Crikey

The final report of the National Health and Hospitals Reform Commission provides a definitive blueprint for the future of health care in Australia.

It is comprehensive and covers all aspects of the system.

The challenge now is for a national debate on the content and implications of the 123 recommendations. That, quite reasonably, is what the Prime Minister has asked for.

The broad thrust of the reforms is clear and supported by most of the health interest groups. That alone is an excellent outcome from a Review that has taken less than 18 months to complete.

The key areas for reform include:

• A greater focus on prevention and primary care, including the Commonwealth assuming full funding for these services.
• Greater clarity of responsibilities between the levels of government in relation to health services generally and hospitals in particular.
• Specific measures in relation to chronic disease, mental health, aged care and indigenous health; and
• Getting action on eHealth-electronic patient records.

The real question is how the Rudd Government will overcome the inevitable blockages in the way of creating “one health system”. The plan to work through the Council of Australian Governments (COAG) is really the only course available at this stage.

Agreement at COAG is achievable, but probably only to a somewhat watered down package. That is the price for consensus in the Australian Federation.

However, agreement at COAG is not enough. COAG is notorious for agreeing to reforms that never happen  — they get lost in the bureaucratic follow through.

We have seen plenty examples of this phenomenon in health: indigenous health; mental health; workforce.

If parts of the system cannot be fixed, how much harder will it be to deliver the comprehensive reform that is needed?

Robert Wells is Director of the Menzies Centre for Health Policy at the ANU and a former senior health bureaucrat.

The Australian Health Care Reform Alliance thinks the report is not perfect but probably the best chance in decades for creating a fairer health system:

• Health policy analyst Dr Lesley Russell warns, however, that it’s looking like the Feds are going to dodge decisive early action on health reform.
• Professor John Wakerman, Director of the Centre for Remote Health in Alice Springs, is disappointed that the Commission has rejected regional governance and service delivery mechanisms.
• Philip Davies, Professor of Health Systems & Policy at the University of Queensland’s School of Population Health, is excited by the potential for e-health reforms.

And there’s plenty more at Croakey…