Croakey is hosting a discussion about how the new primary health care organisations to be known as Medicare Locals might engage their communities effectively in setting directions and priorities.
Scott White, from the Hunter Urban Division of General Practice, kicked off the discussion with this crowdsourcing call for suggestions, and Professor Helen Keleher, president of the Public Health Association of Australia, responded with this piece arguing for some “bigger picture” action that goes way beyond the remit of Medicare Locals.
Now Carol Bennett, Executive Director of the Consumers Health Forum, cautions against tokenism and ticking the boxes. Moves are afoot to develop a more empowered and effective consumer network, she says.
Carol Bennett writes:
It’s hard to disagree with many of the comments in Scott White’s post. Yes, hospitals have for too long been the focal point of the health reform debate; yes, a more accessible and flexible health care system is essential and; yes, community engagement is vital.
It is on this last point, however, that I would like to make some further comments. Community or consumer consultation can just be a feel-good buzz word unless it is clearly defined and more than just the tokenism that will enable the “consumer representation” box to be ticked.
For many years, CHF has placed health consumers on a wide range of important committees and consultation bodies and despite the whole hearted commitment, knowledge and expertise of those consumers, the results (as measured by the quality of services consumers receive) have been patchy.
Individual consumers on high powered committees have had little access to support networks and training and have, at times, felt intimidated and restricted by stringent confidentiality agreements and lack of access to quality external advice.
A couple of dozen consumer advocates with a limited support base, representing the many millions who use and pay for the health system, cannot possibly match large medical industry organisations with access to significant financial resources, specialist advice, research and secretarial support.
It has been an uneven playing field and hopefully that is about to change.
In the hurly burly of the recent election campaign a small announcement by the Health Minister, Nicola Roxon, was hardly noticed.
It’s a drop in the fiscal ocean but CHF has been given $2.9 million dollars (the annual earnings of some medical specialists) to establish a national network of trained and accredited health consumer representatives actively supported and engaged in the National Health and Hospitals Network. This consumer representative network and the associated resources will also support consumer participation in other community, state and national health policy forums.
For both Local Hospital Networks and Primary Health Care Organisations, the challenges are to really find out and understand what their communities need in the way of diverse health services, and to respond in the best way possible to those demands within their accepted budgetary restraints.
Each local area will have communities with different needs and requirements.
CHF’s aim is to identify and train quality consumer representatives and to supply the resources and back-up that these people need to ensure that the community voice is heard and acted upon.
A national network of well trained and experienced consumer health advocates, each sharing experiences, knowledge and problems, will be a powerful voice for those advocating for more efficient and responsive health care across the country.
Consumer engagement must be about more than listening to the views of communities or consumers; it must be about ensuring that health consumers have an accountable voice in decision making.
The dangers of “tick the box”, simplistic models of consultation are that they undermine a strong, effective community voice that can add real value to improving health services.