In part 7 of a Croakey series on election policy, Professor Mark Harris, Executive Director of the UNSW Centre for Primary Health Care and Equity, writes that we still need to hear much more from the major parties about their plans in health.
Mark Harris writes:
“Labor has begun on an ambitious process of health reform including reform of primary health care. There are some clear strategies including more integrated services and restructuring of primary health care organizations with more focus on service delivery (including afterhours). It will invest in a national phone line and support increased after-hours care directly (rather than through Medicare).
Broader initiatives such as e-health and better integrating Commonwealth and State health services are laudable but difficult to achieve, require collaboration with the states and take time to implement.
We are still waiting to see how general practice and state funded community health services will be integrated and just how the new primary health care organizations (unfortunately called Medicare Locals – “Is this where I get put my claims forms in?”) will be structured and function.
The Liberals have not presented a coherent health strategy. They plan to dis-invest in Superclinics, e-health, and coordinated care for diabetes and to invest in general practice through Medicare items for afterhours care, longer consultations and practice nurses (offset by reduced direct funding for nurses) and some funding for infrastructure for existing practices to provide teaching and more comprehensive services.
Their major initiative is in mental health with funding for more beds, early psychosis intervention programs, “headspace” services for young people. In this they really stole the march on Labor, although it is not clear where the workforce to support these services will come from.
The Greens policies are broader but less specific. Their major difference from the other two parties is their plan to introduce a Commonwealth Dental Health Program for low income earners and their families and fund dental health through Medicare. Their broad goals suggest they are unlikely to frustrate Labor’s proposed reforms in the Senate (including proposed reforms to private health insurance rebates).
The major medical organizations have not clearly declared support for any party’s policies. The AMA has called for indexation of Medicare, supported Liberal proposals to increase GP rebates but opposes dropping e-health. The RACGP has welcomed increased rebates for long consultations and practice nurses but supports e-health and has called for more action on Aboriginal health. The national Rural Health Alliance has scored the Green’s policies highly and RDAA has decried the lack of attention by both Labor and Liberal on rural health issues in this election.
Unfortunately the debate [between Minister Nicola Roxon and her Opposition counterpart Peter Dutton] did not really resolve these issues. There are some clear differences – on issues such as e-health.
In the last week of the campaign it would be refreshing to hear more about exactly how the parties plan to achieve better integration between Commonwealth and state health primary health care services to “end the blame game”, maintaining Medicare as a Universal system, dental health and encouraging better uptake of preventive health care by adults (eg colon and breast cancer screening).”
To see the previous posts in the election series:
http://blogs.crikey.com.au/croakey/2010/08/13/beyond-the-election-horse-race-kicking-off-a-health-policy-series/
http://blogs.crikey.com.au/croakey/2010/08/13/a-comprehensive-analysis-of-election-health-policies/
http://blogs.crikey.com.au/croakey/2010/08/13/kellie-bissets-insightful-analysis-of-election-health-policies-dont-miss-this-piece/
How do the major parties stack up on general practice policy?
The Govt & Opposition get a big fat F when it comes to obesity control
In this final week it would be great to hear what the major parties propose regarding the future of the National Bowel Cancer Screening Program. The program was launched back in 2004 when Tony Abbott was health minister and Julia Gillard was shadow health minister, yet six years later it still falls way short of NHMRC and WHO guidelines.
Only the Greens have put their hat in the ring with a promise to expand the program, currently only available to those aged 50, 55 OR 65, to include two more age groups – the 60 and 70 year olds – and a move towards re-screening by 2012-13. They should be commended for that.
In the meantime the future of this fledgling program looks bleak with no strong commitment from Labor or the Liberals to extend funding beyond the end of this year.
What a shame when at full implementation it has the potential to save 30 lives per week.