Introduction by Croakey: The needs of people who are experiencing financial hardship and other forms of disadvantage must be prioritised in health reform efforts, according to Dr Elizabeth Deveny, Chief Executive Officer of the Consumers Health Forum.
Consumers MUST be involved in all stages of system and service reform – from the very beginning of the policy development to implementation and evaluation, she says, while also underscoring the importance of building health literacy.
“We don’t teach anyone how our whole health system works – not even our clinicians – so this is a foundational piece for any system reform,” she says. “It’s important that everyone knows how the system works right now and what changes will mean in the future.”
Elizabeth Deveny writes:
You know the old saying ‘be careful what you wish for’? Well here at Consumers Health Forum (CHF) we wished (and actively campaigned) in the lead-up to the Federal Budget that the Government would listen to the voice of consumers.
And I’m happy to say they did. Overall, consumers were pleased with the depth and breadth of health reforms announced by Health Minister Mark Butler, especially moves aimed at reducing the cost of going to a GP or getting medicines.
However, now the hard work begins.
To enable consumers to have a say about the design and implementation of various Strengthening Medicare reforms, we need to support, educate and activate them. We need all parties – the funders, the providers and the clinicians – to listen to consumers who repeatedly say the health system is broken and doesn’t meet their needs.
This is especially true for consumers who experience significant disadvantage – be it financial, social or ill-health – as they will need more support to understand what the changes mean to them.
This was very evident at the ACOSS post-budget event in Sydney last Monday (15 May) where various panellists, including me, discussed the likely budget impacts on people experiencing poverty and inequality.
Many everyday citizens spoke about the large part of their income that goes on health-related expenses, and how government efforts to reduce these costs may be more significant for them than changes to their electricity bills or rent.
We must ensure that these newly funded health services go to those who are experiencing financial disadvantage as a priority, and this is why consumers must have input into the eligibility criteria and service models as they are developed.
The people who ‘fall between the cracks’ of the system also need to be heard.
For instance, a young Adelaide woman told her story directly to the Minister at a CHF roundtable last week. Having lived with severe arthritis since the age of four, she can’t work due to her disability but she doesn’t qualify for NDIS support, and so she can’t afford regular out-of-pocket costs for the allied health services she needs such as physiotherapy and psychological support.
She and other consumers also spoke of the gaps between the state-funded hospital system and the federally-funded primary care system; the huge divide between those who live in cities and those who live in rural and remote areas; and the increasing divide between those who are digitally savvy and those who are not.
Lived experience matters
Now we can’t solve all these issues in one budget but just having the Minister listen to these stories of lived experience was heartening.
This is why consumers MUST be involved in all stages of system and service reform – from the very beginning of the policy development to implementation and evaluation.
We don’t teach anyone how our whole health system works – not even our clinicians – so this is a foundational piece for any system reform. It’s important that everyone knows how the system works right now and what changes will mean in the future.
CHF has been funded to do a little bit of that health literacy work, but I would humbly suggest it won’t be enough to support 25 million Australians through these changes. While CHF was very grateful to be recognised in the Budget to do this work, our annual funding amounts to just over 10 cents per Australian.
We will be working very hard to provide resources and capacity building for consumers and we are really looking forward to collaborating with other organisations – including funders, providers, clinicians and other peak groups – to help Australians understand and get the full benefit of the changes governments put in place.
Consumers also want to see that all new programs are knitted together. They need the system to be joined up so they can find their way to and through.
It’s critical that the oversight is there to ensure new programs don’t create further complexity in our already fragmented healthcare system. While we might say that our system is the best in the world, we also know that it’s almost impossible to navigate.
Beyond luck
Too many Australians talk about being ‘lucky’ if they’ve managed to get good healthcare. Why ‘lucky’?
While the service you receive may well be high quality – good luck finding it and getting to the front of the queue.
I would suggest it is not luck at all. It is a matter of knowledge, your ability to afford out-of-pocket costs, and even what postcode you live in, as location often determines the availability and quality of the service provided.
While the Albanese Government should be commended for its extra investment in health services for residents in the bush, as well as for First Nations people, no one should say they’re lucky they got good healthcare.
This is a basic right for every Australian and, as the Government leads well-overdue reform, all parts of the system need to make sure that it’s more than luck that drives good care.
• Dr Elizabeth Deveny is Chief Executive Officer of the Consumers Health Forum of Australia
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