Know­ing where and how to get the best treat­ment should not be so hard

The Weekend Australian - Travel - - Health - HE­LEN HOP­KINS

EV­ERY­ONE need­ing health care wants the best pos­si­ble treat­ment. But un­for­tu­nately many peo­ple find that ob­tain­ing op­ti­mum health care is more dif­fi­cult than it should be. Of­ten this is not due to the cost of care, or a lack of avail­abil­ity of ser­vices. Some­times the great­est bar­rier is sim­ply find­ing out what best-prac­tice care is, and how it can be ac­cessed.

The dif­fi­culty of nav­i­gat­ing our com­plex health­care sys­tem comes up time and time again in con­sul­ta­tions with the Con­sumers’ Health Fo­rum of Aus­tralia. For ex­am­ple, many peo­ple who have ex­pe­ri­enced strokes re­port that they are not given ad­e­quate in­for­ma­tion about the ser­vices and sup­ports that will max­imise their qual­ity of life. Of­ten it is up to their fam­i­lies and car­ers to find out whether treat­ments such as phys­io­ther­apy or oc­cu­pa­tional ther­apy would be use­ful and, if so, where th­ese ser­vices can be ac­cessed.

For peo­ple with no ex­pe­ri­ence, iden­ti­fy­ing and lo­cat­ing ser­vices can be a full-time job.

Frus­trat­ingly, many peo­ple bat­tle on their own to find the ser­vices they need, only to dis­cover later that there was a gov­ern­ment pro­gram that could have as­sisted them in this process. Some­times there are lo­cal sup­port groups for peo­ple who have had strokes which can as­sist in pro­vid­ing in­for­ma­tion about lo­cal ser­vices and pro­grams.

How­ever, not ev­ery per­son who has had a stroke has the ben­e­fit of th­ese sup­ports. Nor should fam­i­lies and con­sumer groups be made re­spon­si­ble for what should be pro­vided as a nor­mal part of health care. Of course, some GPs and other com­mu­nity-based health pro­fes­sion­als do a great job in en­sur­ing their pa­tients re­ceive best-prac­tice, mul­tidis­ci­plinary care. But ac­cord­ing to CHF’s con­sumer con­sul­ta­tions, too many peo­ple are still miss­ing out.

CHF be­lieves that the fed­eral elec­tion pro­vides an op­por­tu­nity to change this sit­u­a­tion and to put con­sumers’ need for bet­ter care co-or­di­na­tion squarely on the pol­icy agenda. This can be achieved through a num­ber of strate­gies which we urge all po­lit­i­cal par­ties to con­sider as part of their health pol­icy plat­form.

Firstly, we sup­port mak­ing ex­per­tise in care co-or­di­na­tion a pre-req­ui­site for the pro­fes­sional reg­is­tra­tion of health­care providers. Much as we ex­pect GPs and other health pro­fes­sion­als to have a knowl­edge of anatomy and phys­i­ol­ogy, we should ex­pect them to have a knowl­edge of best-prac­tice care for com­mon con­di­tions, an un­der­stand­ing of the role of other health pro­fes­sion­als and in­for­ma­tion about how this care can be ac­cessed in their lo­cal area. This could be achieved through the im­ple­men­ta­tion of the Coun­cil of Aus­tralian Gov­ern­ments (COAG) pro­posal for na­tion­ally con­sis­tent pro­fes­sional reg­is­tra­tion.

Se­condly, we need to build on the ex­ist­ing suite of Medi­care items for care plan­ning by in­creas­ing sup­port for health­care providers to as­sist peo­ple with chronic ill­nesses in self­man­age­ment. While th­ese item num­bers work well in some sit­u­a­tions to sup­port a planned and team-based approach to care, they are lim­ited in their use­ful­ness as they of­ten rely on GPs to ini­ti­ate the plan­ning process and can only be used for cer­tain groups of pa­tients. Op­tions for us­ing this model to sup­port other health pro­fes­sion­als to play a greater role in care co-or­di­na­tion should be con­sid­ered.

Thirdly, the role of private health in­sur­ance in care co-or­di­na­tion needs to be ex­am­ined. Many peo­ple with chronic ill­ness rely on private health in­sur­ance to as­sist them in meet­ing their health­care costs, but health funds have played vir­tu­ally no role in as­sist­ing their mem­bers in iden­ti­fy­ing and ac­cess­ing the best mix of ser­vices for their con­di­tions. The Gov­ern­ment has de­manded lit­tle from private health funds in re­turn for the sig­nif­i­cant sub­si­dies that they re­ceive. How­ever, re­cent changes al­low­ing health funds to cover a broader range of ser­vices present an op­por­tu­nity to in­tro­duce re­quire­ments for them to do more than sim­ply pay bills.

For ex­am­ple, health funds’ cov­er­age of pro­grams fo­cus­ing on sup­port­ing early dis­charge and pre­vent­ing hospi­tal ad­mis­sions could be made con­di­tional on their in­clu­sion of best-prac­tice care co-or­di­na­tion.

Im­prov­ing care co-or­di­na­tion within the health sys­tem is im­por­tant for con­sumers and an es­sen­tial part of man­ag­ing the in­creased bur­den of chronic dis­ease in the com­mu­nity. It is time that we stopped leav­ing this to chance or the good­will of in­di­vid­ual health­care pro­fes­sion­als and started tak­ing it as se­ri­ously as we do other as­pects of health care. He­len Hop­kins is ex­ec­u­tive di­rec­tor of the Con­sumers’ Health Fo­rum of Aus­tralia

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