Australia's Recent National Health and Hospital Reform Essay

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Australia's Health And Hospital Reform

FASHIONING a FUTURE HEALTHCARE SYSTEM

Australia's Recent National Health and Hospital Reform

The National Health Reform Plan

The goal of this Plan is to deliver landmark reforms on Australia's health and hospital system in order to build the foundations of the country's future health system (NHHN, 2010). These major structural reforms will bring certain changes about. They will make the Commonwealth Government the majority financier of public hospitals. It will assume funding and policy responsibility for general practice and primary health care services. It allocates a third of annual Goods and Services Taxes to state and territory governments. It changes the way hospitals are operated as it assumes control from central bureaucracies and turning it over to local hospital networks. It also changes the funding mode in hospitals by paying local hospital networks directly for services instead of by a block grant from the Commonwealth to the states (NHHN).

These reforms will endeavor to achieve the goals by improve public hospital and primary health care services (NHHN, 2010). They will draw from the strengths of the present health system, which already provides primary health care through Medicare, and free public hospital treatment for the public. They will also keep these foundations sustainable. Most of all, it will utilize the skills, experience and ingenuity of the citizens at the frontline of the health and hospital system. The Reform Plan will build on the achievements of Government's major health reforms, including record funding for public hospitals, increased volumes of elective surgery procedures, relieving emergency departments of pressures, and record investment in the training of more doctors and nurses (NHHN).

Reforms are a must in delivering high-quality health care (NHHN, 2010). The fragmented state of the present health care system has produced sore consequences. It has added to cost shifting among the different levels of government. It has incurred much waste. And it has resulted in long patient wait times. It furthermore faces looming challenges. The population is both growing and ageing. Unprecedented technological advancements are likely to raise health costs. And the burden of chronic disease is also likely to grow. The one consolation is that Australia's rates of hospital admission are higher than those of other countries. This implies better chances at keeping the community healthy (NHHN).

But these are hardly achievable without appropriate and major reforms (NHHN, 2010). The nation's finances must be reformed. In order to implement reforms, the government must continue performing the role of private hospitals and healthcare providers to insure acceptable health outcomes. This reform package evolved from the recommendations of the National Health and Hospitals Reform Commission as well as from the more than 100 dialogues between the government and health professionals and the community. This represents the position of the government presented to the states at the Council of Australian Governments (NHHN).

The Principles

The design principles of the entire health and aged are what citizens and potential patients seek (NHHRC, 2008). People and family-centeredness in being tailor-made for individuals, families and communities as close to home as possible. Equity in that is accessible to all on the basis of health needs rather than the ability to pay. Shared responsibility in that health and the success of the health system depend on the citizens it serves. It is participative. Strengthening prevention and wellness in that is a comprehensive and holistic approach in organizing and funding health services with the end-view of improving the health of the entire nation. Comprehensive as it covers multiple and changing health needs and built on strong primary health care services foundation. Value for money as it requires justifiable local flexibility in financing, staffing and infrastructure in delivering appropriate, timely and effective care. Providing for future generations, this system teaches and trains future generations of health professionals on changes in health care and roles and other adaptations in response to changes. The system recognizes broader environmental influences on health in the global scene, the physical and built environment and the socio-economic environment (NHHRC).

Governance principles focus on how the health system will work (NHHRC, 2008). It takes a long-term view in acting strategically and assuming and a responsible forward-looking stance. It assures safety and quality of clinical governance at all levels of the system in learning from mistakes and improving in all aspects. It commits transparency and accountability in clearly delineating and reporting funding details to all. Public voice allows public participation at multiple levels to assure a viable, responsive and effective healthcare system. A respectful and ethical system is pledged with the highest ethical standards and which recognizes the worth and dignity of the entire person. The system observes responsible spending on health in that it assures effective flow of resources to the front line of care and minimal wastage. Funding systems will promote continuity of care according to common eligibility and access requirements. Both public and private resources will effectively and equitably used in cost-effective ways. Information and communication technologies will improve access in rural and remote areas. And it fosters a culture of reflective improvement and innovation, research and sharing of effective practices to improve specific services and the health of all Australians (NHHRC).

Factors Influencing the Reforms

The first is a system that is unprepared to confront future challenges (NHHN, 2010). These include an ageing population from 14% in 2010 to 23% in 2050; a growing population from 22 million at present to 36 million by 2050; increasing burden of chronic disease; increased and further increasing health costs from today's 15% of government spending to 26% by 2050; and workforce shortages, particularly in the regions and the rural areas. The second factor is too much blame and fragmentation between governments. Patients are, as a consequence, confused as to which level of government can be held accountable for their care. The third factor consists of gaps and poor coordination in needed health services. Primary health care is difficult to access in the rural areas and in the regions or out-of-hours general practice services. Access is also difficult for those in highly disadvantaged areas where health outcomes are poor. Too much pressure on public hospitals and health professionals is the fourth factor. The public hospital system reels under continuously increasing patient demand and drained budgets. Waiting time for surgery and emergency treatment has been longer for more than half a decade. This pressure and other strains are a daily experience to healthcare professionals. The fifth factor is an unsustainable funding model. State government revenue growth has not been able to cope with the continued increase in healthcare costs. Public hospital expenditures grew by 10% from 2003-2008. Health spending alone is projected to cost more than all the state and local government revenue. The sixth factor consists of too much inefficiency and waste. Some public hospitals may be operating less efficiently than best practice at up to 20%, according to the Productivity Commission. Despite improved funding through block grants, transparency remains relatively limited. This lack of transparency prohibits taxpayers and government from making comparisons among states on the matter of efficiency. Too centralized and bureaucratic administrative setups in some states account for part of the problem. These practices discourage efficiency among local clinicians and managers. And the seventh and last factor is inadequate local or clini8cal engagement. Many clinicians and citizens have no adequate involvement in decision-making in the delivery of health services. They fail to make full use of available expertise and commitment of the workforce. Moreover, their services are not suited to the needs of the community (NHHN).

A "Road Test" of the Reforms

A Simulation was held in June 2011 by the Australian Healthcare and Hospital Association or AHHA (2012) for a dry-run of the new healthcare environment and for comments. The participants recognized the prime importance of changed mind-sets for the success of the new ideas. The backing of governments through a common commitment to the entire change process was a common expressed need. Improving clinical services and consumer experience, a foremost goal of the reforms, will largely depend on the close coordination between the Medicare Locals and the Local Hospital Networks for the proposed delivery of integrated patient services. The participants also found the new Commonwealth-State financing arrangements as a main feature of the reforms. They likewise found the new "efficient price" for hospital services controversial. These two features should be refined or adjusted to provide incentives to patient care in the most appropriate settings. The participants, however, warned that efforts to achieve financial efficiency should not sacrifice quality and safety (AHHA).

One of the Reform Plan's major elements is to preview the role of existing and planned national data collection and performing reporting agencies (AHHA, 2012). These agencies should work together to uplift health services instead of hiking red tape and increasing reporting burden for health services. The consumer participants, for their part, found the Simulation useful. But they also confronted their lack of understanding about how to get involved in planning, design, monitoring and evaluation of health… [END OF PREVIEW]

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