Advocating for change

1. Advocating for change The vision of the Australian Health Care Reform Alliance

2. What is AHCRA? • It is not a patient group. • Independent alliance of 46 organisations • Consumer • Clinician • Health professional • Health provider • Academic

3. Members • Australian Consumers Association (CHOICE) • Australian Council on Intellectual Disability • Royal Australian College of GPs • Royal Australian College of Physicians • Australian Nursing Federation • ACOSS • Country Women’s Association • National Rural Health Alliance • Public Health Association of Australia • Rural Doctors Association • Australian Healthcare Association • Catholic Health Australia • Maternity Coalition

4. Common aims • Different groups finding common ground. • Communication, respect, understanding, leadership • Agreed on principles for, and process of reform for the Australian health system to improve: • access • equity • efficiency • effectiveness

5. Our vision • A health system that • assists individuals to be • healthy and delivers • compassionate and good • quality health care to • all.

6. Common principles • Universal access • Equity of health outcomes • Indigenous outcomes to match non-Indigenous • Patient focussed

7. Principles • Preventing disease and maintaining health balanced • with duty to the unwell • Taxation funded • Appropriate, safe, high quality services and products • Community involvement in the development, • planning and implementation of health services • A valued and supported workforce

8. Challenges • Indigenous health – social determinants of health • Some people cannot get health care when and where they need it (eg rural and remote). • Health promotion and illness prevention is poorly supported • Overall quality and availability is deteriorating

9. Challenges • Patient out of pocket expenses • rising • Overstretched workforce and skills • shortages • Inter-governmental arrangements • are inefficient • Over emphasis on acute care

10. Meeting the challenges Workforce Integration Primary Care Community Engagement

11. Workforce National workforce policy • Self sufficiency • Additional places in higher and vocational education sectors • Improved strategies for entry, retention and re-entry into the health workforce • Develop policies to attract the full range of health professionals to ‘hard to recruit’ areas.

12. Integration • Commonwealth/State boundaries inhibit the development of integration across the continuum of health care service • There is widespread recognition of the need to find solutions to jurisdictional inefficiencies

13. Integration • Further expand pooling of federal, • state and territory health funding to • facilitate responsive and integrated • health services • Creation of National Health • Reform Council

14. National Health Reform Council • Role: • Responsible for carrying out and monitoring the health reform process and reporting on progress against agreed principles, outcomes and targets • Membership: • Federal and State senior policy personnel, clinicians and other health and community care service providers, technical experts and consumers. 

15. National Health Reform Council • Some of the questions the council would answer are: • How much Australia needs to spend on health care to achieve the goals wanted and needed by the population? • How do we achieve the right balance in health resource allocation to adequately address the spectrum from prevention to palliative care? • What structures and financing arrangements are needed to achieve a national approach to health care underpinned by agreed basic principles? • How do we achieve a system that is transparent and accountable and which promotes continuous improvement?  

16. Primary care • A National Primary Health Care Policy: • Addresses the social determinants of health • Maximises health promotion, prevention and early intervention • Provide support to allow individuals to • maximise their own health • Reduce hospitalisation through early intervention

17. Primary care • A National Primary Health Care Policy (continued): • Use of multidisciplinary teams to • manage chronic illnesses • Funding systems that reward primary health care teams when their patients/populations are well

18. Community engagement • Fragmented health system is • subject to ever increasing pressures • and rising consumer demand • and expectations. • Health administrators and clinicians • are being forced to make decisions • about the allocation of scarce • resources. • Who should receive the next hip • replacement? How many premature • babies should one unit support?

19. Community engagement • Universal health care does not mean • everything for everyone. • It means that the whole of the • population is covered for a defined • package of benefits and services. • What are the boundaries of this • package?

20. Community engagement • The legitimacy and sustainability of any • major policy decision increasingly depends • on how well it reflects the underlying • values of the public. • As governments ponder difficult and at • times unpalatable choices on health care, • policy needs to be informed by ordinary • “unorganised” citizens, as well as powerful • “organised” interest groups.

21. Community consultation • AHCRA models how different groups can come together and resolve differences and find common ground. • It also demonstrates the real challenges in agreeing on more detailed policy, Eg. financing.

22. Community consultation • Public to be engaged and provide direction on difficult choices involved in health care decision making • Assists governments in priority setting

23. Community consultation • A national dialogue with citizens and consumers could create a common set of values, principles and priorities, and provide the first national vision and framework for the health system to inform all governments in Australia.

24. Next steps for AHCRA • Development of high level indicators of health system performance in terms of access, equity, quality and efficiency. • In consultation with the community.