Volume 191 - Issue 7
Reforming Australian health care
Author: Martin B Van Der Weyden
Med J Aust 2009; 191 (7): 367. || doi: 10.5694/j.1326-5377.2009.tb02840.x
Published online: 5 October 2009
Published online: 5 October 2009
Time to debate the recommendations of the National Health and Hospitals Reform Commission is slipping away
When the history of the Rudd Labor Government is written, undoubtedly a chapter will be devoted to its penchant for summits, inquiries and reports. Health has not escaped this inquisitorial focus. There have been, among others, inquiries and reports regarding preventive health,1 primary care,2 and health care delivery in general.3 The latter was the remit of the National Health and Hospitals Reform Commission (NHHRC), and its final report, A healthier future for all Australians, was released in June this year.3
If the NHHRC’s 123 recommendations are enacted, they have the capacity to change Australian health care in a manner reminiscent of the establishment of Medibank. Despite the report’s length (292 pages) and its prolific list of recommendations, common themes emerge: shared responsibility for care; increased responsibility by the federal government for existing and new health services; consolidation and integration of services, with an emphasis on non-institutional care; shifting care towards being more patient- and person-responsive than provider-convenient; better intrasectoral communication through the use of information technology; extracting greater efficiencies from hospitals; relating remuneration to outcomes and performance targets; and, finally, fundamental changes in the provision of health insurance. In short, if implemented, the report will mean a time of uncertainty, inherent in change. Despite this, the report has not yet been widely debated within the profession.
In this issue of the Journal, we commence a series of articles (National health reform: its time for a decision, A healthier future for all Australians: an overview of the final report of the National Health and Hospitals Reform Commission and Final report of the National Health and Hospitals Reform Commission: will we get the health care governance reform we need?) exploring the social, health and professional impact of the recommendations of A healthier future for all Australians. Prime Minister Rudd is currently engaged in a whirlwind “getting to know you” tour of selected Australian hospitals, before the federal government’s response to the report is further massaged by the Council of Australian Governments into a united policy and a possible implementation plan. If the profession seeks to influence these outcomes, now is the time to present our views and recommendations. If we do not accept this challenge, change will be imposed from on high and may well be uncomfortable or even intolerable! Although it is important to “talk the talk”, this should not excessively delay “walking the walk”.
References
- Schultz M, Austin J, Letcher T, et al; National Preventative Health Taskforce. Australia: the healthiest country by 2020. National Preventative Health Strategy — the roadmap for action. Canberra: Commonwealth of Australia, 2009. http://www.preventativehealth.org.au/internet/preventative health/publishing.nsf/Content/nphs-roadmap-toc (accessed Sep 2009).
- Australian Government Department of Health and Ageing. Primary health care reform in Australia — report to support Australia’s first national primary health care strategy. Canberra: Commonwealth of Australia, 2009. http://www.yourhealth.gov.au/internet/yourhealth/pub lishing.nsf/Content/nphc-draftreportsupp-toc (accessed Sep 2009).
- National Health and Hospitals Reform Commission. A healthier future for all Australians: final report June 2009. http://www.nhhrc.org.au/internet/ nhhrc/publishing.nsf/Content/nhhrc-report (accessed Sep 2009).
Getting on the Same Page: Why Australia Needs a National Maternity Early Warning System (MEWS) Chart
Briony A. Cutts, Lucy Bowyer, Nisha Khot, Sandra Lowe, Stefan C. Kane
Data for Equity: Can Linked Administrative Data Inform Pathways to More Equitable Child Health?
Sarah Gray, Shuaijun Guo, Meredith O'Connor, Elodie O'Connor, Katrina Williams, Hannah Badland, Susan Woolfenden, Josie Dickerson, Gerry Redmond, Marnie Downes, Sharon R. Goldfeld
Specialty College Selection: Why Change is Critical to Support a Future Rural Workforce
Matthew R. McGrail, Jenny May AM, Katherine Logan
The number of cancer‐related deaths that could be attributable to spatial disparities in survival in Australia, 2010–2019: a retrospective population‐based cohort study
Charlotte K Bainomugisa, Jessica Cameron, Paramita Dasgupta, Peter Baade
Differentiated and simplified oral HIV pre‐exposure prophylaxis (PrEP) models hold the key to virtually eliminating HIV transmission in Australia by 2030
Tyson Arapali, Sarah Warzywoda, Anthony K J Smith, Curtis Chan, Timothy R Broady, Erin Sullivan, Catherine MacPhail, Mohamed A Hammoud, Alexander Dowell‐Day, Benjamin R Bavinton
Non‐technical errors associated with deaths in surgical care, Australia, 2012–2019, by surgical specialty (Australian and New Zealand Audit of Surgical Mortality): a retrospective cohort study
Jesse Ey, Victoria Kollias, Octavia Lee, Kelly Hou, Matheesha Herath, John B North, Ellie Treloar, Suzanne Edwards, Martin Bruening, Adam J Wells, Guy J Maddern