Volume 200 - Issue 1
Challenges in health policy: the next 10 years
Author: Justin M Nazareth
Med J Aust 2014; 200 (1): 17. || doi: 10.5694/mja13.11060
Published online: 20 January 2014
Published online: 20 January 2014
To the Editor: I would like to commend Penington for his insightful opinion piece regarding the challenges facing the Australian health system over the next decade.1 I, and I am sure many others, share his warranted concern regarding the future of quality and safety in health care in a politically charged, target-based funding system.
As highlighted by Penington, the recently published McKeon report provides a suggested ...
To the Editor: I would like to commend Penington for his insightful opinion piece regarding the challenges facing the Australian health system over the next decade.1 I, and I am sure many others, share his warranted concern regarding the future of quality and safety in health care in a politically charged, target-based funding system.
As highlighted by Penington, the recently published McKeon report provides a suggested path towards a national health system that is based on embedded research and development and would be the envy of our peers and improve quality and safety for patients for years to come.2 However, at present, policymakers appear to be more content in repeating others’ mistakes.
Take, for example, the introduction of the 4-hour rule in Australian emergency departments. An idea transplanted from the United Kingdom’s National Health Service (NHS), it has failed to produce any evidence of consistent improvement in quality of service provision in emergency departments in the UK, despite its enormous cost (£820 million from 1998 to 2007). Another monumental failure of this politicised, target-based approach is the once lauded, now shamed Mid Staffordshire NHS Foundation Trust, which, despite being considered to perform well based on mandated targets, had a standardised mortality ratio of more than 20% greater than the NHS average.4
As health care providers, we should be advocating for health policy that returns to the key tenets of health care quality — effectiveness, efficiency, safety and patient centricity — by adopting measures such as embedded research and development, before it is too little, too late.
Competing interests
No relevant disclosures.
References
- Penington DG. Challenges in health policy: the next 10 years. Med J Aust 2013; 199: 153. 0_CHDCDEEE
- McKeon S, Alexander E, Brodaty H, et al. Strategic review of health and medical research. Final report February 2013. Canberra: Australian Government Department of Health and Ageing, 2013. http://www.mckeonreview.org.au/downloads/Strategic_Review_of_Health_and_Medical_Research_Feb_2013-Final_Report.pdf (accessed Aug 2013).
- Jones P, Schimanski K. The four hour target to reduce emergency department ‘waiting time’: a systematic review of clinical outcomes. Emerg Med Australas 2010; 22: 391-398. 0_pgfId-2963627
- UK Healthcare Commission. Investigation into Mid Staffordshire NHS foundation trust. Summary report. London: Commission for Health Audit and Inspection, 2009. http://image. guardian.co.uk/sys-files/Guardian/documents/2009/03/17/Investigation_into_Mid_Staffordshire_NHS_Foundation_Trust_Summary.pdf (accessed Aug 2013).