What you won’t find in election policies

There is one major health policy reform that many nursing leaders would like to see – although realistically, it is unlikely to ever appear in an election policy.

Shifting away from fee-for-service healthcare to capitation funding models is vital for improving the integration and quality of care, they say.

However, they acknowledge that the medical lobby’s political clout means this policy is unlikely to surface during an election.

Mary Chiarella, professor of nursing at the University of Sydney, said there is a “groundswell of opinion” across the health sector that fee-for-service is an obstacle to healthcare improvement.

Moving towards a capitation-based system would improve the care of people with chronic and complex conditions, as well as enabling nurses across the system to work more to their full scope, she added.

Professor Sabina Knight, of the Mount Isa Centre for Rural and Remote Health, said there was growing support for moving away from fee-for-service healthcare towards more flexible funding arrangements with bundled payments for care over time.

“It has to happen,” she says. “You will get better outcomes and it will allow nurses to make a more meaningful contribution to care.”

Kathy Bell, CEO of the Australian Primary Health Care Nurses Association, says there is room to explore the impact of current financing models on integration and quality of care, and to examine alternatives.

“We need a financing model that encourages members of the primary healthcare team to work to the top of their scope of practice, and deliver the best possible model of care for the patient,” she said.

Carol Bennett, CEO of the Consumers Health Forum, said patients would benefit from a move away from fee-for-service care towards performance-based payments.

“We need a new way of funding primary healthcare,” she said. “When you say, ‘What is better for patients?’, you’ve got to look at results-based or performance-based care.

“There are lots of good models you can deliver in primary care that deliver good results, not just for consumers but [which are] also more effective systems and a better deal for the professions economically.”

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