The budget holds two particularly promising developments for health, says Robert Wells, Director of the Menzies Centre for Health Policy at the ANU.
Firstly, the mental health announcements suggest some realisation of the long-stated ambition for whole-of-government policies in health. And the emphasis on Medicare Locals in these announcements is also good news, he says.
All things considered, the budget reflects well on health portfolio
Robert Wells writes:
Ross Gittins makes the comment in the Sydney Morning Herald (11 may 2011) with respect to the 2011 Budget that ‘there’s nothing like having your back to the wall to focus your mind’.
This comment is particularly apt in relation to the health component of the Budget.
For the first time in many budgets, health has had its back to the wall and has come up with the goods.
Not only are the measures just what is called for, especially in mental health, they are targeted, challenge many of the vested health interests and are sufficiently modest in scope to have a good chance of effective implementation now.
Others will comment on specific measures – or complain about what has been left out.
I want to highlight what are two of the most promising features – the ‘whole of government’ approach to mental health; and the linking of delivery of implementation to the new reform structures, Medicare Locals.
‘Whole of government’ has been a rhetoric of successive governments since the mid ‘noughties’ and of profound pronouncements by the Council of Australian Governments (COAG).
Unfortunately the reality has been well short of the rhetoric, with a couple of exceptions.
The 2011 mental health measures correct the rhetoric/reality imbalance with a coordinated strategy across DoHA, FAHCSIA and DEEWR to tackle the social, housing and service access issues that have bedevilled attempts to tackle mental health in Australia.
This will all be overseen by a new National Mental health Council located within the Prime Minister’s portfolio.
Further, the implementation of key elements of the mental health package will be delivered through the new Medicare Locals, key planks in the primary health care reform.
Medicare Locals should be the best place to embed these new measures – the flexibility inherent in several of the measures will allow local responses to locally identified needs and in a timely way.
There are of course some major challenges ahead – not the least of which is that the Medicare Locals do not yet exist and getting them up and running as well as taking on the challenges of mental health reform will be a big ask indeed.