A report card for the health reform commission: 'D' for disappointing

Better proposals exist. One such idea involves the establishment of a national authority to administer all health care funding and distribute it to regions on the basis of need. This was explored as Option B in the commission’s interim report but is mysteriously absent in the final, despite significant public and health sector support for the model. But the potential for significant improvement under this option demands its revival along with a clear explication of, “how to get there”.

A new paper published this month by the Centre for Policy Development offers some direction in this regard. Impatient with the lack of clear reform directions in the Commission’s earlier report, its four authors turned their minds to the task of how a new system of funding and governance could be introduced without dramatic interruptions to the current system.

In this paper, a staged process is outlined that would see the establishment of locally governed Regional Health Organisations which (armed with substantial data about the health needs of their community) would advocate for, and ultimately distribute funding for, services to meet the priority health care needs of their particular population.

This would enable resources to be equitably distributed among the national population for the provision of high quality, clinically effective services.

It would improve integration of care, and put an end to the confusing and bewildering pathways that patients are so often forced to navigate alone. Accountability would be enhanced, there would be greater citizen and community engagement in health care planning and delivery, and social and geographical inequities could be overcome.

In terms of addressing the essential reform directions outlined by the Commission (healthy communities, strong primary health care, timely access, integrating aged care, closing the gap, addressing rural and remote inequity, a sustainable workforce and improving funding and governance) this proposal ticks all the boxes.

It is time to act, but the government should act on the spirit of reform with which they established the commission in 2008, and for the sake of the health of the people of Australia, implement substantial, systemic, reform. The establishment of RHOs is a good place to start.