How sick is our health system?

Fifth, there needs to be a re-allocation of resources towards the “front end” of health care - public health and primary care. Well-resourced primary health care centres can take a significant load off public hospitals and can provide an integrated services including general practice, nursing, pharmaceutical services, diagnostic services, physiotherapy, some basic specialties etc, providing users with the convenience, efficiency and safety of “one stop” health care. Such a re-allocation is likely to occur when responsibility for health care is more focussed, and when programs are no longer divided along service-provider lines.

Can it be done?

Only an extreme optimist would expect any fundamental policy proposals in the current election campaign. As in previous campaigns, most proposals from both main parties are cautious and incremental, often dealing with specific high profile problems and often targeted at marginal seats. Thanks to “reforms” introduced by the current government, particularly the so-called Costing of election commitments, the cards are stacked any opposition party proposing fundamental policy re-direction.

It was refreshing, therefore, to see a press release from Kevin Rudd on September 25 in which, in reference to the Mersey Hospital intervention, he said:

We believe that what Tasmania needs and what Australia needs is a national approach, an integrated national approach to dealing with health and hospital services, not just one plan for one hospital in one seat in the country.

Labor has also made some promising statements on the need for greater integration of aged care and hospital care, on health promotion, and on the importance of primary care. Health centres, as proposed by the CPD, may become a reality under a Labor Government. (The Whitlam Government did establish some community health centres, but rather than being universal they tended to be targeted to disadvantaged regions.) On the other hand, Labor has no unifying health policy proposal, and has promised to retain budgetary support for private insurance.

If Labor wins office will it be seeking a national integrated approach to health policy, or will it slip into the comfortable, incremental approach which tinkers only at the margin - the approach preferred by lobbyists and bureaucrats, fearful of change and lacking in imagination?