If we don’t improve at managing chronic disease, providing required rehabilitation and preventing complex conditions from becoming worse, then the health system will continue to stagger from crisis to crisis, regardless of who manages it or how it is funded.
The Prime Minister talks about ending the blame game and planning for the growing and changing health needs of our population but his plan says nothing about who will be responsible for making sure that each community and region across Australia gets its fair share of funding.
The Prime Minister’s faith in the capacity of efficiencies to drive reform is going to need an army of bureaucrats to measure the number of discharges, complex surgical operations and outpatient appointments completed and multiply that by the amount of money invested in treatment and buildings. Yet you could argue that pressure for efficiencies are already present in the system in the form of hard budgets, growing demand and full capacity.
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The government's method of paying for hospital activities is by setting a national efficiency price for those activities, however, these might bring in other problems such as ghost wards and the temptation to treat people more quickly, and who have become unnecessarily sicker, to do more with less. Will we see hospital networks being taken over by Rudd’s bureaucrats if they don’t meet targets? Will they be closed down? Some local hospital networks might have to merge with their neighbours in order to achieve greater efficiencies and if so, who will pick up the cost for all those merger and acquisition fees? Will regional centres be left without their local hospital?
Who will pay the inevitable gap between the efficiency price and what it ends up costing? Will the Commonwealth simply hand over its 60 per cent funding if a state can’t find its 40 per cent contribution? Perhaps this has been deliberately left unclear.
Australian of the Year, Professor Patrick McGorry has called for significant increases in mental health funding as a “low-risk reform strategy with rapid and dramatic benefits in health gain and cost savings”. He says the implications for not dealing with the problem now will consign a generation of young Australians to unnecessary disability as well as premature death from suicide and cardiovascular disease.
Where does aged care fit into the government's plans? Older people who are unnecessarily in acute care because there aren't enough beds in residential aged care facilities cost the hospital system hundreds of millions of dollars. Ensuring that Australia has adequate aged care services and facilities will not only free up hospital beds but also provide better care for older Australians.
Where are the plans for dental care? We know that access to dental care is essential for better health outcomes yet the government has made no announcement on this vital area of our health system.
The government has announced only a fraction of the health reform necessary, yet seems to want the States to sign off on partial and obviously incomplete reform - these are just some of the questions that need to be answered before the COAG meeting on April 19.
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