Federating health care would mend our health system

Since it is highly unlikely that either electable party will chase with tax payer’s money the work value dollars needed by GP’s to stay in business, we face the perpetuation of a two tiered system in which incomes are equalised either by volume or a co-payment unless we can move away from the traditional “fee for service” model.

AHC regional areas would offer contracted or salaried positions to a number of primary care providers including GP’s who could then work within an integrated team. Health promotion and better rationalisation of the use of appropriate skills would allow many patients to be cared for in the community rather than hospital. Many GP’s are already working for private consortia which often restrict services such as home visits. Many doctors, nurses and allied health professionals will be attracted to a stronger clinical environment where a patient’s needs, not the clock, determine consultation times. No coercion is involved as duality is assured by maintaining the existing Medicare options.

What about accountability for an organisation that would become Australia’s biggest business?

This was the only aspect of the plan commented on by ministers at their meeting. It’s an important matter but accountability could hardly be said to feature strongly at present, when daily accusations flow back and forth from the states and Canberra as everyone plays the “blame game”. The AHC would have a board of Governors with representation from all states, territories and Canberra. Consumers and clinicians would be board members. The board would report to all state ministers and the federal minister at their regular meetings. All parties would enter into five-year plans and could withdraw at such intervals if unhappy with the operation.

The AHS will not be owned by either Canberra or the States. It is a creation of state/federal collaboration and would run much the same way as do our Universities and Water Authority. The board of the AHC could be dismissed by a majority of ministers, as could the corporation’s CEO. An independent authority would investigate complaints about any aspect of the AHC’s performance. The Australian community would be the ultimate arbiter.

Many details of the plan must unfold for debate and an article such as this, one hopes, will generate many questions - a good thing. However without a radical overhaul along the lines suggested, we are likely to see our health care system steadily deteriorate. The Alliance requested that the ministers immediately establish a top-level task force to analyse this proposal in depth and report on its deliberations at their July meeting in Hobart. This they declined to do, much to our disappointment.

They did not however, dismiss the idea and will have bureaucrats examine the concept. It is not clear if that strategy can add much value to the work already done. What is certain is that this broad coalition of informed professionals and consumers will continue to pursue the concept with our politicians in this election year, and do all we can to have the public understand the concept, and embrace the solutions on offer.

The current system is so seriously flawed than nothing less than this major restructuring would give Australians the health care system they want, need and can afford.