Health reform is generating much activity and interest right around the world. What can we learn from the experiences overseas?
Dr Mary Haines, Editor of the Hospital Alliance for Research Collaboration (HARC) eBulletin, has been investigating the lessons from the UK.
She has filed this report, based on the latest HARC eBulletin, released today:
“For those unconvinced about the merits of attempting health reform in Australia, recent success of reducing hospital waiting times in the UK suggest some cause for optimism.
In the late 1990s and early 2000s when significant healthcare reform was implemented in the UK, health care providers were concerned that the reforms may disproportionately advantage higher socio-economic groups.
A recent study published in the British Medical Journal, profiled in the HARC eBulletin released today by the Sax Institute, suggests that healthcare reform reduced inequality in waiting times for elective surgery.
This study examined the question: did the reduction in waiting times for elective surgery between 1997 and 2007 differentially benefit patients in hospitals in more affluent areas compared with those in lower socio-economic areas?
The study found that in 1997 there was a significant positive association between waiting times and hospitals in lower socio-economic areas (i.e. the lower the socio-economic area of hospital, the longer the waiting time).
But by 2007 variation in waiting times became more uniform across different areas: the reforms actually reduced inequality of access to hospitals.
Much has been written about the UK government’s ambitious 10 year health reform agenda that involved measures such as: increasing the supply of doctors, increasing funding for the health service, setting rigid waiting time targets, and introducing market based reforms.
It is not clear what aspect of these reforms led to the reduction in waiting times. But what these results do show is that the “reforms have not had a deleterious impact on the equity of waiting times for elective surgery in England”.
Embedding evaluation into the roll out of changes in the health system helps clear the air about who are the beneficiaries of reform actions.”
• The HARC (Hospital Alliance for Research Collaboration) eBulletin, is produced by the Sax Institute partnership with the NSW Clinical Excellence Commission and the Greater Metropolitan Clinical Taskforce.