Australian Journal of Public Administration, vol. 77, no. 4, pp. 829–842 doi:10.1111/1467-8500.12323

Research and Evaluation Digital Infrastructure as a Determinant of Health Equity: An Australian Case Study of the Implementation of the National Broadband Network

Ashley Schram and Sharon Friel The Australian National University

Toby Freeman, Matthew Fisher, and Fran Baum Flinders University

Patrick Harris University of Sydney

Inequities in access to fast and reliable internet connections, essential for digital access to services and information that are important for health, can exacerbate social inequalities in health. We evaluated the social equity of the rollout of the National Broadband Network (NBN) in based on the type of digital infrastructure delivered to areas of varying socioeconomic status. We found that areas of greater socioeconomic disadvantage were significantly less likely to receive the highest quality infrastructure, controlling for level of remoteness. These social inequities in provision of quality infrastructure will shape and possibly exacerbate inequities in health. In our discussion we consider how political decisions have obstructed equitable implementation of the policy. Lessons from the Australian case study may be valuable for other countries investing in public digital infrastructure who want to ensure equity of provision and can also inform Australian policy in the NBN’s remaining rollout.

Key words: health inequalities, social inequity, social determinants of health, digital infrastructure, policy implementation

Introduction Cave and Martin 2010; Willson et al. 2009). The US Broadband Opportunity Council de- Affordable quality broadband technology has clared in 2015 that broadband is ‘taking its been noted as a key component of effective place alongside water, sewer and electricity national telecommunication infrastructure. Ev- as essential infrastructure for communities’ idence has accumulated for its role as a vital en- (Middleton 2015). The growing acknowledge- abler of economic growth, social inclusion, and ment of broadband as a critical infrastructure environmental protection (Broadband Com- service is reflected in the increased prioriti- mission for Sustainable Development 2016; sation and investment from national govern- ments in telecommunication infrastructure, an area that has traditionally been the domain of No conflict of interest declared. private enterprise. A recent analysis found that Accepted for publication: March 26, 2018 151 out of 189 countries reviewed have adopted

C 2018 Institute of Public Administration Australia 830 Digital Infrastructure and Health Equity December 2018 national broadband plans (Broadband Commis- inclusion by connecting friends, families and sion for Sustainable Development 2016). communities across the country and around the The shift to government investment in digital world through voice and video communication infrastructure provides an opportunity to alter services. Likewise, the internet provides un- underlying policies and strategies away from paralleled opportunities to deliver formal and commercially driven business models (Budde informal education through online degree pro- 2017). Under commercial models, higher in- grams or platforms such as TED Talks. Further- come neighbourhoods that are better able to more, it can support improved healthcare de- afford more expensive service packages have livery, such as patient engagement with online been more likely to receive higher quality in- personal health records, mobile health appli- frastructure that supports better digital access cations, telehealth tools and population health (Helsper et al. 2009). This has contributed to research initiatives, and the transfer of high res- a digital gradient (Parsons and Hick 2008) – olution medical images. wherein populations experiencing greater ad- Consequently, public investment in digital in- vantage have better access to digital technolo- frastructure may help support access to online gies, and associated opportunities, relative to health, education, and employment opportuni- populations experiencing greater disadvantage ties to improve health outcomes and reduce (Vinson et al. 2007). health inequities (Ahern et al. 2006; Latulippe et al. 2017; Shaw et al. 2006). However, re- National Broadband and Health Equity ducing inequities in access to the social deter- minants of health through online services will Much evidence shows that individual and popu- only be effective to the extent that enhanced lation health are determined in large part by the digital access is achieved equitably. social and economic conditions in which peo- ple live, the social determinants of health. Po- Australia’s National Broadband Network litically structured socioeconomic inequalities contribute to inequalities in access to social de- The roots of government investment in a Na- terminants of health and in health outcomes be- tional Broadband Network (NBN) in Australia tween groups of differing socioeconomic status began in 1994, when under an Australian La- (WHO Commission on Social Determinants of bor Party1 government concerns were raised Health 2008). These inequalities have been de- in the senate about monopoly power in Aus- fined as health inequities on the grounds that tralia’stelecommunications infrastructure (Ag- they are largely avoidable and unfair (White- ius 2013). On releasing the Networking Aus- head 1991); a normative stance which we en- tralia’sFuture report in 1995, then Prime Minis- dorse and adopt in this paper. ter Paul Keating noted ‘ . . . that access to the na- Thus the digital gradient is increasingly prob- tional information infrastructure will be no less lematic for health equity, as the internet has a general right than access to water, or public evolved into an essential determinant of health, transport or electricity’ (Keating 1995). How- supporting full participation in economic, so- ever, before any Labor initiatives commenced, cial, educational, political, and cultural life a Coalition government was formed in 1996 un- (Baum et al. 2012; Kvasny et al. 2006; Vin- der the Prime Ministership of John Howard.2 It son et al. 2007). This can include new ways has been argued that this marked the beginning to access or participate in the economy by of an 11-year period of a national broadband means of the internet as a comprehensive tool strategy that prioritised subsidies for market to search for new employment, as a method actors to support development in regional and to work remotely, as a source of employment remote areas (Agius 2013). in and of itself, and as a way for businesses By failing to address initial concerns about and entrepreneurs to engage with global mar- monopoly power, in the mid-2000s Australian ket opportunities. Fast, reliable and affordable telecommunications company, , held the broadband connections can also enhance social single largest telecommunications monopoly in

