Public policy and bureaucracy: 'a new era' of HIV policy in NSW

Theories of the policy process provide explanatory models for how issues come to the attention of policymakers and how public policies change. The pluralist orientation of this literature emphasises civil society and political actors in processes of policy change. This orientation is consistent with popular and scholarly accounts of HIV policy in Australia, which centre community activism and political leadership in shaping Australia's lauded HIV policy settings. This research utilises a case study approach to explore whether closer attention to bureaucrats and bureaucracy can improve our understanding of public policy. The case offered is of HIV policy over the period 2007 to 2015 in New South Wales, Australia, including a period of transformative change from 2011. This research describes the arrest of a long period of policy drift and the establishment of new, ambitious policy settings. The case description is compatible with policy process theories but emphasises endogenous sources of change even in the context of rapid exogenous developments in HIV prevention science and technology. It identifies bureaucratic conditions that order and constrain the possibilities for policy change and characterises bureaucratic effort as practices that manage gaps between policy in its real and ideal forms. The study suggests that bureaucratic conditions and practices are independently important in this case of policy change and that greater attention to bureaucracy can aid our understanding of public policy.