As the new Government embarks on health reform, it would do well to consider the lessons from countries which began this journey sometime before us.
A salutary lesson comes from hospital reforms in the UK, where substantial funding increases have been slow to have a real impact on health outcomes.
This is because insufficient attention and funding were devoted to addressing the important determinants of health – things like smoking, obesity, physical activity and diet.
This raises some important questions for the Rudd Government, which has pledged to move prevention to the centre of the health system.
It needs to inject some clarity into its promise. What, for example, does it mean exactly by preventive health activities? And who is responsible for carrying out the preventive agenda? How will it be integrated within the health care system?
For example: is the preventive care that will be delivered by GP Super Clinics about keeping patients fit and healthy through better nutrition, anti-smoking programs, tackling binge drinking, and ensuring everyone gets their vaccinations and mammograms or is it about reducing the negative impact of established disease by restoring function and reducing complications, thus preventing unnecessary hospital admissions?
These are not matters of semantics but have an important bearing on the type of workforce that will be needed.
Is the Government on track to putting prevention at the centre of the health system? Or is this an impossible task? What will be the major barriers?
Dr Russell is a Menzies Foundation Fellow at the Menzies Centre for Health Policy, University of Sydney/Australian National University. She recently raised these issues at a seminar on health reform at the University of Sydney
The public Health System will never work as people want. All people on the public system want private cover advantages without paying the costs of private health insurance. There are always going to be long waiting lists for all operations. I am afraid to say the introduction of Medicare was disaster waiting to happen. I remember the days before Medicare and just about everybody had private health cover. With so many members costs were low, for those few who required medical care they payed the the full bill, usually car accidents victims. Now we are so far behind with memberships, we will never catch up, perhaps the New Federal Government should encourage more private Health members by either increasing the Medicare Level or dangling a bigger carrot. Either way things will not improve until private membership gets up to 70 or 80% of total population.