The Australian health care system. 3rd ed. S J Duckett. Melbourne: Oxford University Press, 2007 (xxi + 370 pp). ISBN 978 0 19 555142 6.

Having taught a course on comparative health care systems for more than 25 years, I have become increasingly uncomfortable with the use of the word “system” in regard to the numerous ways different societies make health care available to their people. System may imply a carefully thought out plan, and appropriately coordinated sets of arrangements, whereby people get access to high-quality health care in an efficient and effective manner. This is universally not the reality when one examines health services throughout the world. If, however, one interprets system as a set of interdependent parts, regardless of how well they function, then it is appropriate to talk about a health system.

Health care is often a major political issue. Politicians address “health” as a major campaign issue and propose “solutions” to “fix” problems such as runaway health care costs, access to comprehensive health services, improving public health or ensuring adequate numbers of health care professionals to cope with increased, ageing populations. All too often, these political fixes focus almost exclusively on different approaches to raising and spending funds. Underlying factors, such as the importance of behavioural changes and their influence on health status, inadequate attention to health promotion and disease prevention measures, and poor public health services, are usually ignored.

In The Australian health care system, Duckett combines a strong academic approach with extensive practical experience in health administration and policy in different settings in Australia. The content is comprehensive, ranging from a discussion of the health status of Australians through financing, health workforce, governmental structures, hospitals, public health, primary and community care, and pharmaceuticals to health policy challenges.

For students beginning a study of the health issues, problems and challenges facing Australians, this book will be a valuable resource. For practising health professionals, it provides a broad discussion about the complex functioning of health care in Australia. Hopefully, it will encourage them to see the big picture as opposed to the narrow perspective from their particular specialty. For the teacher of health services management and policy, public health or public policy, this book will be a tremendous asset. It includes extensive references to resource materials on all the topics addressed and this is beneficial for preparing course outlines and encouraging further research.

The layout of the book is excellent: reader-friendly, clearly written and not overloaded with health care jargon. The charts, figures and tables help clarify and explain the message. Textbooks such as this one are expensive, but I feel this one is good value for money.