Clarity and vision lost en route
but equally important issues — such as how to rearrange the current health workforce, and the need to adequately fund the shift and to share the gains evenly across society.
Fiona Armstrong, chair of the Australian Health Care Reform Alliance, says for Australia to deliver on its 2020 vision it must address the waste and red tape created by the multiple tiers of government health services.
‘‘ The ‘ big ideas’ and ‘ overarching ambitions’ developed at the summit reinforce that structural reform to the system of funding health care in Australia is imperative,’’ she said post-event.
But despite dominating debate ahead of the summit, such structural reforms are few and far between in the final communique, as other issues side-tracked discussions.
On the summit’s eve, for, instance, peak doctors’ groups the Australian Medical Association (AMA) and the Australian General Practice Network (AGPN) went head-to-head over the latter’s proposal to shift some health dollars from fee-for-service to block funding for general practices.
Other participants aimed to loosen doctors’ stranglehold over Medicare and dramatically restructure health degrees, while indigenous groups sought to hold all levels of government to account for failings in health service delivery.
At summit’s end, though, many of the proposals had become the poor secondcousins of the preventative health push.
A proposed indigenous health inequalities commission mutated into a more broadranging health equalities commission, with fewer inquisitorial powers. Likewise, the plan to ‘‘ radically reform’’ the rights, responsibilities and training of Australia’s health workforce rated little more than a late mention, while the AGPN’s proposal to reform healthcare funding was subsumed by motherhood statements.
The AMA, a fierce defender of the existing fee-for-service model, applauded the final communique’s refusal to ‘‘ embrace any suggestion that would reduce patient choice and ration funding for health needs’’. The APGN, on the other hand, expressed disappointment’’ at the omission. The most telling remark, however, came from former AMA president Mukesh Haikerwal. At the end of the two days, he was asked his view of the recommendations of the heath workforce and service provision discussion stream.
Speaking with surprising candour, Haikerwal said: I’m not really sure what they were, to be honest’’.