There are a few inconsistencies in the National Health and Hospitals Reform Commission report. It puts great emphasis on maintaining the role of private health insurance, for example, while also acknowledging that “there are increasing concerns that a two-tiered health system is evolving, in which people without private health insurance have unacceptable delays in access to some specialties such as cataract surgery and joint replacements”.
The National Aboriginal Community Controlled Health Organisation (NACCHO) has identified some more inconsistencies in the report, including the difference between the high profile given to Indigenous health – the first major issue covered in the executive summary – with the actual depth of considerations around this issue.
NACCHO has just put out this statement:
“While Aboriginal health is seen as a priority by the National Health and Hospital Reform Commission, its central recommendation of a Health Authority to aggregate Aboriginal health funding and purchase services is barely developed in its report.
Dr Mick Adams, chair of NACCHO, the peak body for community controlled Aboriginal medical services said, “The National Aboriginal and Torres Strait Islander Health Authority concept is an interesting option we have discussed within our sector and it would have assisted if the Commission had further explored a range of models for it”.
“There’s no detail on how the $58 million Health Authority might work to ensure Aboriginal people’s role in setting the priorities to improve our health for example.
“Our sector welcomes the chance to work to improve the Authority idea. We will be wary that implementation of the Authority’s purchaser provider model doesn’t disadvantage Aboriginal community controlled health services’ holistic model of care.
“We don’t want something similar to the massive disruption to Aboriginal Legal Aide services caused by introduction of tendering of services.
“There is a clear contradiction where Recommendation 59 argues for ‘a substantial increase on current expenditure’ to match the level of need in the Aboriginal and Torres Strait Islander community yet it then claims (page 266) no increase is required due to recent COAG funding.
“NACCHO sees much of this COAG funding for Aboriginal health is committed to supporting mainstream GP services at the expense of being able to expand Aboriginal community controlled health services for the more disadvantaged patients.
“We welcome the Commission’s recommendations to address financial barriers to good dental health which have seriously affected and added to the burden of disease in our communities.
“NACCHO is interested in the ‘health care home’ concept (Recommendation 18 p256) enabling young families, Aboriginal and Torres Strait Islander people and people with chronic and complex conditions to register at a single a single primary health care service attracting funding to support multidisciplinary services, care coordination and funding to keep people well. It could fit well with our sector’s comprehensive primary health care if it also recognises our local community controlled governance model.
“The initiative to better coordinate training and accreditation of health professionals also deserves further examination especially in supporting more Aboriginal and Torres Strait Islander people to gain qualifications.”