C 2018 Institute of Public Administration Australia Schram et al. 831 any developed economy (Budde 2017). Gre- as the fixed wireless, and satellite being rolled gory (2017) contends that Telstra’s market out in regional and remote areas are all inferior dominance allowed it to delay broadband up- toFttPintermsof‘...speed and capacity de- grades and prevent other companies from hav- livery, maintenance costs, reliability, longevity ing access to its broadband networks (Gregory and upgrade costs’ (Quigley 2016, p. 32) (see 2017). When the Coalition announced in 2007 Figure 1 for overview). Significant differences that it would allocate 1 billion dollars in fund- in cost, data allowance, and speed between the ing to telecommunication providers Optus and various NBN services (FttP, FttN, HFC, fixed Elders to bring faster internet access to regional wireless, and satellite) may be putting some and remote Australia, Telstra launched a law- populations at a significant disadvantage in ac- suit, which Aguis (2013) claims contributed to cessing health opportunities (Australian Medi- a rapidly deteriorating situation in Australian cal Association 2017) as well as other key social telecommunications. The federal election in determinants of health such as employment, November 2007 saw a return of a Labor gov- education, and social inclusion. The Coalition ernment and the move to the development of an is now facing heavy criticism itself (see, e.g. NBN. Coyne 2016; Kenny 2016) as the NBN remains After one false start, in 2009 the Labor gov- behind schedule and over budget, while de- ernment announced plans to invest 43 billion livering an inferior product. As of mid-2017 dollars in a fibre-to-the-premises (FttP) net- the NBN had been rolled out to just over 50% work – widely believed to be the gold standard of premises in Australia with completion pro- of broadband infrastructure (Ellis et al. 2015; jected in 2020 (NBN Co Ltd 2017). Ross 2012) – to 93% of homes and businesses In this paper we examine the implementation and fixed wireless or satellite to the remaining of a national digital infrastructure policy, the premises in remote and rural Australia. That NBN in Australia, as it relates to its capacity to same year the government established the NBN mitigate or exacerbate inequities in digital ac- Co to design, build, and operate the wholesale- cess. Specifically, we explore the deployment only, open-access broadband network. It was of various broadband technologies across the framed as a nation-building investment that socioeconomic gradient and level of remote- would help transform the Australian economy. ness 5 years into the NBN implementation. Reports stressed the role of high quality broad- Evaluation of the NBN rollout in Australia will band in creating greater equity in access to provide valuable insights for countries consid- e-government, e-health, and e-education ser- ering public investment in digital infrastructure vices – particularly in regional and rural areas regarding policy implementation issues related – recommending the development of targeted to equity and can also inform Australian policy programs for those currently experiencing digi- in the NBN’s remaining rollout. tal disadvantage (Alizadeh 2013; 2011). A preliminary evaluation of Methods the first 60 NBN sites suggested that the most socioeconomically disadvantaged and most ge- The current analysis is part of a larger ographically isolated communities were under- body of work studying implementation of the represented in the early stages of the rollout NBN, including mapping policy instruments, (Alizadeh 2013, 2015). monitoring, and reviewing media and grey The Coalition was heavily critical of Labor’s literature, and conducting semi-structured in- NBN plan, and in 2013 when the party re- terviews with experts and key stakeholders. turned to power it fundamentally altered the To understand the unfolding equity effects of implementation strategy for the NBN (Braue NBN implementation, we employed quantita- 2013). The Coalition replaced approximately tive methods as described below to analyse the 60% of the FttP rollout with a multi-tech mix distribution of NBN technologies, in relation (MTM) of fibre-to-the-node (FttN) and hybrid to the level of advantage and disadvantage of fibre coaxial (HFC). FttN and HFC, as well areas, controlling for location.

