Healthcare reform: possible ways forward*

John Menadue
Med J Aust 2003; 179 (7): . || doi: 10.5694/j.1326-5377.2003.tb05595.x
Published online: 6 October 2003

There is little disagreement about the directions public health reform should take — greater emphasis on primary and preventive care, workforce reform, community participation, improved governance and better application of information technology. It is clear that there are gaps and duplication in clinical services that reflect outdated population patterns and jealously guarded clinical territories. There is concern about the health disadvantage of certain groups, and particularly Aboriginal and Torres Strait Islander people. In quality of life measured by life expectancy, Australia ranks number two in the world, but in healthcare equality we rank number 17.1 If all Australians had the same health experience as Aborigines, we would rank number 140 in the world, alongside Bangladesh.

  • Watsons Bay, NSW.


  • 1. World Health Organization. World health report 2000. Health systems: improving performance. Geneva: WHO, 2000: 143-200.
  • 2. Report of the NSW Health Council. A better health system for NSW. 2000. Available at: (accessed Aug 2003).
  • 3. Better choices, better health. Final report of the South Australian Generational Health Review. April 2003. Available at: (accessed Aug 2003).
  • 4. O’Neil O. A question of trust. BBC Radio 4 Reith Lectures 2002. Available at: (accessed Aug 2003).
  • 5. Building on values: the Final Report of the Commission of the Future of Healthcare in Canada. November 2002. Available at: (accessed Aug 2003).


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