Health consumers are seeking to put the lessons learnt from the COVID-19 pandemic into action.
Leanne Wells writes:
Much health policy decision-making is a contest between government and the powerful vested interests in health. That poses a constant challenge to ensure the interests of the most important player, the consumer, are not squeezed, or in fact squeezed out, of the process.
It’s why Australia needs a consumer health leaders academy which would draw on the skills and expertise of our national health consumer network to equip advocates with the knowledge and leadership to work for the best interests of consumers.
The academy concept is a central recommendation of the Consumer Commission, established by the Consumers Health Forum of Australia (CHF) in July to identify and develop the lessons learned from the COVID-19 experience.
The Commission, comprising 30 consumer and health leaders from around Australia, has produced a report which draws on the strength of consumers and their experience with health care and the system.
It is often overlooked that it is consumers and particularly those with chronic conditions who are more likely to experience all aspects of the health system than most health care providers.
Consumers’ lived experiences are critical to understanding what works, where the gaps are, and what changes are needed to improve outcomes.
In its report, Making Health Better Together, the Commission has made 23 recommendations, identifying six key areas for change:
- Mental health
- Integrated care and coordination
- Health equity
- Digital health
- Governance and national leadership
The report gives strength to existing initiatives of CHF, including the development of a national social prescribing scheme to provide the supports for GPs and other health providers to link patients with chronic conditions to social service.
The best health care is that which meets the individual needs of individual patients, an ideal which would be helped considerably by a national network of care coordinators which the Commission recommends.
We saw how the pandemic touched the lives of everyone and set off big changes in the health system. Yet often care was delivered without much consultation with the most important stakeholder – the patient/consumer.
While this rapid development may have been of necessity, there was nonetheless room for better outcomes where the community and consumers could have been more directly consulted in terms of public health education and system management.
The experience highlights the need for us to build consumer leadership through a consumer academy that would enhance partnerships between consumer organisations and other sectors.
A striking example of the paralysis caused by competing interests is the disconnected health system. While consumers want integrated, joined-up health and social care, the reality is that most parts of care continue to operate in silos, impeding effective care.
Funding is a key factor that drives behaviour with the fee-for-service model incentivising a more transactional approach that doesn’t meet the needs of many people.
The Commission report reinforces our advocacy of primary health care reform and of the need for a rethink of the divided and dysfunctional federal and state health funding arrangements that fail to focus on best outcomes for patients.
The report proposes pooled Commonwealth-state funding for joint planning and commissioning of health services.
The Commission’s proposal is that the Commonwealth Government should establish an independently governed national health consumer leadership academy, with co-support from states and territories and other contributors.
The academy would be a key component of the health system, supporting consumer leadership, qualifications, mentorship of emerging consumer leaders and advocates, and networking opportunities to amplify the consumer interest.
It also recommends that all governments provide more training, resources and support to health consumer organisations to build leadership capacity and capability among consumers and providers, influence decision making through partnership approaches and produce evidence of consumer sentiments and lived experience to inform health policy.
CHF has laid early foundations for the Academy with the development of our Collaborative Pairs program which has shown that, with the right preparation, consumers and clinicians can work together effectively for better services. The scheme has been evaluated as a national demonstration project.
The Commission report has brought home to us how inextricably linked the population’s health is to economic health, inequality and overall wellbeing across the community.
Invest in prevention
Australia would achieve huge fiscal and physical benefits long term by lifting preventive health spending to at least five percent of the health budget.
The report recommends the establishment of an independent expert committee along the lines of the Pharmaceutical Benefits Advisory Committee which makes recommendations and the government acts on that advice as to where preventive health funding should be spent.
The Commission proposes that the Government adopt a Health in All Policies approach and an overarching wellbeing framework that embraces cross-portfolio social determinants as the basis for improving health outcomes. This should include a wellbeing budget and a national report card to track performance against key wellbeing metrics.
Given so much of our lives is now measured or governed in metrics, why should we not apply such contemporary measures to fostering wellbeing in Australia?
Leanne Wells is Chief Executive Officer of the Consumers Health Forum of Australia.