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CoAG + health reform « Previous | |Next »
March 25, 2008

CoAG meets in Adelaide tomorrow and it appears that the Rudd Government is using this as a way of governing the country and pushing the modernizing agenda --to make CoAG a reform workhorse. The suggestion to widen the CoAG agenda to include financial regulation of margin lending, mortgage brokering and non-bank lending indicates that. It's about time that kind of national financial regulation happened.

Is CoAG picking up on the older National Reform Agenda on which little progress had been made under the Howard Regime? Is the older strategy of incentive payments pioneered under National Competition Policy going to be used?

Health will also be on the agenda. The signs indicate that the commonwealth's emphasis will be for more accountability from the states on health, insisting they accept tough performance reporting requirements to demonstrate efficiency in spending commonwealth money. No doubt the NSW Lemma Government will continue to resist with spurious arguments.

The signs are there that here will be a push of a national registration and accreditation scheme. The AMA has come out in opposition as is expected. They have a history of opposing major reform that undercuts their power as the gatekeepers of the health system. That power must be defended at all costs. It is a totemic political issue.

Some of the proposed reforms are long overdue such as paying the states to clear the nation's hospital wards of 2000 elderly people who are occupying valuable bed-space but who should be in nursing homes and nationally harmonized occupational health and safety legislation.

| Posted by Gary Sauer-Thompson at 7:49 AM | | Comments (6)


You say "demonstrate efficiency in spending commonwealth money".

Any thoughts on how this efficiency should be measured? There's the problem that mere throughput might be rewarded rather than measuring impact on the well-being of the population as a whole.

I'd love to read suggestions for appropriate (and inappropriate) metrics.

it should be effective as well as efficient as there is a need to reduce adverse events in public hospitals.

On the efficiency measurement issue I haven't seen any proposals in public so I do not know how they are going to address the throughput/wellness problem.

You can address wellness negatively: reducing adverse events in public hospitals and keeping people well from chronic illness through good primary care so that they don't end up in the emergency departments of public hospitals

I see that the nurses have criticised the Australian Medical Association President Rosanna Capolingua opposition to the push for national registration. The AMA arguing doctors should remain independent from government in setting accreditation guidelines.

So how does the AMA propose to prevent rogue doctors such as Graeme Reeves, the so-called Butcher of Bega, who is accused of mutilating women while practising as a gynaecologist?

How does the AMA propose to deal with the code of silence among doctors over bad conduct?

yes the AMA is opposed to any government control over the national registration and accreditation scheme for doctors. They want to continue with their self-regulation. Anything else is anathma.

it would appear that the Rudd Government and the states are willing to stare down the AMA---the most powerful union in the country. That would be circuit breaker.

If you're right about that and they succeed it will be a major achievement.

Self regulation doesn't work anywhere, but self regulating the size and shape of cornflakes is one thing, self regulation among scalpel wielders is another.

The case Nan pointed out is an obvious illustration. I'd also like to see what happens when an independent regulator takes a close look at cosmetic surgery.