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Health: reform on the way? « Previous | |Next »
April 23, 2004

A CoAG ministeral meeting about health care took place in Canberra today. Mark Metherell at the Sydney Morning Herald has some comments. He says that an alliance of 22 national health groups will challenge the ministers to investigate proposals for a single funding system and report back by July, only months before the federal election. Some have been advocating such ideas for many a long time.

The Australian Health Reform Alliance have proposed the creation of a Central Australian Health Commission to end blame-shifting between States and Canberra. The new body would hold Australia's health budgets in a single account and be responsible for running hospitals and all facets of care. The plan mirrors South Australia's Generational Health Review, which mooted a joint Federal/State Commission.

The public health system has become increasingly dysfunctional, health care services are rapidly deteriorating, whilst the Canberra state divide has become a major barrier to reform. What is needed are fresh ways to end state-federal fights over funding that is based on divided responsibilities

We also need to address the divisions between hospitals and community care. Current funding is based on hospital bed use when the trend was towards reducing hospital stays. And there is a need to reduce dependency on hospitals and maximise preventive care by doctors and community-based services.

The background to this move for reform is this. It gave rise to this, which was based on the papers of the 1993 Health Care Summit

It was in this context that I read Julia Gillard's speech to the National Press Club. After saying that Australians want a world-class health system with a universal Medicare at its centre Gillard says that:

"Australians know our health system needs reform, real reform. The Howard Government knows that real reform is required - but instead they go for band-aid solutions, because deep down they do not want and are philosophically opposed to Medicare. They want to dismantle it, and they will - if they are re-elected. Saving Medicare and implementing real health reform can only be done - and will only be done - by a Latham Labor Government."

Most of the speech is political in tone and intent as it is concerned to paint a partisan picture of how the Howard Government promises a lot but delivers nothing eg., calling Medicare Plus Medicare Minus.

So what does Gillard propose by way of real health reform other than saving Medicare?

She mentions the ALP plan to get doctors bulk billing again, their Australian Dental Care plan to get half a million Australians off dental waiting lists and into dentists' chairs, and their plan to bring Medicare Teams of doctors and nurses to health hotspots around Australia.

That looks more like conserving Medicare to me than real health reform.

There is a commitment to the principles of primary health care, a recognition that burden of disease in modern Australia lies in chronic conditions such as mental health, and the end of cost shifting through a pooling state and commonwealth money.

Good ideas. Can the ALP deliver? Will the hard hearted straightners in the ALP stand aside for the reformers?

| Posted by Gary Sauer-Thompson at 2:13 PM | | Comments (2)


What's interesting and a source of hope here is that the investigation of the reform proposals is being sponsored by the health ministers. In the rounds that I was involved in back in the 90s, the leadership was coming from the central agencies, and the ministers were the main blockage. Looks to me that, at last, they just can't take it anymore.

it does appear that the ministers have had enough and want something to be done.Public health cannot be handled with just a clever media strategy.

Maybe the Ministers have come to realize that the neo-liberal strategy of efficiency efficiency efficiency has run its course. That strategy got them a decade, but there is no more fat left to trim in the public hospitals.

And the Minsiters cannot push too much more in the privatisation of public hospitals, since that hits up against the wall of political reality. Australians want to keep public health and are willing to pay increased taxes to do so.

So rationalization through Hawke's cooperative federalism is recovered from the early 1990s. Only this time it is the health ngo's pushing the Ministers, not the bureaucrats.