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Figure 1. Overview of National Broadband Network Technologies

Data Collection was not rolled out to premises until June 2016 (7 months out of 67 months in our dataset). Data on the NBN rollout were acquired from We restricted our analysis to areas with ser- the NBN Co website published on 7 Decem- vice available, as areas with a status of ‘build ber 2016. The dataset provided the name of commenced’ or ‘build preparation’ could still the suburb and the postcode as well as NBN be subject to changes in NBN technology. We status (service available, build commenced, or removed duplicates (matched on suburb, post- build preparation) and service type (brown- code, status, and service type, but different IDs fields fibre (existing housing), greenfields fi- assigned by NBN) leaving us with 5091 unique bre (new housing development), fixed wireless, areas. or ‘other’ (satellite)). This reporting structure We linked the NBN data by postcode with is reflective of the FttP-only rollout and was decile scores from the Index of Relative Socio- not adapted to account for the MTM. After Economic Advantage and Disadvantage (IR- the switch to the MTM the fixed wireless and SAD) from the Australian Bureau of Statistics greenfields fibre category remained the same. (ABS) collected as part of the 2011 Census However, NBN technology in the brownfields of Population and Housing. The IRSAD sum- fibre category introduced the inferior FttN in marises information about the economic and addition to FttP, whereas the ‘other’ category social conditions of households within an area, started counting HFC in addition to the far where relative disadvantage is indicated by in- inferior and vastly different satellite technol- ter alia many low-income households and many ogy. The NBN Co declined to provide a revised individuals in unskilled occupations and rela- dataset delineating FttN from FttP, and HFC tive advantage is indicated by inter alia many from satellite. Contamination of these two cat- high-income households and many individu- egories is limited as FttN was not rolled out als in skilled occupations. A low score indi- to premises until September 2015 (16 months cates relatively greater disadvantage and a lack out of 67 months in our dataset) and HFC of advantage in general, whereas a high score

C 2018 Institute of Public Administration Australia Schram et al. 833 indicates a relative lack of disadvantage and significantly less brownfields and greenfields greater advantage in general (ABS 2013a). fibre than expected and significantly more Decile 1 reflects the lowest scoring 10% of ar- fixed wireless connections than expected (see eas, decile 2 the second lowest 10% of areas, Figure 2). Conversely, in the top four deciles and so on, up to the highest 10% of areas which (61st to 100th percentile), there was signifi- are given a decile number of 10 (ABS 2013b). cantly more brownfields and greenfields fibre IRSAD data were missing for 9 cases, reducing than expected and significantly less fixed wire- our final sample to 5082 areas. less connections than expected (with the excep- To disaggregate our analysis by level of re- tion of brownfields fibre in decile 8, which did moteness we used ABS data from 2011 on the not reach significance). Accessibility/Remoteness Index of Australia, The relationship between type of NBN tech- which overlays a statistical area on the Aus- nology and IRSAD decile remained significant tralian Statistical Geography Standard on a one controlling for remoteness (see Figure 3 and kilometre grid covering all of Australia where Supporting Information Table 1), such that ar- each grid point is allocated a value based on eas with greater socioeconomic disadvantage the measurement of road distances to service were receiving disproportionately less fibre centres. All grid points contained within an technology relative to areas with greater so- area are averaged to provide a remoteness score cioeconomic advantage. The results were sig- (ABS 2014), further categorised as either a ma- nificant for major cities χ 2 (27, N = 1639) = jor city, an inner regional area, an outer regional 167.95, p < 0.000; inner regional areas χ 2 (27, area, remote Australia, or very remote Australia N = 2257) = 142.04, p < 0.000; and outer (ABS n.d.). regional areas χ 2 (27, N = 1103) = 266.14, p < 0.000. The effects are less pronounced Data Analysis in major cities, with a few lower deciles ex- hibiting significantly less fibre technology or All analyses were run in IBM SPSS Statistics R significantly more wireless or other; and a few version 24. A chi-square test of independence higher deciles exhibiting significantly more fi- was used to test for a significant association be- bre technology or significantly less wireless or tween our two main variables (NBN technology other. A similar pattern emerged in inner re- and IRSAD decile) across all areas of Australia. gional Australia, where lower deciles (1, 2, and Individual chi-square analyses were also run by 3) had significantly more wireless technology, area of remoteness (major cities, inner regional, whereas upper deciles (8, 9, and 10) had signifi- outer regional, remote, and very remote). To cantly more brownfields fibre technology. This explore statistical significance within cells we trend was also evident in outer regional Aus- ran adjusted standardised residuals, which ac- tralia where the lower deciles (1, 2, and 3) had count for variation in sample size across all significantly less fibre technologies and sig- cells. Values less than −2.0 and values greater nificantly more wireless technology, whereas than 2.0 indicate significance at the level of upper deciles (7, 8, and 9) had significantly 0.05 (Agresti 2012). more fibre technologies and significantly less wireless technologies. We were unable to run sub-analyses for re- Results mote and very remote Australia due to low sample sizes. To gain an understanding of Across Australia the association between type whether remote and very remote Australia do of NBN technology and IRSAD decile was sig- not have sufficient sample sizes available or nificant χ 2 (27, N = 5082) = 908.42, p < whether they have been proportionately under- 0.000, such that areas of greater socioeco- represented in the rollout we examined a crude nomic disadvantage were less likely to receive measure of representation. That is, we com- the superior fibre technology. In the bottom pared the number of unique postcodes within four deciles (1st to 40th percentile), there was each geographical classification of Australia

