Putting a stethoscope to the patient

Regardless of arguments about the federal government’s motivations in intervening into Aboriginal communities in the Northern Territory, there remain serious questions about whether their strategy is sufficiently coherent, well targeted and properly funded to deliver some real, ongoing health gains. Monitoring the progress of the intervention for practical results, rather than the political pontificating, will be a key task of the Senate after the federal election, assuming the Senate can be returned to being a house that is not controlled by the government of the day.

There are also geographic inequalities between rural and urban Australians and between socioeconomically disadvantaged communities and their wealthier counterparts.

In the socially and economically disadvantaged suburbs of Brisbane, people are more likely to experience ill-health, and more likely to die, than they are in the affluent suburbs.

Similarly, country Australians experience reduced access to health care, and as a result have poorer health and higher death rates than their city counterparts.

Some areas of health provision just continue to miss out completely. Despite the increasing attention that mental health has garnered in recent times, we are still not earmarking adequate resources to meet growing areas of need in mental health and disability services.

Health is a large, expensive and complex system - filled with vested interests. There are multiple competing objectives, expectations and demands and our health care needs are changing.

As Australians live longer, chronic and preventable diseases such as Type 2 diabetes are become more and more common. Older people have increasing expectations about access to operations and procedures that were previously limited. The range of conditions for which existing medicines are prescribed continues to expand, while new and expensive pharmaceuticals and surgical procedures are continually being added to the list of treatment options.

Health spending in Australia now accounts for 10 per cent of our GDP. This put us in the high spenders club internationally. And there are always calls for more money.

But good health policy is not just about throwing money around like a drunken sailor - something we will no doubt see a lot of in the election campaign.

It is not about putting out a spot fire here and there by announcing expensive, ill-thought out programs that will dampen down public concern but not actually address the real problems - such as the federal government’s recent offer to takeover the running of a single hospital in Tasmania. Good health policy is about spending money wisely and engaging with the long term issues.

The Productivity Commission has projected that over the next 40 years spending on health care will increase to between 16 and 20 per cent of GDP. If we want to rein in costs and make sure that that every dollar spent on health is spent wisely, it is time for real change and fundamental reform - not more tinkering at the edges.

The Productivity Commission estimates that a 5 per cent improvement in the productivity of health services would deliver resource savings of around $3 billion each year.