Tuesday, August 19, 2014

Australian Health Care Reform Alliance Summit – Canberra, 15-16 July 2014


The Australian Health Care Reform Alliance held a summit in Canberra in July. Four members of HCCA attended: Russell McGowan, Bill Heins, Fran Parker and Sue Andrews. We encourage consumer representativeness to share reports on events they attend and Sue Andrews has provided the following report on the summit.

The AHCRA summit brought together its peak body membership as well as a range of speakers offering expert health research and industry perspectives in the context of the election of the Abbot government in September last year, and more specifically the measures  in the May 2014 Federal budget. Overarching concerns were the dismantling of government infrastructure to deliver health reform and a range of budget initiatives that will, if implemented, seriously threaten our universal health care system, particularly the MBS and PBS copayments, and plans to privatise primary health care.

Speakers challenged and critiqued the current government’s rationale for its budget measures -seeing ‘health’ only as a budget issue, a lack of understanding about the complexities of the health care system, particularly the importance of preventative health and primary health care. Speakers such as Peter Martin, Economics  Editor of The Age newspaper, argued against  the government’s proposition that our health system is not sustainable. We may spend more but we get good services and good health outcomes overall. He highlighted the research that indicates that people are willing to pay taxes to fund good quality, equitable healthcare. Adam Elshaug   (Menzies Centre for Health Policy) noted that a significant amount of money is spent on ‘low value and no value’ healthcare and argued for an ongoing review and assessment of MBS items, many of which are overused and others cause harm.  Michael Armitage, CEO, Private Healthcare Australia put a case for increased involvement of the private health care providers in contributing to higher quality and lower costs of healthcare.

The session about ‘What happened to health reform?’ included presentations from Tony Sherbon on the fate of National Funding Reform and Activity Based Funding for acute care/hospital services; Heather Yeatman, President of  PHAA, emphasising the need for clarity about the difference between  ‘health’ and ‘healthcare’; and Paresh Dawda from Ochre Health in Canberra, pointed out that countries with strong primary healthcare systems have lower overall costs and generally have healthier populations.

A Members panel offered a range of different perspectives about where things are at and what needs to be done  -  a grim picture of fragmentation, withdrawal of resources – human and financial, lack of investment in professional training, lack of attention to models of care that work ie that meet the needs of patients/consumers/citizens. The crucial role of the consumer voice was discussed and the importance of always involving consumers and their advocates in these debates, taking account of models of care that work ie consider the evidence, evidence based decision making.

At the end of the summit a communique was crafted which drew together the key issues  discussed at the forum and provided that basis for subsequent discussions with Parliamentarians. It includes: Concern about the shift away from a universal system, value of primary health care, qualified support of PHNs, issues of sustainability, health workforce issues, continue improvement of oral healthcare system, stronger role of consumers, as well as AHCRA strategies for better engagement with the broader community about all these issues.

The main challenge at this point in time was about how to engage with a Government perceived to be driven primarily by ideology rather than a broader understanding of the complexities of our health care system and an evidence based policy approach. A government that is committed to introducing a system that is based on principles of users pay, increasing privatisation, deregulation, and minimal Commonwealth government involvement in funding.  These are critical issues that will adversely affect all consumers of healthcare and about which HCCA needs to keep a watching brief.

Sue Andrews

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