Advocating for change

The vision of the Australian Health Care Reform Alliance

What is AHCRA?

It is not a patient group.

Independent alliance of 46 organisations• Consumer• Clinician• Health professional• Health provider• Academic

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

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

Our vision

A health system that assists individuals to behealthy and delivers compassionate and goodquality health care to all.

Common principles

Universal access

Equity of health outcomes

Indigenous outcomes to match non-Indigenous

Patient focussed

Principles

Preventing disease and maintaining health balancedwith 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

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

Challenges

Patient out of pocket expenses rising

Overstretched workforce and skills shortages

Inter-governmental arrangementsare inefficient

Over emphasis on acute care

Meeting the challenges

Workforce

Integration

Primary Care

Community Engagement

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.

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

Integration

Further expand pooling of federal, state and territory health funding tofacilitate responsive and integratedhealth services

Creation of National Health Reform Council

National Health Reform CouncilRole: 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. 

National Health Reform CouncilSome 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?  

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

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

Community engagement

Fragmented health system is subject to ever increasing pressuresand rising consumer demand and expectations.

Health administrators and cliniciansare being forced to make decisionsabout the allocation of scarceresources.

Who should receive the next hip replacement? How many prematurebabies should one unit support?

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?

Community engagement

The legitimacy and sustainability of any major policy decision increasingly dependson 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.

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.

Community consultation

Public to be engaged and provide direction on difficult choices involved in health care decision making

Assists governments in priority setting

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.

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.