In part 10 of Croakey’s election series, Professor Peter Brooks, a prominent advocate of health reform and director of the Australian Health Workforce Institute at the University of Melbourne, says the national broadband network and e-health are vital, not only for improving health service delivery but also health education.
Peter Brooks writes:
At least in the health area, we have a stark contrast between the major parties – back to the future with the Liberals – with a focus on more hospital beds and specialist acute services, while Labor will continue to develop its plans for health professional role expansion, GP superclinics and developing the prevention agenda.
The addition of the new rebates for telemedicine consultations for rural and remote and outer metropolitan patients is a real winner, although it is too little and doesn’t start until next year.
It is, however, a start and when evaluated will (as in other countries) be shown to be cost effective, particularly in terms of time taken for patients to travel to specialists. The next phase has to be to developing teleconsultations from remote sites and this seems to be envisaged with the video links with Nurse Connect programs.
Now we are talking 21st Century stuff – this is certainly going on around the globe – and will develop here, as long as we have the appropriate means of sending large amounts of data through the ‘ether’.
This, of course, will depend on a National Broadband Strategy, which is as important to advancing the health care system as it is for increasing the education and productivity opportunities for this nation. (Just in case though, this correspondent has a large amount of firewood put aside so that he can communicate by smoke signals with the outside world if the NBN does not go ahead as a result of the election).
Telemedicine will be driven by consumers who, at last, will have the opportunity of contacting doctors and other health professionals when they need advice and not be placed on a “waiting list “ be it for a GP or specialist consultation.
Certainly there are issues of confidentiality, billing and indemnity, but these have been addressed in other jurisdictions and solutions will be found here as well.
We are well “bedded” in Australia when you compare us with other countries – we need to use our beds better – like the surgeons in NSW who have reduced waiting lists to zero in some parts of the system – not by having more beds, but by doing things differently. Some 5 years ago, the Productivity Commission suggested that the health system (hospitals in particular ) were about 20% inefficient. This needs to be urgently addressed. Perhaps the MyHospital website will help, but only if real outcome data is posted on the website.
We still need to better develop the prevention agenda – how do we move that portion of the health budget that we spend on prevention (around 3 %) to something that is meaningful and starts to have an impact – say 15-20%.
We could then compete with Vietnam and Cuba which put nearly 25% of their health budgets into prevention – now we are talking serious prevention stuff.
We also need much more engagement of consumers – and some real efforts probably in conjunction with the education (schools) system to seriously increase health literacy.
These initiatives may be assisted by the E Health agenda which, as well as delivering health services, has the potential to deliver health education as well.
This may also be adapted for the aged care sector – not really discussed by any political party, but desperately in need of reform.
Here is where consumer choice, use of technology to maintain folk at home as long as possible and creative ways of funding is sorely needed. How society is going to cope with the very significant increase in those over the age of 65 is still not clear and needs to be urgently addressed by the incoming Government.
This is a great opportunity to use the strengths of the public and private sectors with active consumer engagement to create a new way of approaching ageing Australia
We know that the costs of health will increase significantly over the next 2 decades but no party is really addressing the “elephant in the room”. This is the way health is funded – an uncapped fee for service system which has few controls on it. The gap payments are becoming a major issue and are starting to impact on the access to health care for increasing numbers of Australians .
We need a vigorous campaign – Mind the Gap – to address some of these inequities and maintain equity and access to quality health care all Australians.
To see the previous posts in the election series: