The vision of the Australian Health Care Reform Alliance Advocating for change The vision of the Australian Health Care Reform Alliance

What is AHCRA? It is not a patient group. Independent alliance of 46 organisations Consumer Clinician Health professional Health provider Academic

Members Australian Consumers Association (CHOICE) Australian Council on Intellectual Disability Royal Australian College of GPs Royal Australian College of Physicians Australian Nursing Federation ACOSS Country Women’s Association National Rural Health Alliance Public Health Association of Australia Rural Doctors Association Australian Healthcare Association Catholic Health Australia Maternity Coalition

Common aims Different groups finding common ground. Communication, respect, understanding, leadership Agreed on principles for, and process of reform for the Australian health system to improve: access equity efficiency effectiveness

Our vision A health system that assists individuals to be healthy and delivers compassionate and good quality health care to all.

Common principles Universal access Equity of health outcomes Indigenous outcomes to match non-Indigenous Patient focussed

Principles Preventing disease and maintaining health balanced with duty to the unwell Taxation funded Appropriate, safe, high quality services and products Community involvement in the development, planning and implementation of health services A valued and supported workforce

Challenges Indigenous health – social determinants of health Some people cannot get health care when and where they need it (eg rural and remote). Health promotion and illness prevention is poorly supported Overall quality and availability is deteriorating Its good for all or our organisations to understand its purposes and activities and whether or not these are charitable. One immediate reason is that it is possible that the ATO may decide to review your organisation’s entitlements to tax concessions.

Challenges Patient out of pocket expenses rising Overstretched workforce and skills shortages Inter-governmental arrangements are inefficient Over emphasis on acute care

Meeting the challenges Workforce Integration Primary Care Community Engagement ATO recommends annual audit

Workforce National workforce policy Self sufficiency Additional places in higher and vocational education sectors Improved strategies for entry, retention and re-entry into the health workforce Develop policies to attract the full range of health professionals to ‘hard to recruit’ areas. Turning now to some boring bits. Basically summary of the fact sheets and discussion paper. Realise many of you will be very familiar with this already.

Integration Commonwealth/State boundaries inhibit the development of integration across the continuum of health care service There is widespread recognition of the need to find solutions to jurisdictional inefficiencies

Integration Further expand pooling of federal, state and territory health funding to facilitate responsive and integrated health services Creation of National Health Reform Council

National Health Reform Council Role: Responsible for carrying out and monitoring the health reform process and reporting on progress against agreed principles, outcomes and targets Membership: Federal and State senior policy personnel, clinicians and other health and community care service providers, technical experts and consumers. 

National Health Reform Council Some of the questions the council would answer are: How much Australia needs to spend on health care to achieve the goals wanted and needed by the population? How do we achieve the right balance in health resource allocation to adequately address the spectrum from prevention to palliative care? What structures and financing arrangements are needed to achieve a national approach to health care underpinned by agreed basic principles? How do we achieve a system that is transparent and accountable and which promotes continuous improvement?  

Primary care A National Primary Health Care Policy: Addresses the social determinants of health Maximises health promotion, prevention and early intervention Provide support to allow individuals to maximise their own health Reduce hospitalisation through early intervention

Primary care A National Primary Health Care Policy (continued): Use of multidisciplinary teams to manage chronic illnesses Funding systems that reward primary health care teams when their patients/populations are well

Community engagement Fragmented health system is subject to ever increasing pressures and rising consumer demand and expectations. Health administrators and clinicians are being forced to make decisions about the allocation of scarce resources. Who should receive the next hip replacement? How many premature babies should one unit support?

Community engagement Universal health care does not mean everything for everyone. It means that the whole of the population is covered for a defined package of benefits and services. What are the boundaries of this package?

Community engagement The legitimacy and sustainability of any major policy decision increasingly depends on how well it reflects the underlying values of the public. As governments ponder difficult and at times unpalatable choices on health care, policy needs to be informed by ordinary “unorganised” citizens, as well as powerful “organised” interest groups.

Community consultation AHCRA models how different groups can come together and resolve differences and find common ground. It also demonstrates the real challenges in agreeing on more detailed policy, Eg. financing.

Community consultation Public to be engaged and provide direction on difficult choices involved in health care decision making Assists governments in priority setting

Community consultation A national dialogue with citizens and consumers could create a common set of values, principles and priorities, and provide the first national vision and framework for the health system to inform all governments in Australia.

Next steps for AHCRA Development of high level indicators of health system performance in terms of access, equity, quality and efficiency. In consultation with the community.