Putting a stethoscope to the patient

We need role renewal and we need up-skilling, multi-skilling, and team work. We also need to restructure the MBS which overvalues diagnostic and surgical procedures, and encourages investment in such interventions to the detriment of lower cost primary prevention and self-care.

We have to start making these decisions based on evidence and start tackling the barriers that are put up by some health professions.

Health care still remains too dangerous. We learnt just how dangerous 10 years ago when the first hospital safety report showed that each year 10 per cent of Australian patients suffered an adverse event because of an error in their care and 18,000 died as a result. At least 50 per cent of these adverse events were deemed avoidable or preventable.

Preventing adverse outcomes would save $2-4 billion a year - not to mention lives and disability.

We also need to change the culture in health care. We only need to look at the Bundaberg Hospital scandal to see how staff who notice mistakes are victimised. We need a culture of openness and transparency so that there is continuous improvement.

A mandatory national open disclosure standard for when things go wrong could help identify problems.

E-health also has a pivotal role to play in improving healthcare. Electronic patient records that go with the individual would enable safer and more efficient health care. It would cut huge amounts of duplication - saving time on collecting basic information, cutting down on the repeating of tests as people move from doctor to doctor and results are lost or not shared in a timely fashion, and improve medication adherence.

A national system of shared electronic health records that protects patient would support better clinical decision making, avoid waste in equipment, supplies and resources and support continuity of care and self-management.

And we need to tackle the elephant in the room - private health insurance. Private health insurance pushes up health costs and doesn't deliver better health care - taking into account the 30 per cent rebate, the 1 per cent tax penalty and other measures support for the private health insurance industry is costing about $6 billion a year.

This money could be used for more important services in Indigenous health, mental health, primary care, prevention and dental care.

If the government was to fund private sector providers directly this would still provide support to the private health sector and it would save the administration costs. Private hospitals would be better off and it would also give the government some control over costs - something that the PHI sector has not been able to do.

Health care is changing, resources are limited, and not everything can be done but the only voices we tend to hear are the doctors, pharmaceutical companies and health ministers. We need to involve the public in debates on health care and what we want for the future. One thing is clear - we can’t continue to operate using the same complex, convoluted and increasingly inequitable system to meet our future needs.