Consumer Bites - Issue 8 out now

The next Issue of Consumer Bites is now available.

• There are new committee vacancies that many of you will be interested in, including two new positions at Calvary; one on their accreditation team and the other providing consumer input to the Simply Better program.
• There are reports for three committees, including the AIP Steering Committee and Pharmacists Board.
  
• There is also a report on a workshop I attended recently on improving the Australian Health Care Agreements.

ABC Talkback: The hospital experience

ABC Life Matters talk back on hospital experiences last Friday. They explore the experience of being in hospital - or more specifically what it's like to be a patient.

One of our members drew it to my attention. The MAGGIE project at John Hunter Hospital We (which has influenced the ACT Health Access Improvement Project) was discussed as well as the need for our health system to deliver care in more appropriate settings and not be limited to hospital.

It's easy to download and listen to on your computer. We have downloaded this at the office and can give you a copy of you would like to listen.

Australia 2020 Summit

Like many of you I have been paying some attention to the reports of the 2020 summit over the weekend. I have a strong interest in education as well as what the participants come up to for the long term vision of health.

There seems to be an understanding of the social determinants of health and I have heard reference to many factors that are fundamental to good health including the need for

"good housing, nutritious food, a safe and clean environment and modern health services" .

The background paper is available on the Australia 2020 website. (The pdf is 314kb.)

There are plenty of places on the web where you can find out what has been discussed:
ABC reports:

The 2020 summit's health group outlines its top-seven big ideas, including a health version of Facebook and a ratings system for food. The stream's co-chair, Queensland Institute of Medical Research director Professor Michael Good, tells Prime Minister Kevin Rudd they are also proposing a national preventative health strategy funded by taxes on junk food, cigarettes and alcohol. But one delegate believes the group has neglected the need to close the Indigenous life expectancy gap.

There are also web-casts. I watched the plenary of Kevin Rudd speaking to the group. He held my interest and commented on issues that we have been arguing for. He said:

The challenge of public health policy is to deal with the immediate and the long term at the same time. What happens in the ED tonight, in acute hospital beds tomorrow, the clogging up of the system by people who need to be in aged care beds. This all needs to be fixed.

It certainly sounds promising.

CHF prepared a submission for the 2020 summit. It is available on their website.

Our overall vision is one where consumers are partners in their own health care and are included in all discussions and debates around health policy and programs and in all committees involved in the implementation and monitoring of projects and programs. This partnership is premised on availability of and access to well-communicated information that enables consumers to make informed decisions and to navigate the health system to get the best health outcomes.

Improving the Australian Health Care Agreements

In March, Russell McGowan and I attended a workshop on how to improve the Australian Health Care Agreements. This workshop was run by the Australian Health Care Reform Alliance. HCCA is a member of this Alliance.

The Australian Health Care Agreements (referred to as the ‘the AHCAs’ elegantly pronounced ‘Ackas’) are bilateral five-year agreements between the Australian Government and each state and territory. They a way of transferring funds from the Commonwealth to the states and territories to provide free public hospital services to the Australian community.

John Deeble, Emeritus Fellow at ANU, provided an historical overview of the AHCAs. The AHCAs have been in place since 1974. In this time major changes have occurred in the community that have led to an increased demand in the public hospital system. He spoke of the increase in demand for public hospital services. For example, in 2005-6 public hospital admissions increased by 190 000. Prue Power, CEO of the Australian Heathcare and Hospitals Association said that there has been a 25% increase in the admission rate in public hospitals in the last ten years.

When the AHCAs were first negotiated health care was provided to patients in hospital. Now there are many types of care that are provided in a range of community settings, including in the patient’s own home, or community clinics or outpatient clinics. Our population is aging. Currently, there are 1.9 million Australians aged 70 and over, comprising 9.3 per cent of the population. Within 40 years the number of people aged over 65 will almost triple, from 2.8 million today to around 7.2 million in 2047, or from around 13 per cent of the population today to over 25 per cent. Technology has made spectacular advance resulting in a range of effective, less invasive procedures.

There was strong support at the workshop for the scope of the AHCAs to be broadened to a ‘whole of system’ approach to include community based health services in addition to these services performed in public hospitals.

John Deeble gave an overview of who uses the public hospitals. In very general terms he divided admissions into three categories:

• 50% admission through the emergency Department
• 25% serous and acute episodes that are life threatening
• 25% related to chronic illness.

There was agreement by many of the participant that chronic disease management was an area that could be targeted within the funding agreements. If the AHCAs are to be scoped then there is a great opportunity to have funding tied to health promotion and health prevention aspects in the continuum of care.

There is a significant need for health reform. We currently have a silo funding of hospitals, caged care and primary care. This series of disconnected programs and fragmentation has resulted in poor coordination of services for consumers. It has a negative impact on continuity and integration of care. (And of course there are issues with transferring patient information as a result.)

There is room to consider alternate models of health funding. One idea that was put forward is the potential to have perpetual agreements between the Commonwealth and states and territories. These could then be supplemented by particular project funding to promote innovation in practice. There can be five year review points.

Many of these matters will be considered by the National Health and Hospitals Reform Commission. The Commission is calling for submissions to help design Australia’s future health system. Submissions are due by 30 May. HCCA will be working to complete a submission for consideration. We welcome your thoughts.

Queensland Health has put together a interesting paper on the health care agreements. They provide useful background but also explain why the AHCAs are inadequate in the way in which they fund the states and territiories. A pdf of this report is available online ...

What is del.icio.us?

On the right hand side of the page (underneath the HCCA logo) you will see a section that has links to websites that we think may provide you with useful information. Included here is a link to del.icio.us.

What is del.icio.us?

del.icio.us is a social bookmarking website -- the primary use of del.icio.us is to store your bookmarks online, which allows you to access the same bookmarks from any computer and add bookmarks from anywhere, too. On del.icio.us, you can use tags to organize and remember your bookmarks, which is a much more flexible system than folders.

We have started a list for HCCA bookmarks.

If there are websites that you find useful, we would love to know about them and add them to the list we have.