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