The National Health and Hospitals Reform Commission report is not perfect but represents the best way forward, says Tony McBride, Chair of the Australian Health Care Reform Alliance, that is seeking major change in the Australian health system to make it more equitable, accessible and sustainable.
He has filed this report for Croakey:
“Yesterday was a noteworthy day in Australian health politics, for various reasons.
First, we were presented by the National Health and Hospitals Reform Commission with the most comprehensive analysis of the entire health system we have ever had. Certainly we may not all have agreed with every recommendation, but few would have argued with this analysis of the flaws in our current system. Indeed much was culled from the words of the system’s myriad critics over the last ten years. Announced significantly by the Prime Minister, this analysis is now very much the core currency of the coming health debate, with recognition from the top.
Second it is the most coherent, legitimate and (because of its source) powerful call for a national health system and the end to the Blame Game. We have known this for 20 years but it is now mainstream, not whispered about in corners at health events as necessary but really a political impossibility.
For that change we have to thank many, but two people especially. Professor John Dwyer’s persistent advocacy and naming of the Emperor’s clothes led to the formation of the Australian Health Care Reform Alliance and ultimately the ALP policy to establish the Commission. But we also need to recognise the courage of Nicola Roxon for having the nerve to set up the ALP policy for reform in the face of many doomsayers.
Of course despite the call for the Commonwealth to run all of the primary health system, the proposals do not yet add up to a national health system (and some including no doubt John and many of AHCRA’s members) will be disappointed by that.
However, few will doubt the wisdom of a system where GPs, community health services and other allied health practitioners are all funded under the one set of policies and funding. And there is much to be said for the Commonwealth having a transparent stake in hospital funding (40%), giving it an incentive to maximise prevention.
But the final decisions have yet to be made – there is a consultation to be had – although the political boundaries of change are fairly easy to discern in Rudd and Roxon’s comments.
Third, the report represents both the broadest set of recommendations for change we have seen for decades, and also a set based on some commonly held values. For example, even if not all of the 123 proposals are perfect and some are missing, many of the report’s recommendations represent valuable pieces of the jigsaw towards a more equitable health system including multidisciplinary primary health care services, equitable funding for rural areas, greater investment in Indigenous health, a universal dental scheme (albeit with some reservations about the model), and a network of youth mental health services.
AHCRA also welcomes the proposals to make the health system more person-centred. These include offering aged care service recipients choices about whether to receive home of residential care, stronger indigenous control over health services, better quality information for consumers and stronger voices in their own health care, and more community engagement around policy and resource allocation decisions.
Of course the government’s blind spot is around private health insurance and the wasteful rebate. Yet even there some movement has been visible in the last Budget.
In my opinion this report offers the best opportunity for significant improvements in the way our health system is run for decades. Not perfect for sure, but streets ahead of anything we have seen for decades. Yet it will have many critics.
We need to make sure that we both keep the pressure on the government to improve this suite, but also provide vocal support and encouragement so they don’t end up seeing it as to hard. Lastly we need to ensure the final detail mirrors the Commission’s valuable core principles, not its more satanic counterparts.”