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Figure 2. NBN Multi-Technology Mix by Socioeconomic Advantage and Disadvantage Decile with Actual and Expected Counts and Adjusted Residuals E, expected; A, actual; *, actual value significantly differs from expected value (p < 0.05)

All Areas 500 A

450 A A 400

350 E E E E E A 300 A A E 250 E A 200 E A A E

Number of Areas Number of E E E A 150 E E A A A A E E A E A A E A E E E E E A E E A E E A A A 100 A E A A A E A A A A E E A E E E E A E E E A A E E A 50 A A A A 0 12345678910

Socioeconomic Advantage and Disadvantage Decile

E = Expected; A = Actual; * = actual value significantly differs from expected value (p<.05)

Figure 3. NBN Multi-Technology Mix by Socioeconomic Advantage and Disadvantage Decile by Area of Remoteness

where NBN service is available relative to the (364/881); but only 12% of postcode areas in total number of unique postcodes within each remote Australia (36/300); and only 3% of post- classification. We found that service is avail- code areas in very remote Australia (5/164). able in 49% of postcode areas in major cities Although this is not a perfect measure of the of Australia (504/1023); 57% of postcode ar- actual percentage of completion of the NBN eas in inner regional Australia (493/863); 41% rollout in each geographical classification, it of postcode areas in outer regional Australia does provide an indicator of the geographical

