Healthy infrastructure: Australian National Broadband Network policy implementation and its importance to health equity

Critical social and economic resources, such as employment, education, and health services, increasingly require online access, highlighting the growing need to address equity of access to high-speed broadband telecommunications. Ensuring access to broadband requires the necessary infrastructure which, in Australia, is the National Broadband Network (NBN). In this paper, we use policy implementation theory to examine the translation of the government’s NBN policy into service delivery, specifically in relation to the choice of policy instruments to install the broadband infrastructure, the associated barriers and enablers to their implementation, and the equity considerations that are emerging as the policy is implemented. We conducted a rapid review of NBN policy documents and academic and grey literature to map the NBN policy instruments and to examine how key contextual, political, and technical aspects of NBN policy implementation are likely to affect equity. Our findings indicate a range of equity concerns in the implementation of NBN policy. The instrument choice of a public–private ‘hybrid’ organisation to implement NBN policy has created a fertile ground for competing political, social, and commercial priorities, thereby affecting how the policy is implemented and thus increasing the risks to equity as it competes with other priorities. As these mixed public–private instruments become more prevalent as policy tools to deliver major infrastructure, determining the best means to safeguard equity is a vital consideration to ensure the benefits are distributed fairly.