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‘The patient will see you now’: why we need patient solidarity as much as ever

Ahead of tomorrow’s 2015 Patient Solidarity Day, Leanne Wells, from the Consumers Health Forum of Australia, writes about why patient solidarity is not an outmoded ‘throwback’ in Australia, but central to very complex and contemporary debates on health care.

***

Leanne Wells writes:

Patient Solidarity Day occurs this Saturday, 5 December, an internationally recognised day to proclaim the principle of healthcare as a human right.

Most Australians would know that there are many parts of the world where health care, let alone the right to it, hardly exists, where many children and adults die of diseases routinely preventable or treatable in the developed world.

To Australians though the notion of “patient solidarity” may sound like a throwback to outmoded socialist concepts. Who needs solidarity when you are a developed, advanced economy and have a universal health system like Medicre?

Yet there are many Australians who don’t or can’t get the care they need for cost or reasons of location.  The Consumers Health Forum has done a significant amount of work on out-of-pocket expenses and the impact these have on access to care. We know from the official statistics that that 1 in 20 Australians delay or do not go to a GP because of cost. And many do not get prescriptions filled because of cost.

A report that CHF commissioned in 2014 found that the impact of high out of pocket costs is most profound for people who are most in need.

Most Australians would agree that the vulnerable in our communities especially those with complex and chronic conditions, should not be deterred from getting appropriate care because of the cost or other barriers to access.

So patient solidarity does live on in Australia.  It may not be seen as patients marching shoulder to shoulder to storm the hospital, but the notion of equitable access to healthcare remains a fixture of the Australian way and of the community’s expectations of its healthcare system.  It is demonstrated by the high rating consistently given to health by Australians in opinion polls.

But healthcare as a human right will seem a sick joke to some Australians, such as the 14 per cent of those with a long term health condition who are more likely than those without to report problems caused by a lack of communication between health professionals, or the many people who wait years for elective surgery, or those with mental illness who cannot afford appropriate psychiatric care because it’s only available in a private hospital.

The allocation of Government funding to health care is becoming an issue of increasing significance as expenditure continues to rise along with the availability of new treatments and the growth in chronic and complex conditions and ageing which pose fresh demands for coordinated care.

The current debate over how to reform the Medicare safety net and where that sits in relation to wider reforms such as the review of Medicare benefits items and primary care arrangements give an indication of the complexities involved in protecting people facing heavy medical bills.  A key point of the safety net was to help those on low incomes afford expensive medical treatment.  The reality has been that for a number of reasons, the safety net has overwhelmingly benefited those in better-off suburbs.

That’s but one example of the challenges in ensuring a well-meaning national scheme can deliver the hoped-for benefits in a local area.

Fortunately we are seeing developments which should deliver to consumers and patients more influence over the shape of their local health services.  The Primary Health Networks which are now responsible for commissioning local health services are expected to have greater consumer input, providing a real focal point for local influence over health care.  The new plans announced for mental health services foresee them as part of the Primary Health Networks.

Notions of ‘patient-centred health care homes’ are also gaining traction, canvassed most recently in a discussion paper produced by Health Minister Ley’s Primary Health Care Advisory Group.  That Australians, particularly those with complex and chronic conditions, could have access to a single health care destination, itself supported with the right workforce and funding mix to coordinate all their care, is an attractive proposition indeed.

In the developed world, the health consumer is taking a more active role as the evidence builds that patient-centred care delivers better outcomes for patient and the system.

Some doctors are even learning to accept the new rubric: “The patient will see you now.”

That’s patient solidarity 2015 style.

Leanne Wells is Chief Executive Officer of the Consumers Health Forum of Australia. She tweets at @LeanneWells63. You can also follow the CHF at @CHFofAustralia

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