C 2018 Institute of Public Administration Australia Schram et al. 835 distribution of NBN services available as of equities further down the line. Future studies December 2016. might explore changes in reliable and afford- able access to e-health and other services across Discussion the various NBN technologies, for example, the ability of end users across the various technolo- Five years into implementation, the most so- gies to seamlessly stream video content for ed- cioeconomically disadvantaged and most ge- ucational or health purposes. ographically isolated communities have con- Spokespeople for the NBN Co have insisted tinued to fare the worst in the NBN rollout, – in response to a media article developed from consistent with early findings (Alizadeh 2013, the analysis reported here – that the network 2015). Across Australia, areas with greater dis- is being rolled out across Australia regard- advantage have received proportionately less less of any socioeconomic mapping (Schram NBN fibre technology (and consequently more et al. 2017). Inadvertently, this decision not fixed wireless and satellite technology) relative to consider equity may in fact help explain to areas with greater advantage. Although it the inequitable implementation of the NBN to could be suggested that areas facing disadvan- date. The NBN Co has noted that factors such tage are more likely to be increasingly remote as‘...thelocation of construction resources, and thus receive inferior digital infrastructure current service levels, existing broadband in- due to distance, this socioeconomic gradient of frastructure, growth forecasts and proximity to NBN technology was present even when hold- NBN infrastructure such as the transit network’ ing level of remoteness constant. That is, the (Schram et al. 2017) are weighed when deter- gradient was present when we restricted the mining which NBN technology an area will areas in our analysis to only major cities of receive. Closer examination reveals that many Australia, or to only inner regional areas, or to of these are in fact socioeconomic and geo- only outer regional areas. For example, in outer graphical indicators – current service levels are regional Australia, 78% of areas in the highest indicative of the type of internet packages res- decile have received fibre technology, whereas idents are willing or able to afford; existing only 12, 4, and 3% of areas in the lowest three broadband infrastructure may be indicative of deciles received fibre technology. the existing level of digital disadvantage or re- Existing inequities in these socioeconom- moteness of an area, whereas location factors ically disadvantaged and geographically iso- such as distance to construction resources or lated communities are thus compounded by the transit network may disadvantage more ru- comparatively inferior digital infrastructure. ral and remote communities. Thus a vicious These communities are receiving lower speeds, cycle is established whereby decision making poorer reliability, and less longevity, meaning during NBN implementation, amplified by the that in addition to receiving inferior service, switch to the MTM, has used the infrastruc- residents of these areas may have to shoul- ture and resources of an area and the finan- der higher maintenance and upgrade costs in cial resources of its residents as determining the future (Quigley 2016). Moreover, as was factors for the type of digital infrastructure it identified during the early stages of NBN plan- will receive. This continues to define the in- ning, those currently disadvantaged by the dig- frastructure and resources of an area and the ital gradient stood to benefit the most from financial resources of its residents, reinforc- greater equity in access to e-government, e- ing a digital exclusion cycle (Newman et al. health, and e-education services (Parliament of 2010). Australia 2011). Although at this stage we can- Concerns about the negative effects of polit- not reliably attribute changes in health equity ical influence in the infrastructure sector have outcomes to NBN service, this study demon- been expressed in the media (Kohler 2011; strates that NBN implementation to date has Murphy 2017; Wiggins 2017) and the sector as been stratified by characteristics of disadvan- a whole has been accused of being highly vul- tage, which is very likely to create health in- nerable to political bias (Benitez et al. 2010).

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In light of this, and the findings of this pa- 56 billion dollars (Tucker 2015). This ‘faster’ per, we consider whether any private political and ‘cheaper’ NBN was to be achieved by re- agendas were potentially at work during NBN placing approximately two-thirds of the FttP implementation, and if so, whether this might rollout with the technologically inferior FttN have had implications for the diminished role and HFC. The Coalition win in 2013 can, in all of equity considerations during the rollout. probability, be partially attributed to promises It has been suggested that an exceedingly of a faster and cheaper NBN. strong focus on getting elected or re-elected is The first formal evaluation of the Coalition’s one source of negative political influence in ef- plan was to come from the NBN Co to the fective infrastructure governance (Benitez et al. incoming Coalition government; however, the 2010). During policy implementation such an NBN report was omitted from any public doc- emphasis has been hypothesised to result in umentation and according to Braue (2013) re- pork barrelling, where public funds are targeted peated freedom of information requests for its to particular areas based on political consid- release were denied. The NBN Co report, later erations (Evans 2004; Leigh 2008); favouring leaked to the public, revealed a damning as- short-term spending over crucial long-term in- sessment of the Coalition plan. NBN Co had vestment; and a lack of systematic concern for advised that the technologically inferior FttN infrastructure access for the poorest segments wouldn’t support the Coalition’spolicy promise of society (Benitez et al. 2010). of delivering guaranteed 50 Mbps services; and There is evidence that electoral motivations instead that it would produce lower revenues, on behalf of both the Labor and the Coalition keep prices higher, face resistance from local governments appear to have interfered with ef- councils, and threaten the ability to provide fective implementation of the NBN. To begin government, e-health and other services across with, evidence suggests some pork barrelling the network (Braue 2013). by the Labor party in its selection of the early A second source of potential negative politi- NBN rollout sites in 2011 (Alizadeh and Farid cal influence during the NBN implementation 2017). Areas where Labor held seats in the 2007 may stem from industry relations. Benitez et al. and 2010 Federal elections were most likely (2010) claim that overly friendly relations with to receive NBN service during the initial roll- industry, either in the form of campaign fund- out, whereas seats held firmly by the Coalition ing or the ‘revolving door’ between political were the least likely to receive the infrastruc- office and private sector positions, may result ture. For example, none of the marginal seats in in a procurement process that supports certain Queensland held by a Coalition party member interest groups or influences project scope to- in 2007 were early release sites, whereas 63% wards less efficient solutions that benefit the of marginal seats held by Labor were included. private sector. Telco giant Telstra claims that Although Labor lost the election in 2013, Al- it does not make political donations (Telstra izadeh and Farid (2017) claim the swing to Corporation Limited 2015). However, in the the Coalition was less pronounced in the NBN 2015 to 2016 financial year, Telstra Corpora- early release sites. tion donated $12400 to Labor Holdings Pty The Coalition also promised to deliver a Ltd (Elvery 2017a) – whose recipient is the faster, cheaper NBN than Labor during its 2013 (Elvery 2017b) – and electoral campaign. It alleged that Labor’s ver- $186000 to the Cormack Foundation Pty Ltd sion of the NBN would cost up to 94 billion dol- (Elvery 2017a) – whose recipient is the Lib- lars during the election, a figure that was later eral Party of Australia (member of the Coali- revised down to 74 to 84 billion dollars (Braue tion) (Elvery 2017b). Previous accusations that 2013); concurrently, the Coalition claimed its Telstra makes political donations at criti- version of the NBN would cost 29.5 billion cal policy-decision junctures have been made dollars and be completed by 2016 – a number (House of Representatives 2004). Some move- that was also revised once in power to 41 bil- ment between political parties and Telstra lion dollars by 2020, and then again to 46 to has also occurred, such as Stephen Ellis,

