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

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

3. 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

4. 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

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

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

7. 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

8. 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.

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

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

11. 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.

12. 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

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

14. 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. 

15. 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?  

16. 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

17. 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

18. 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?

19. 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?

20. 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.

21. 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.

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

23. 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.

24. 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.