Clar­ity and vi­sion lost en route

The Weekend Australian - Travel - - HEALTH -

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’’.

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