Are we on the verge of real health reform?

We’re not even close – and if you’re expecting anything meaningful to happen before 2020, you’re just not paying close enough attention.

That’s  the assessment of Professor Ian Hickie, executive director of the Brain and Mind Research Institute at the University of Sydney.

And he thinks the Federal health reform bandwagon now visiting a hospital near you is just a distraction from the main game.

He writes:

“As I’ve expressed in an editorial in next week’s Medical Journal of Australia, this ‘consultation’ process is a major distraction.

What is clear is that the Government (assisted by the final report of the National Health and Hospitals Reform Commission) is rapidly retreating from any serious reform agenda.

Medicare Select, the reform previously known as ‘Option C’ (i.e. competitive national social insurance) has been sent to the back-blocks of Woden for a well-earned period of long-service leave. Regional health providers (Option B) are not on the agenda either.

Inevitably, a future (and somewhat braver) Government will be forced to revisit the issue of genuine health reform (in about 2020). At that time it will dust off the NHHRC interim report and have another look at a
financing system that had some real chance of changing the way that health care is delivered in this country.

In health, as in most human endeavours in the modern world, you get the health care system you pay for. If you pay for disconnected services, a narrow focus on acute care and one-off (i.e. fee-for-service) procedures
and other interventions – then that is what you’ll get.

The really neglected areas of chronic disease management, dental care, mental health, indigenous health, youth health and coordinated aged care will remain at the bottom of the pile.

The Government has already demonstrated its real (political) priorities through its major new investments in acute care hospitals, cancer care and reducing surgical waiting lists.

While the major economic stimulus package prioritised the retail sector (do we really need two plasma screen TVs in every Australian home?) and basic educational infrastructure, the health services and medical research sectors were obviously low priorities.

In the meantime, this round of hospital-centric public relations events will keep everybody chattering till we all quit for Xmas.

Clearly it is designed principally to soften us up for another round of public ‘hospital’ reform (i.e. senior Woden officials telling the States to get their act together).

Any one who has sat through “the (powerpoint) presentation’ that goes with these hospital-based events will realise rather quickly that we are not on the precipice of major ‘health’ reform.

There is no serious discussion about changing how the money flows or opening up the sector to a new breed of regional or national health care providers.

The most likely outcome for the post-2010 election period is some more money, a lot more talk and the same old divided Federal-State delivery system.”

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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