Thursday, May 8, 2008

Beyond the Blame Game

The National Health & Hospitals Reform Commission has posted its first report on the Australian Health Care Agreements (AHCAs). The report is called Beyond the Blame Game: Accountability and performance benchmarks for the next Australian Health Care Agreements

The NHHRC is looking to overcome ‘the blame game’ traditionally associated with the (AHCAs) to improve patient care.

In brief the NHHRC report suggests that the scope of the next generation AHCAs will be broader than hospitals. This report has a strong focus on accountability. The NHHRC are considering a shift in responsibility. They propose:

  • States to be accountable for public hospitals, mental health, maternal and child health and public health,
  • the Commonwealth to be accountable for primary care, prevention, aged care and indigenous health.

This assignment of responsibilities does not necessarily imply an immediate transfer of functions: states will continue to have an important role in service delivery in areas where we have suggested the Commonwealth exercise greater policy leadership with corresponding accountability

The proposed accountability framework comprises 44 benchmarks where performance against a target should have a clear and usually financial consequence. The Executive Summary says that

the most significant of these criteria in terms of transforming the AHCAs are: the need to move towards a single level of accountability for the effective use of benchmarks; the importance of reciprocal accountabilities and benchmarks on all governments; and the need for benchmarks to be set at levels that encourage real improvement.
In addition to this the report highlights twelve health and health care challenges that must be addressed in the AHCAs to enhance health promotion and wellness and to make the health system work better for the people who need it and use it.

The twelve challenges are:

  1. Closing the gap in Indigenous health status,
  2. Investing in prevention,
  3. Ensuring a healthy start,
  4. Redesigning care for those with chronic and complex conditions,
  5. Recognising the health needs of the whole person,
  6. Ensuring timely hospital process,
  7. Caring for and respecting the needs of people at the end of life,
  8. Promoting improved safety and quality of health care,
  9. Improving distribution and equitable access to services,
  10. Ensuring access on the basis of need, not ability to pay,
  11. Improving and connecting information to support high quality care, and
  12. Ensuring enough, well-trained health professionals and promoting research.
You may notice that some of these issues were raised in the 2020 Summit. An overview of the Summit is in the current issue of Consumer Bites.

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