Patient-centred health reform

The micro-economic reform agendas of past decades have left this sector relatively untouched. Not surprisingly, new ways of operating or providing appropriate care have been slow to evolve in a systemic sense.

Some have suggested that at least 15 per cent of present resources could be released, to address unmet demand or taken as savings.

But this cannot be achieved through blunt cost-cutting measures or budget limits.

The effects of such measures in the past have left us with a legacy of skills shortages and overcrowded, understaffed and stressed public hospitals.

What we need is a systemic and systematic view of reform for health care.

The approach must take account of the changing patterns of disease and best-practice treatment models, adopt more business-like administrative systems and harness the advances in information and communication technologies to those needs.

The battle for scarce resources means that all assets, people, information and capital, need to be used as efficiently and effectively as possible so that unnecessary duplication is eradicated. All of these are likely to be achieved if services are designed around the needs of the patient.

A simple contrast: when a guest checks into a hotel, they are provided with one "file" and account. All departments of the hotel enter their information and services on to that one file.

When you check out you get a single bill that incorporates every service and product you have purchased during your stay. But if you "check in" to a hospital today, you receive multiple bills from your hospital stay. Patients face the risk of injury or inconvenience as information must be passed through multiple departments and professionals before treatment is provided. From a business and administrative perspective alone, there is ample opportunity to improve the experience of patients and reduce waste and risk. The lessons learned from many other sectors stand to provide some guideposts.

Most importantly, we need to recognise that the health workforce itself is ageing. Despite the recent increases in training numbers and international recruitment, the offsetting reduction in hours means that on present projections and treatment models, there will be insufficient people to staff the system as it is currently configured. Mounting stress in parts of the system is exacerbating turnover rates. The issues are linked.

The real implication of the Intergenerational Report is not about rising expenditures on the federal budget. It is much more about how we will optimise our human resources as the composition of our population changes, and how we ensure that all can participate and contribute to their potential. Through this we maximise our economic and social prosperity.