C 2018 Institute of Public Administration Australia Schram et al. 837 former advisor to Malcolm Turnbull, then- However, it is important not to see negative communications minister for the Coalition gov- political influence in the NBN rollout as en- ernment, who had spent 6 years writing the demic to public infrastructure provision. By ex- Coalition’stelecommunications policy and was posing political failings during implementation hired by Telstra in 2016 as a consultant (Bat- we can separate promising models from flawed tersby 2016). Such relations could be seen executions. as motivating government’s continued friend- That the NBN has already been rolled out liness towards Telstra. For example, despite to over 50% of premises in Australia as of claims that Telstra failed to make any invest- mid-2017 (NBN Co Ltd 2017), along with ments in its broadband infrastructure and used the lack of upgrade pathways for FttN, means its monopoly power to keep prices high and there are relatively few policy options to re- competitors out (Gregory 2017), the company duce inequities at this stage; however, there are has continued to profit from development of opportunities to enhance equitable access to the NBN. Telstra was paid $11.2 billion in com- broadband in Australia moving forward. The pensation by Labor to decommission its legacy 2015 Regional Telecommunication Review copper and HFC networks (Hutchinson 2011), recommended developing a new Consumer which the Coalition then paid it 1.6 billion dol- Communication Standard for voice and data lars to upgrade these networks for inclusion in that would set technology neutral standards the revised NBN rollout (Tucker 2016). in terms of availability, accessibility, afford- Although it seems that the original public in- ability, performance, and reliability (Regional vestment in the NBN was at least in part driven Telecommunications Review 2015). The suc- by equity and social concerns, negative politi- cess of this type of an approach will depend cal influence during implementation of the type on where the baseline for such standards is demonstrated above appears to have resulted set, and the regular review of standards to en- in a shift towards prioritising economics and sure that they keep pace with growing capac- cost reduction, with less consideration for eq- ity and demands. More recently, in its inquiry uity. For example, the selection of early NBN into the Telecommunications Universal Service release sites seemingly to further the political Obligation in 2017, the Productivity Commis- ends of Labor is a perversion of public pol- sion recommended that the Australian Gov- icy and makes it unlikely that valuable infras- ernment should revise the objective for uni- tructure dollars will be invested in the places versal telecommunications services to provide that need it most. This has been demonstrated baseline broadband services to all premises in by the underrepresentation of the most socioe- Australia, having regard to the accessibility conomically disadvantaged and geographically and affordability of these services. However, isolated communities in the early stages of the Productivity Commission caveated their the rollout (Alizadeh 2013, 2015) and repli- recommendation, noting that to contain costs cated by our analysis 5 years on. Moreover, to the broader community, the baseline should the co-option of the NBN as a nation build- be set to meet the basic needs of most Aus- ing project by the Coalition to deliver short- tralians in the majority of circumstances (Pro- term, inferior outcomes as an election tool has ductivity Commission 2017). Similar to a con- greatly hindered the chance to make a signifi- sumer communication standard, a universal ser- cant improvement in digital equity. Rather than vice obligation will only be as effective as the delivering a ‘future proof’ digital infrastruc- baselines it sets. What is more, any assess- ture equitably to 93% of Australians, some ment of cost containment must consider the full claim it has provided a patchwork infrastruc- range of social, environmental, and economic ture tiered according to socioeconomic sta- benefits from providing equitable access to tus, with those least able to afford upgrades fast and reliable broadband service to all Aus- having been disproportionately provided dig- tralians and take account of the rapid integra- ital infrastructure that will no longer be fit- tion of the internet into our daily lives when for-purpose in 10 to 15 years (Patton 2016). forecasting ‘basic needs’.

