This is one of the many questions posed in Reform of the Federation White Paper – Roles and Responsibilities in Health that was released by the Federal Government last week (12 December).
Set against the backdrop of a broader examination of Commonwealth, State and Territory, and local government responsibilities, the Issues Paper on Health outlines where efficiency and flexibility in the health system could be improved to deliver better health outcomes for all Australians.
Better alignment of responsibilities
Australian Healthcare and Hospitals Association (AHHA) Acting CE Andrew McAuliffe said the discussion provided the opportunity to better align responsibilities for the delivery of primary and hospital care services to patients.
"For too long, fragmentation of responsibilities between levels of government has contributed to inefficiencies in the health system," McAuliffe said.
"Multiple funders and service overlaps and gaps result in confusion and makes the system difficult for consumers to navigate.
"Reducing uncertainty and streamlining responsibilities will undoubtedly improve the efficiency of the health system, which in turn will help address health inequalities and improve health outcomes for all Australians."
Reform "hand-in-hand" with funding
While the Government has previously stated that Reform of the Federation will be closely aligned with a reform to the Australian taxation system, little consideration is given in the Issues Paper on Health of the need to match funding with service delivery obligations.
"The Commonwealth Government has previously recognised the fundamental relationship between revenue raising capacity, service delivery responsibilities and accountability to the public. The White Paper acknowledges that the States and Territories bear the cost of an inefficient system," McAuliffe said.
"It is essential that the Commonwealth ensures that any options proposed for reform within health are considered hand-in-hand with the need for sustainable and durable funding."
