Reform Alliance has responded to Health Commission report

24 February, 2009

The Australian Health Care Reform Alliance (AHCRA) has welcomed the interim report from the National Health and Hospitals Reform Commission this week.

“Many of the directions outlined in the report reflect the concerns of health professionals and consumers with regard to the current failings of the health system,” AHCRA Chair, Fiona Armstrong said.

“The emphasis on primary health care to address people’s health care needs throughout their lifespan, and keep them well, with the establishment of multidisciplinary primary health care centres close to where people live, is strongly supported,” Armstrong said.

“There is strong evidence for this; most other countries are endeavouring to do it – not only to reduce the burden on individuals, but to prevent social exclusion, reduce costs on the health system, and maintain national productivity – because illness prevents people participating in employment and community life.”

AHCRA welcomed other recommendations with regard to improving the safety and quality of care through performance monitoring; and addressing inequities in rural and remote health, mental health, Indigenous health and dental health.

However the absence of recommendations to improve the equitable distribution of health funding, and address the anomalies that arise out of health funding from public and private sources was disappointing.

“There has been an unwillingness in this report question the current mix of health care resources raised through taxation, private health insurance, and out-of-pocket contributions,” Armstrong said.

“Is this the most cost effective and efficient way to fund health care? There is a lot of evidence to suggest that it isn’t, and that revenue raised through taxation, for everyone, is the most equitable, and cost effective way to fund health care.”

While the introduction of national insurance for dental services was welcome, the mechanism of delivering the funding through the flawed fee-for-service model would only entrench inequity, Armstrong said.

“Tackling this gap with a faulty funding mechanism is not the best way to give teeth to these health care reforms."

“The current funding and governance of the health system is one of the major flaws in the current system, so it is disappointing that it forms just one, latter section of the report. This is the part of the health system that needs major surgery. It’s not an optional element of reform – and it needs to be tackled first and foremost in order to give direction to other reforms.”

In addressing health system funding, the Australian Government should take the advice of the Commission in establishing a mechanism to ensure health care priorities are informed by clinical, economic and community perspectives, AHCRA said.

“Given the quantum of funds spent on health care, it is vital that we determine, as a population, what our priorities are for that care,” Armstrong said. “The recognition of this, and the importance of improving health literacy and bringing the focus of health care back to individuals and communities in the report, is welcome. This must be underpinned by a funding and governance system that will make it happen.”