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A key limitation of our study was the nature band for all Australians, at affordable prices. of the data made publicly available by the NBN Instead, so far, it is simply reinforcing and po- Co. As noted previously, although the inclusion tentially widening social inequities. Despite the of FttN may distort our fibre results, it was not recognition during early stages of the develop- rolled out to premises until September 2015 (16 ment of the NBN that it could address the dig- months out of 67 months in our dataset). If we ital gradient, the most socioeconomically dis- assume that the NBN provided FttN technol- advantaged and most geographically isolated ogy proportionally across the socioeconomic communities continue to fare the worst in the gradient, then the impact would be to reduce rollout. This paper has raised concerns about the overall number of premises in this category, growing inequities in digital access as a social not its distribution. If, however, lower decile ar- determinant of health at a time when the in- eas have actually received more FttN relative to ternet has become increasingly essential to the FttP, then our current results would in fact un- provision of information and services. A 2017 derestimate the steepness of the socioeconomic report from the Joint Standing Committee on gradient of the NBN rollout. Similarly, the in- the NBN echoed these concerns, noting that: clusion of HFC technologies is included with ‘The committee is concerned that NBN is de- satellite; however, HFC was not rolled out to livering a service of quite varied quality with premises until June 2016 (7 months out of 67 the potential to fall short of a ubiquitous net- months in our dataset). This data aggregation work in which a foundation of reliable, afford- is most problematic in inner regional Australia able, high-speed internet is available to the vast where communities may receive either tech- majority of households and businesses. The un- nology; however, in major cities the counts of even nature of the multi-technology mix and the premises would reflect HFC and not satellite apparent over-use of satellite broadband could service, whereas in outer regional Australia it exacerbate existing social, economic, and digi- would likely reflect satellite service and not tal inequality’(2017, pp. 161–162). As the NBN HFC. The Australian Competition and Con- is not yet complete, by demonstrating an urgent sumer Commission launched a study in July need to consider the socioeconomic implica- 2017 to monitor the broadband connections of tions of the various implementation decisions, approximately 4000 Australian households to particularly in light of the MTM policy change, determine typical broadband speeds and per- the results of this work may be able to influence formance at various times during the day (Aus- the rollout as it proceeds. tralian Competition and Consumer Commis- Although this analysis is specific to Aus- sion 2017). Although they aim to include a tralia, there is significant international rele- range of retail service providers, broadband vance. As additional countries pursue invest- technologies, and retail plans, they will not ment in broadband as an essential service, be including satellite or fixed-wireless broad- leaders should look carefully to the successes band services, and there is no indication that and failures of the NBN. Labor’s plan to build the data will be representative across socioeco- an all FttP broadband network gave Australia nomic or remoteness classifications. An effort the chance to be a global leader, but instead due to collect nationally representative data of this to adverse political influence, Australia has be- nature would be invaluable for projecting the come what McMillen (2017) dubs the ‘what impacts of the various NBN technologies dis- not to do’ of the broadband world. The NBN tributed across Australia and subsequently the is the most expensive digital network in any implications for digital access to the social de- developed country, and yet it ‘has been a po- terminants of health. litical plaything from the start’ and although the Coalition’s plan may have been politically Conclusion expedient, it ‘has forgone the opportunity to invest in a competitive, leading edge, future- The NBN was intended to be a nation build- proofed communications system’ (Newman ing project that would deliver superfast broad- 2016). The failure to enact an equitable NBN is

