Some links to recent articles that may be of interest….
Health economist John Deeble doubts the PM’s claims that the plans will end the blame game, according to this piece published online by the Medical Journal of Australia. He also thinks it is a “big ask” to gain the states’ agreement by the April meeting of COAG, especially as the plans are in conflict with the concept of federalism agreed by COAG in 2008, under which the federal government would set outcome targets for broad programs only, leaving the states free to manage them.
Also in the MJA, David Penington agrees that the plan will not see the end of “blame shifting”, and warns that the proposals will leave many hospitals in “dire straits”, and that the states will have to pick up the tab for much more than the 40% envisaged in order to keep many hospitals solvent. Even in Victoria, there are 40 regional hospitals that have to operate on block grants because casemix cannot adequately recognise services they need to provide for their communities. He proposes devolution to larger regional clusters, each built around a public university with a Faculty of Medicine and Health Sciences, with the capacity to build an interface between hospitals and primary care, and to integrate the role of nurses — not only in hospitals but in community care of older people — and of physiotherapists, who have much to offer in rehabilitation and aged care, especially as cheaper subacute (rehabilitation) hospitals are developed.
The Centre for Policy Development has also published a series of articles, including one from Fiona Armstrong on the merits of integrating all health services – not only hospitals – into regional organisations, while Jennifer Doggett writes about the burden of out-of-pocket costs for patients. She cites a recent survey of people with mental illnesses which found that over half of the respondents (54%) had not been able to afford treatments recommended by their doctor, and 42% had not filled scripts for medication they had been prescribed because of the expense.
Meanwhile, in this piece published in The Canberra Times, Lesley Russell says the bean counters in the Department of Treasury have left their fingerprints all over the reform plans. “The key focus of this plan is on health-care financing: on who pays for what, and on what basis. Patients and their needs are not at the centre of this proposal,” she says.