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September 9, 2009
Building a 21st Century Primary Health Care System says that it provides a road map to guide future policy and practice in primary; that represents the first comprehensive policy statement for primary health care in Australia’s history; and presents the Australian Government’s views on possible future
directions for a modern 21st century primary health care system.
The right implication is that Australia has been until now, going along without any strategy or sense of direction. The draft strategy acknowledges the obvious: that the health system overall would benefit if a more systematic response from primary health care, together with more effective integration of other health sectors with primary health care, could be achieved and secondly, primary health care services have historically been delivered in a relatively unplanned environment.
Consequently, primary health care in Australia currently operates as a disparate set of services, rather than an integrated service system:
it is difficult for primary health care to respond effectively to changing pressures (such as demographic change, changes in the burden of disease, emerging technologies and changing clinical practice) and tocoordinate within and across the various elements of the broader health system to meet the needs of an individual patient.
The Strategy talks in terms of key building blocks (regional integration, Information and technology, including eHealth, skilled workforce, Infrastructure, and financing and system performance) and priority areas for change (improving access and reducing inequity, better management of chronic conditions, increasing the focus on prevention and improving quality, safety, performance and accountability).
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Isn't the Primary Health Care Initiative an attempt to redress the imbalances that have crept into the health system over the past 25 years.
Doctors do not bulk bill because its against their religion or because the payments are too low or whatever. This means that patients who can't pay $65 to see the quack have to find a bulk billing doctor. In areas where medical super clincs are being established people who want to see a doctor might wait 3 weeks for an appointment after fronting at emergency. The population of these areas can't afford $65 consultations.
The other strand is the modern trend to keep people in the community as long as possible - no longer do people want to institutionalise their disabled, dying or elderly relatives and there aren'tthe facilities. New mothers are lucky to spend 48 hours in hospital, abdominal surgery is released after 3 days