C 2018 Institute of Public Administration Australia Schram et al. 839 likely to have long term social and health con- Ahern, D. K., J. M. Kreslake and J. M. Phalen. sequences for the country in the future. Where 2006. ‘What is eHealth (6): Perspectives on Australia has veered, other countries should the Evolution of eHealth Research’. Journal stay the course and follow the advice of the of Medical Internet Research 8(1):e4. Available Broadband Commission for Sustainable Devel- from https://www.ncbi.nlm.nih.gov/pmc/articles/ opment (2016) and commit to long term invest- PMC1550694/ ment in essential digital infrastructure that will Alizadeh, T. 2013. ‘Towards the Socio-Economic Patterns of the National Broadband Net- contribute to inclusive and sustainable devel- work Rollout in Australia’, State of Aus- opment and deliver vital social determinants of tralian Cities, Sydney, Available from https:// health to its population. www.researchgate.net/profile/Tooran_Alizadeh/ publication/267569973_Towards_the_Socio- Acknowledgements Economic_Patterns_of_the_National_Broadba nd_Network_Rollout_in_Australia/links/5514a This study is part of a wider National Health and 6360cf283ee08381b66.pdf [Accessed 26 July Medical Research Council funded Centre for Re- 2017]. search Excellence in the Social Determinants of Alizadeh, T. 2015. ‘The Spatial Justice Implica- Health Equity (APP1078046) examining the policy cycle in areas that shape the distribution of power, tions of Telecommunication Infrastructure: The money, and resources that affect people’sdaily living Socio-economic Status of Early National Broad- conditions, including infrastructure policy, and the band Network Rollout in Australia’. International implications for health equity. Journal of Critical Infrastructures 11(3):278– 296. Endnotes Alizadeh, T. and R. Farid. 2017. ‘Political Econ- omy of Telecommunication Infrastructure: An In- 1. The Labor party self-declares as a social vestigation of the National Broadband Network democratic party that promotes big government Early Rollout and Pork Barrel Politics in Aus- and social justice; however, privatisation and tralia’. Telecommunications Policy 41(4):242– 252. deregulation policies in the 80s and 90s have Australian Bureau of Statistics (ABS). 2013a. ‘IR- led some to suggest that the party is more ac- SAD’, Australian Bureau of Statistics, 28 March, curately centre-left (https://rotundamedia. Available from http://www.abs.gov.au/ausstats/ com.au/2015/07/05/an-idiots-guide-to- [email protected]/Lookup/2033.0.55.001main+ -major-political-parties/). features100042011 [Accessed 17 July 2017]. Australian Bureau of Statistics (ABS). 2013b. 2. The Coalition is led by The Liberal party ‘Using and Interpreting SEIFA’, Australian Bu- which is centre-right and pursues policies of reau of Statistics, 19 September, Available from economic liberalism and social conservatism. http://www.abs.gov.au/websitedbs/censushome. The Liberal Party rarely obtains enough votes nsf/home/seifahelpansuis?opendocument to win an election in their own right and has &navpos=260 [Accessed 17 July 2017]. relied upon forming a Coalition government to Australian Bureau of Statistics (ABS). 2014. govern. ‘The Australian Statistical Geography Standard (ASGS) Remoteness Structure’, Australian References Bureau of Statistics, 10 June, Available from http://www.abs.gov.au/websitedbs/d3310114.nsf/ Agius, A. 2013. ‘Australia’s Broadband His- home/remoteness+structure#Anchor1 [Accessed tory’, Reckoner: The Culture of Technology 17 July 2017]. in Australia, 24 September, Available from Australian Bureau of Statistics (ABS). n.d. ‘Re- http://parlinfo.aph.gov.au/parlInfo/download/ moteness Structure’, Australian Bureau of media/pressrel/C3520/upload_binary/C3520. Statistics, Available from http://www.abs.gov. pdf;fileType=application%2Fpdf#search= au/websitedbs/d3310114.nsf/4a256353001af3ed %22media/pressrel/C3520%22 [Accessed 14 4b%202562bb00121564/6b6e07234c98365aca September 2017]. 25792d0010d730/$FILE/ASGS%20Remoten Agresti, A. 2012. Categorical Data Analysis (3rd ess%20Structure%20-%20Fact%20Sheet.pdf ed.). New York: Wiley. [Accessed 17 July 2017].

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