Professor Mike Daube, Professor of Health Policy, Curtin University of Technology:
“There are some good things in the report – from the commitment to tackling inequities to the emphasis on prevention.
What seems to be missing, a year on from the Commission’s establishment, is final conclusions on Commonwealth/State relationships, and how new funding can be found for the areas where it is most needed. It is to be hoped that this will emerge from the final report, and that the report will appear soon enough that the Government can act on it before the next election.”
***
From a NACCHO statement quoting chair Dr Mick Adams:
“The Commonwealth taking more responsibility for primary health care must come with the government accepting greater accountability for its actions.
As the main deliverer of primary health care to Aboriginal peoples the Aboriginal community controlled sector is already largely a Commonwealth responsibility.
However the government’s accountability for its decisions and performance is non-existent. We need performance benchmarks for governments to ensure our services have the resources to fully match our community’s health needs.
The Aboriginal community controlled health sector, representing over 145 urban, regional and remote services with over thirty years experience in frontline care, is subject to the whims of the Commonwealth’s Office of Aboriginal and Torres Strait Islander Health with little input from our sector, least of all in setting policy direction.
Our sector welcomes the Commission’s endorsement of the Aboriginal community controlled health service model and its proposal to expand it while recognising that the Commonwealth’s allocation of resources to Aboriginal health services is insufficient and that Aboriginal people are underserviced.
The Aboriginal community controlled health sector welcomes the opportunity to be part of further deliberations on the Commission’s recommendations and to be full partners with governments in designing and delivering services for our people.
We believe that Aboriginal people’s full participation in the health service design, delivery, monitoring and evaluation is integral to improving health outcomes for Aboriginal people.”
**
Dr Jenny May, National Rural Health Alliance:
“We welcome any simplification of the current system as a means of putting an end to the blame game. Today’s interim report offers a prescription for improving the health of more than seven million Australians in rural, regional and remote areas, but it remains to be seen whether there is money in the till to buy the product and people on the ground to deliver it.
As one would expect there are still large gaps but the sentiment is clear – assistance with PATs, MBS top-up and flexible workforce options are all ideas floated today that have the potential to deliver better health to rural consumers. The big issue of governance needs further work and we look forward to participating in the robust discussion that needs to follow.”
**
Prue Power, Australian Healthcare and Hospitals Association:
“The Commission’s findings reflect AHHA’s longstanding concerns that years of under-funding have left Australia’s hospital sector unable to meet the growing demands for care from the community. We strongly support the Commission’s finding that: “hospitals are under severe pressure, directly influencing their ability to provide safe, high quality, accessible and timely care to all patients.” (Pg 117)
The report also validates AHHA’s repeated calls for increased investment into primary and community-based care in order to prevent the high numbers of avoidable hospital admissions currently experienced by public hospitals.
AHHA supports the Commission’s recommendations for increasing accountability and transparency of the hospital sector. This can include setting targets for key outcomes, such as emergency department access, and tying financial incentives to these targets. However, it is vital that these targets take account of events outside of hospitals’ control – such as natural disasters – so that hospitals are not unfairly penalised for taking on this responsibility.
It is also vital that sufficient resources are allocated to hospitals to enable them to reach the targets and that the very different caseloads of public and private hospitals are considered when comparing performance across these sectors.
AHHA agrees with other recommendations in the report, including the need for more data collection and analysis across the hospital sector. In fact, we have developed some practical strategies for achieving this in our policy paper Data and Benchmarking, which has been made available to the Commission.
The call for a greater emphasis and nationally coordinated approach to clinical leadership is also supported by AHHA members who have previously called for similar measures.
AHHA will be providing more detailed feedback on these issues to the Commission after consultation among our membership and looks forward to working with the NHHRC to further develop their recommendations in the final report.”
**
Libby Muir, ANF:
The ANF broadly supports the shift in focus to PHC and keeping people well, instead of the current situation where people are unnecessarily admitted to hospital when they could be cared for in the community or prevented from getting sick in the first place. We maintain the PHC model won’t work if the people cared for by nurses, particularly nurse practitioners are only able to access rebates for that care where doctors are scarce and where the skills of the whole health team are not adequately used.
Nurses are not a stop gap for doctors and doctor centric care will only limit the options people have for accessing high quality, people focused health care. Nurse practitioners and other health professionals must have PBS in all areas. Nurses do nursing work, not doctors’ work, they do things that doctors can’t do and vice versa, as is the case with all health professionals.
We have to look more closely, but we are fairly supportive of the report and the health education and prevention direction that the NHHRC is taking, but would like more information about proposals in aged care and in workforce.
It’s encouraging to note the Health Reform Commission recommending access to dental care being universal under their proposed Denticare. What is very disappointing however, is the complete failure of the Commission to recognize that their plan is grossly inequitable, despite it being an improvement on the current appalling situation.
Fee for service access under Denticare means that those people who live in areas where there a few or no dentists will receive little or nothing. Allowing private health insurance cover means that access will be like access to hospital care is now ie if you can afford the extra cost for private dentists, you wait a month, if you can’t afford insurance, you wait a year or more. The proposal does not limit private dentists charging what they will. Where is the equity in these proposals?
Dr Tim Woodruff
President
Doctors Reform Society