ineffective/ repeat customers

Best case Headline - Positive attitude to life Systemic causes/ characteristics - Early intervention/ Prevention People value Fully integrated system Trust Information rich Individual awareness of benefits to a safer life Community responsibility No stigma

Business as Usual Headline - WorkSafe and TAC will look after me Systemic causes/ characteristics - Medical focus Follow the trends Todays trends Treatment vs. Prevention

Outliers Headline - Im OK, Everyone is OK Systemic causes/ characteristics - Instant cure Happiness Index Detection screening Get treatment you need Abundant amount of suppliers

FIGURE 10. GROUP 3: FUTURES OF EMOTIONAL AND MENTAL NEEDS IN SAFETY, COMPENSATION AND RECOVERY SYSTEMS

The best case scenario Positive attitude to life was examined by Group 3 in more detail. Group 3 also did a backcasting exercise to define what actions or innovations would be needed in order for the compensation system to embrace emotional and mental needs. The results are presented in Figure 11.


2035

Positive attitude to life

Early intervention

Prevention

All valued

Understand issues

Awareness

Communication to improve positive attitudes to life

Start benchmarking (Vic popn.)

Evidence to support targeted campaign

Group research to measure attitudes

Wellness centres

2011

2012

2013

2015

2020

2025

2030

2035

FIGURE 11. GROUP 3: BACKCASTING - EMBRACING EMOTIONAL AND MENTAL NEEDS IN COMPENSATION BY 2035

Through this exercise, the group determined that realizing the vision would require a ten year effort to: establish a foundation of understanding issues and measuring attitudes, benchmark to establish baseline information about emotional mental needs, create infrastructure such as wellness services/ centres; and to generate evidence to support a targeted campaign.

6.2.4 GROUP 4: 30% OF SCHEME BUDGET IS PREVENTION

Overview

Group 4 focused on scenarios associated with extra money being spent on the prevention of accidents that cause personal injuries (additional 30%). The group discussed how additional funds might be spent and the possible roles of the regulator in relation to this objective. The group observed that some of the most successful TAC and WorkSafe innovations had come from "leaps of faith" lead by a strong regulator in an environment of "crisis". The observation was also made that in all likelihood, a "portfolio" approach would be preferred with some investment across a variety of approaches to prevention.


Futures Wheel

The futures wheel created by Group 4 is shown in tabular form in Figure 12. A number of implications of the central proposition were traced. Industry and its expertise would have to broaden if one third of the schemes budget is dedicated to prevention and mental health and stress would need to be included as a stream of focus for schemes. The role of regulators would shift to one of enabling prevention. Workers, in assuming more market power, would be in a position to demand information from employers or prospective employers about their compensation history.

Implications if 30% of scheme budget is prevention


New ways for prevention Broaden industry and expertise

Mental health/ stress?

Society prevents

More collaboration between employees and employers

Role of individuals?

Role of government?

Role of the regulator To enable?

Incentive - employer focus

New way of measuring success?? Not just $$

Workers have market power What's your compensation history?

What's your safety history?

Political backlash at where $ are spent

How to prove results?

Employers laying off staff

Increased premium initially then reduced

Society's attitude changes School contributes education Whole of safety focus

Most dominant message

Less injured and dead

More advice to employee

Increase enforcement - every workplace



Scenarios

Group 4 applied the Double Variable technique to explore futures associated with bringing the percentage of schemes budgets for prevention to 30%. Participants identified two key variables as shaping the four futures scenarios: community-society collaboration vs. independent authority-strong regulation control, and public vs. science.


2035 Community/ Society

Collaboration

Pub

lic

Headline - Speculative Systemic causes/ characteristics - Car companies and workplaces sponsor community for safe work Many ideas from many community and industry Small seeds lead to big change/ deep in community

- strong ownership/ social movement

- differential outcomes - success and failures - political risk and controversy - farmers markets

Headline - Collective IQ Systemic causes/ characteristics - Grants/ community and industry Self insurance model Government and industry collaboration/ technology Incentives/ fines to innovate Slow and bureaucratic

Science

Headline - Leaps of faith Systemic causes/ characteristics - Public - ego/ guts Confident regulator Strategic risk taking and venture capital model Big scale changes Social judgment Big brother / GPS 100% monitored vehicle Big Brother hoons drive bicycle

Headline - Tried and true Systemic causes/ characteristics - Technology innovation Evidence, science, statistics Super safety Risk averse decisions Data based Small gains/ little resistance Lack of innovation No dramas/ traditional

Independent authority/ regulation Control

FIGURE 13. GROUP 4: FUTURES OF THE COMPENSATION SCHEME BUDGET FOR PREVENTION


6.2.5 GROUP 5: BROADER WAYS OF MEASURING SUCCESS IN IMPROVING HEALTH OF SOCIETY

Overview

The group scoped the business as usual situation, where activities are driven by what is currently measured, then imagined a broader system that uses a variety of techniques (qualitative & quantitative) to measure clients' recovery, the contribution of the compensation scheme to a healthy society and broader aspects of scheme performance. The group generated the analogy between managing the compensation system and flying an aeroplane to explore what would need to be measured and by whom. In this analogy, 'business as usual' would be the single pilot operating the plane using a narrow range of instruments on the control panel. The new system would have co- or multiple pilots (eg representing the compensation system, consumers, other key stakeholders) and multiple instruments on the control panel (reflecting a desire to manage the system in response to a broader range of inputs). The broader range of instruments would provide information that shows the dynamic relationship between population health, system performance and client/ community satisfaction. This would remove dependency on one type of data and result in a more community-driven system measuring scheme success in improving the health of society. While the group had limited time to discuss specific measures of a healthy society, the point was made that such measures have the properties listed in the best case scenario.

