Inter-government bickering over health care must stop
THEY may disagree about everything from choice of football code to whether meat pies come with tomato sauce or pea soup, but one thing the states and territories always agree on is that the Commonwealth should pay more for health care.
Last weekend the state and territory governments jointly released a report arguing that they had been short-changed to the tune of $1.1 billion in public hospital funding.
Consumers have good reason to be cynical about this move. While many would support additional funding for the public health system, the endless bickering between governments about who pays the bills for health care is becoming more than a little tiresome.
What politicians seem to forget is that regardless of who signs the health care cheques, the money to pay the bills is coming out of consumers’ pockets. If governments were serious about improving the health system, they would stop arguing about funding responsibilities and start talking to consumers about whether they feel they are getting good value for their tax dollars.
From our widespread consultations on the performance of the health system, the Consumers’ Health Forum of Australia (CHF) has found that many consumers are not satisfied with the level of care they receive.
For example, we often hear from people who are diagnosed with a specific illness or condition and who find themselves on their own, trying to negotiate through an often complex health care system without being given adequate information about entitlements, or any support to help them access the best possible care for their condition.
This is particularly true for people with chronic and complex conditions who often require ongoing treatment from a range of different providers and in a range of different settings. This group of healthcare consumers frequently reports problems such as a lack of co-ordination between healthcare providers and health services, so that they are forced to tell their story over and over again each time they require health care.
Sometimes tests have to be duplicated because data hasn’t been shared between healthcare providers. These can be invasive, inconvenient for consumers and an unnecessary use of resources.
Consumers with more complex needs can also have difficulty finding a health professional who understands their condition, particularly if they require care after hours or in an emergency. Often they feel they know more about their condition than the junior doctor in a hospital emergency department.
Another common problem is that consulta- tion times are often not long enough for consumers to provide all the relevant information about a complex condition. Some health problems simply cannot be dealt with in a sixminute consultation.
In general, people with chronic illnesses find that there is no one in the health system who is responsible for overseeing their care, who manages the different services required and who understand the total needs of a person with a complex condition.
The Consumers’ Health Forum acknowledges that there have been some attempts to help the health system provide better care to people with these conditions. Recent government initiatives include the co-ordinated care trials, the enhanced primary care Medicare item numbers and programs that support selfmanagement for chronic conditions.
However, these have had only limited success, perhaps because they are often not based on an equal partnership with consumers. From consumers’ perspectives, they often seem to be more about meeting the needs of healthcare providers than about improving quality of care. Perhaps it is simply easier for governments to argue with doctors and hospitals — and among themselves — about health funding, than to make the changes required to deliver a truly consumer-focused health system.
The end result of this, however, is an increased cynicism among consumers about governments’ real commitment to improving health care. New initiatives come and go, but the in-fighting between governments over health funding remains.
Real and lasting improvements to our health system will only happen if governments make a genuine attempt to end their bickering over health funding and listen to the people who use, and ultimately pay for, all healthcare services. Mitch Messer is chairman of the Consumers’ Health Forum of Australia