Letters
Health services administration
Volume 191 - Issue 7

Are we ready for the next big thing?

Author:  Heather J Cleland

Med J Aust 2009; 191 (7): 412-413. || doi: 10.5694/j.1326-5377.2009.tb02860.x
Published online: 5 October 2009
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To the Editor: Duckett rightly points out that community knowledge and expectations of the delivery of medical services have increased in recent years, and that the “baby boomers” of today will not accept the hospitals of yesteryear.1 He claims that the Australian health system has responded to technological change, but not to sociological change.

Although the introduction of new medical technologies — a process largely driven by clinicians — has helped ensure that Australians still have access to quality health care, the same claim can not be made for the other kinds of technologies necessary to support delivery and review of good-quality care; notably, health information technology lags lamentably behind other sectors. In addition, we have not been “adept in responding to technological change”, because we have not figured out how we are to pay for it.

The sociological changes that Duckett is concerned with are well recognised by many working in the public health sector. He states that macro- and provider-level reforms set the context for the interaction between the patient and clinician. He seems inclined to view this interaction as the final frontier — resistant to change and responsible for what he characterises as an ongoing lack of responsiveness in hospitals and health facilities.

However, his outdated and stereotypical characterisation of doctors working in the public health sector must call into question his knowledge of what actually goes on in modern health care settings, in addition to pointing to a tendency to underestimate the difficulties of working in these austere and pressured environments.

The conversation that privileged baby boomers actually need to have is one that forms part of a public debate about how much health care costs and how we should be thinking about rationing its delivery, or else paying more for it, as Queensland Health has perhaps finally learned.

It is disappointing that, despite Duckett’s long years of experience in the public health sector, he fails to address the real implications of the changes, both technological and sociological, to which he alludes in his opening paragraph — how exactly are we going to manage the ever-increasing demand for increasingly expensive treatments by an ageing population?

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