Futures wheel

The futures wheel created by Group 5 is shown in tabular form in Figure 14. A number of implications of broadening the measures of the schemes success were noted. Establishing the scope and duration of measures was identified as an important basis, with approaches like life course and holistic health offering conceptual frameworks for designing a measurement system. Integrating worker and transport compensation schemes was identified as an implication of wanting to measure the longer term impact of schemes on wellbeing. An overall implication is that scope of a schemes mandate would need to be reassessed.


Implications of broadening ways to measure scheme success in improving the health of society


Measurement over extended duration

Measure sustainability of impact of scheme

Integrate schemes (work, transport etc)

Measure health beyond the scheme return to work, lifespan approach

Measurement across broader range of factors

We do what we measure Mandate of schemes challenged

Narrower?

Define what a healthy society is

What is the story - physical indicators - mental indicators - happiness - satisfaction - disability management of integration - attitudes to vulnerable groups (inclusiveness)

Virtual scheme Less segregation between schemes



Scenarios

Group 5 applied the Organisation Scenario technique to develop futures related to measurement of the success in safety, compensation and recovery schemes in improving the health of society. The four scenarios generated by Group 5 are presented in Figure 15.

2035

Business as Usual Headline - Data driven Systemic causes/ characteristics - Narrower focus Focus on those who are injured Reactive Inward focused Lagged indicators Keep doing the same thing Innovation within current boundaries Change only occurs from reaction World view doesnt change

Outlier Headline - Self driven Systemic causes/ characteristics - Self defined measures Individuals define their measures based on whats important to the individual

Worst case Headline - No driver Systemic causes/ characteristics - No measurement No accountability No purpose / direction Deterioration No satisfaction customer, our people Activity mode no positive outcomes

Best case Headline - Co-driven Systemic causes/ characteristics - Valid, relevant, reliable, realistic, repeatable measures relevant to healthy society Qualitative and quantitative Improved technology Linkage to community health Measurement to focus on increasing the well Consumer accessible information about themselves and benchmarked to others

FIGURE 15. GROUP 5: FUTURES OF MEASUREMENT OF SUCCESS IN IMPROVING HEALTH OF SOCIETY

6.2.6 GROUP 6: UNIVERSAL CARE FOR SUPPORT AND DISABILITY

Overview

The discussion in Group 6 led to a description of an idealized world in which there is no compensation system and universal care is provided regardless of the circumstances in which people were harmed. This grew out of a discussion about how research has revealed that in some circumstances, compensation itself can lead to poor outcomes because access to compensation can foster a level of dependency and is therefore a disincentive for optimal recovery.

The group portrayed the best approach as being to move to a more national, and harmonized system. Group participants agreed that a more integrated and national approach would be better for people than the current numerous and different compensation systems throughout the states and territories, and supported the steps taken by the Productivity Commission to review the systems. This best case scenario explored the ideal situation where there was universal care and support for those injured in a workplace or motor vehicle incident as well as a strong emphasis on prevention. Good


research will have identified what was demonstrably best practice amongst the diversity of the current state based systems and these will have been integrated into a system of universal care and support. It was agreed that better integration with the health services would ensure that people experienced a smooth transition from acute care, rehabilitation and into recovery and independence. There would be no need for a compensation scheme and this would eliminate the risk of the unintended harm caused by compensation which can result in dependency and less than optimal levels of recovery.

The group believed that the worst case would be if there was an increasingly underfunded and fragmented system with no investment in prevention. Support for injured people would be significantly affected. The outlier scenario speculated about the impacts of a collapsed economy and the need to be entirely personally responsible for recovery after an incident.

Futures Wheel

The futures wheel created by Group 6 is shown in tabular form in Figure 16. The group identified a cluster of implications of providing universal care for support and disability. These were:

mutual accountability between the different parties issues for how the scheme would be resourced potential for creation of incentives for prevention and healing (to enable better

management of costs) and reduction of demand for social support reduction in litigation.

Implications of providing universal care for support and disability


Mutual accountability

How will it be resourced

Risk moral hazard

Incentives for prevention

Improved infrastructure

Less social support required

Less litigation

[unclear text] equity

More incentives for healing

Efficiency in services



Scenarios

The group applied the Organisation Scenario technique to develop futures related to providing universal care and support and disability describing Business as usual, Worst Case, Best Case, and an Outlier alternative. The four scenarios generated by Group 6 are presented in Figure 17.

Business as Usual Headline Widening gap Incremental gain cant keep pace with increasing demands Systemic causes/ characteristics Incremental move to harmonization Incremental change to changes in population, work conditions, work arrangements Widening definition of injury Worldview (Thinking) - Economic rationalism Competitive Reactive Directed by political debate Factionalism

Outliers Headline Self healing Systemic causes/ characteristics Self healing - the power of the mind/body system to alleviate injury Economy collapses completely Worldview (Thinking)- No risk aversion

Worst case Headline System goes broke Systemic causes/ characteristics Universal disadvantage Anarchy No sustainable support for the injured Model unsustainable Lack of investment in prevention Increase in injuries, illnesses, disabilities Worldview (Thinking) Disempowered Overwhelmed

Best case Headline Universal/ integrated Systemic causes/ char

R2_ISCRR Futures Initiative Long Report 220811

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