Health reform is still not putting the patient first

By not seeing health care as an economic issue, we are denying ourselves powerful tools to help solve the problem, says BCA.

COAG health reforms are a first step in improving the funding of the healthcare system but are a long way short of the reforms needed to build a sustainable healthcare system and improve Australians’ health, the Business Council of Australia says.

“While COAG’s focus on improving our healthcare system is welcome, debates over who pays and how they will pay are not getting to the real issues,” chairman of the BCA Healthy Australia Task Force Rohan Mead said.

“The real job of health reform is still ahead. By not seeing health care as an economic issue, we are denying ourselves powerful tools to help solve the problem,” Mead said.

“The challenge for governments is to consider more fundamental reforms that address how we can get better value for our health dollar and how to ensure health outcomes are as good as they can be for our current and future health requirements.

“The healthcare sector is too large to ignore the need for economic reform. In 2008–09, total national spending on health was almost $113 billion, with $78 billion from Commonwealth, state and territory governments and $34 billion from non-government sources. Healthcare spending is growing faster than inflation and GDP.

But, said Mead, this wasn’t just a job for governments. As a community that is living longer with more illness, some of which is preventable, everyone needs to do more to reduce demand.
“We need to do better to prevent and contain illness and injury, and we also need to be open to the new ways of receiving health care that new technologies allow,” he said.

Mead’s comments come as the BCA releases a new paper on the healthcare challenges facing Australia, Using Microeconomic Reform to Deliver Patient-Centred Health Care.

The paper, based on consultation with business, healthcare professionals, government and the community, highlights the dilemma facing the healthcare sector is the emerging gap between demand for services and our ability to supply those services.

As a result we experience longer waiting times, variable quality, continuing staffing and training place shortages, and lack of services in rural and regional areas and the less well-off suburbs.
“With up to 20 per cent of current resources wasted there is ample scope to increase capacity, let alone freeing up the system through rigidities that do not permit the full advantages of new technologies to be taken up,” Mead said.

“These challenges are not new. We have done it before in other sectors.
As a knowledge and labour-intensive sector, the healthcare sector’s largest expense is wages and fees. The sector employed 1.3 million people as at December 2010, representing 11.4 per cent of the overall workforce. Australian professionals are supplemented with immigrants.

The National Health and Hospitals Reform Commission estimated that without changes to existing models of care, the healthcare sector will need to employ 20 per cent of the overall workforce.
Despite the growth, health professional shortages are projected, particularly in some areas.
Comparative data shows Australia has slightly fewer practising physicians per thousand population than the OECD average and about average for nurses per thousand population.

“More money for key parts of the system will have a limited impact unless we also ensure that services better meet current health requirements and are delivered in more efficient ways that focus on the health outcomes for patients,” Mead said.

“An integrated national e-health infrastructure that enables secure and quick sharing of information, eliminates duplication and fills gaps in communication is a key underpinning.
But so too is having strengthened governance arrangements that allow for independent monitoring of the performance of the system and provide the trigger to ongoing adaptation and change.

“The Prime Minister is right to suggest that increased transparency and accountability will generate ongoing change. But we have a long way to go in making available relevant, timely and reliable data on which they can make informed decisions about their options for health care,” he said

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