Prime Minister Kevin Rudd is unveiling his government’s plans for health reform at the National Press Club right about now. (The ABC was reporting the Government will claw back $50 billion in GST revenue to directly fund the public hospital system as Crikey went to press.)

So what should journalists be asking him and ministers Nicola Roxon and Warren Snowdon in the days that follow? The main questions that emerge from a deluge of suggestions from Croakey contributors are:

  • Just what exactly is the problem you’re trying to fix, and how will you know that you’ve fixed it?
  • How will these plans for hospital funding do anything to produce better integration between hospital and community care, in particular for people with chronic diseases?
  • How will these plans do anything to redress the major inequities in the system, especially for under-served areas such as rural and remote regions, mental health, dental health, aged care, and Indigenous Australians?

Meanwhile, here are some other choice questions from a range of health and policy experts:

Health policy analyst Yvonne Luxford:
Given that the stated objective has been to keep people healthy and out of hospital, why haven’t comprehensive announcements been made about prevention before addressing hospitals?

Professor Stephen Leeder, Menzies Centre for Health Policy, University of Sydney:
How will he measure outcomes — improvements in health — as opposed to outputs which at present he proposes to reward?  Outcomes concern the nutritional value and flavour of the sausages.  Outputs as in case-mix are just sausages — neatly packaged, vacuum sealed, but untested sausages of variable quality nevertheless.

Associate Professor Gawaine Powell Davies, UNSW Research Centre for Primary Health Care and Equity:
How will the new system avoid “provider capture” where providers organise services in ways that suit them rather than the public?

Robert Wells, director, Menzies Centre for Health Policy, ANU:

Will you proceed if only some states accept? If not, what precisely is your next step?

Professor Mark Harris, executive director, Centre for Primary Health Care and Equity, University NSW:
How will public health and health promotion services be funded (as they don’t provide care to individual patients)?

Professor David Penington, former vice-chancellor and dean of medicine, University of Melbourne:
Public concern prior to the election was with the quality and safety of public hospital services after disasters in Bundaberg, and then at the Royal North Shore and even in the Road Traffic Unit at the Alfred in Victoria — all hospitals performing well on budgets and patient number indicators.  How will the new model safeguard quality and safety with appropriate clinical governance overseeing the quality of medical services delivered?

Dr Peter Mansfield, Healthy Skepticism:
Given that misleading promotion of health products (including pharmaceuticals) has killed far more Australians than terrorists during the past decade, why isn’t the government giving the issue proportionate attention?

The final question is, of course, whether Rudd et al will have the answers to the complexities raised by many of these questions — or whether their replies will be aimed squarely at capturing the headline grab.

I suspect it will be quite some time until we gain a true understanding of the answers to these questions and the impact of Rudd’s plans.

For more on Rudd’s health reform announcements stay tuned to Croakey…