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    Raymond Bange

    An excellent collation of policy issues and proposals for study and potential change.

    Give them their due – the government of the day has addressed the need for change in a number of ways despite incredible myopia and opposition at times, vested interests and financial pressures from the knock-on impact of externalities.

    Through their support for review, establishment of agencies like Health Workforce Australia and other positive policy moves such as disability care the government has opened up the debate and initiated change to a greater extent than many appreciate.

    The challenge will be to implement some of the proposals already being explored and to break down the existing barriers that inhibit change and innovation.

    One matter I have observed in my association with the paramedic health workforce is the extent to which there remain silos of interest and the gulf that often exists between primary care and later stage care.

    Paramedics constantly work with people in everyday circumstances including those affected by minor ailments, or more serious cases involving drugs and mental conditions, cardiac events and trauma. Yet the critical healthcare in the transition from everyday life to definitive care is often forgotten.

    Healthcare begins with the patient and not at the hospital or clinic door, and the funding and integration of paramedic services and emergency care as part of an holistic and systemic approach to healthcare is rarely mentioned.

    That’s probably the critical issue – the need to consider healthcare as a system with a focus on patient outcomes and community benefit applied across a bewildering array of settings and inequities that have developed over many years.


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