Medicare under threat

Queensland’s problems and solutions are now being identified

In Queensland lately the major focus has been on the serious problems highlighted by the Davies Inquiry Report and the Queensland Health systems review (Foster Report). The Queensland Government must accept its share of responsibility for the issues identified by these inquiries. However, while the events took place in Queensland they could have happened anywhere in Australia.

While these reports focused on the public health system many of the issues are just as relevant to the private health sector. Factors that contributed to these problems include the historic under-funding of public health services in Queensland and the entrenched cultural dysfunction of our state’s health and political systems.

The Queensland government responded to the Forster report by issuing its Health Action Plan (pdf 234KB) in October 2005. This will see health expenditure increase significantly until 2010-11. The critical issue will be to ensure there is a process for monitoring the outcomes achieved from this significant additional funding. Real improvements in the quality and standard of health care delivery must be achieved.

The focus now must be on addressing the problems and rebuilding community confidence in our health system. Premier Beattie is correct to say this requires a national approach and PHHAMAQ supports his call for a national health summit.

As a member of the Australian Health Care Reform Alliance (AHCRA) PHHAMAQ participated in a summit in Adelaide late last year aimed at highlighting critical areas for reform and to promote debate. The key priorities identified at the AHCRA Summit were: health workforce; primary health care; rural and remote health; improving integration of health programs; and engagement with the community on health care reform. Reports on these issues and more information on AHCRA and its overarching principles for reform, can be accessed at AHCRA’s website.

AHCRA has worked hard to identify the problems but more importantly has also identified possible solutions. These are based on a clear statement of values that we believe must underpin health policy and practice. All that is needed now is the political will to reform our health system. AHCRA members want to work with government and the Australian community to achieve this end.

Similarly in Queensland the Forster and Davies inquiries have raised a number of serious issues about the provision of health services in this state and these require considered and inclusive deliberation on health reform at the national and local level. Fundamental to this is informed engagement with the Australian community about health needs and expectations and how health should be funded.

This is a prerequisite to health reform and until such engagement occurs we will continue along the path of health care cost blow outs and growing health inequalities - unsustainable trends, economically and ethically. In recent years other countries - Canada, New Zealand, the UK, France and Sweden, have consulted their communities about the health systems they want or are developing. Why can’t we do the same in Australia?

In the end it should be shared community values that underpin health policy and decision making. Unfortunately governments of all political persuasions at present seem reluctant to engage in genuine community consultative processes. Is this because they cannot be assured of an outcome? Demographic and funding pressures are such that governments will increasingly find it difficult to refuse to engage the community on such issues. There must be genuine and informed community consultation about the future of our health system and the way that this is best funded.

PHHAMAQ intends to continue to promote community consultation as a prerequisite for future health reform by producing materials to raise community awareness and encourage debate. This is a debate that is long overdue. The future of our health system depends on it.