In the lead up to the Federal election, AHCRA has released a series of media and policy statements on key health issues. AHCRA will continue to lobby political parties to commit to health policies that will deliver a better and fairer health system.
In particular, AHCRA will be advocating for a greater focus on prevention and primary care, consumer participation and action to meet the needs of identified vulnerable population groups, including people living in rural and remote areas and the disadvantaged Indigenous population. Mental and dental care will be addressed as well as care for the physically and intellectually impaired population.
We will highlight the drawbacks of the fee-for-service model, including its impact in reducing equity and constraining innovation. AHCRA will also address other issues that warrant reform, including the mal-distribution of services and health professionals, out-of-pocket expenses for consumers and workforce innovation and reform.
Along with such initiatives AHCRA supports continuing review of ways in which efficiencies can be realised, including areas of ineffective expenditure where funding could be redirected to better effect. This waste may arise from a range of sources, including failures of care delivery; failures of care coordination; overtreatment; administrative complexity; pricing failures; and fraud and abuse.
Among the priorities that AHCRA has for reform are:
- Building a consumer-centred health system
- Continue Closing the Gap between Indigenous and non-Indigenous Australians
- Strengthening primary health care and prevention as core elements of the health system
- More effective prevention of ill-health and promotion of well-being by consideration of the social determinants of health
Building a consumer-centred health system
The current health system has been developed to suit professional and organisational needs, not those of consumers. Re-orienting the health system to reflect the needs and priorities of the community will result in a more efficient health system which delivers better health outcomes for all.
This should include strengthening the requirements for health services to involve consumers in decision-making and move towards more consumer-centred care; funding research which develops the notion of consumer-centred care and more effective consumer participation; developing mechanisms for stronger citizen engagement in discussing/guiding policies for the health system; and increasing the community’s health literacy, especially within more disadvantaged populations.
Continue Closing the Gap
Indigenous health is the number one health issue facing Australia and continued investment in this must continue. Indigenous people have significantly poorer health, on average, and a much lower life expectancy than the non-Indigenous population.
Indigenous people experience higher incidence rates for many chronic diseases, including heart disease, diabetes and some forms of cancer. In almost all areas, the determinants of health are poorer for Indigenous people with inferior education outcomes, higher rates of unemployment, greater poverty, homelessness and psychological stress with the more common outcomes of death from accidents or from suicide.
Health care based on standard Australian biomedical models of medicine is useful in identifying and reducing disease and is a necessity in all societies. However it does not adequately take into account the population-wide approach that is important for indigenous peoples. A population-wide approach is needed that incorporates the social determinants of health and empowers people to take control of their own lives and improve their health through culturally appropriate mechanisms.
Community- controlled health services are thus vital in reducing the ‘health gap’ by providing person-centred and to culturally relevant care which includes both a biomedical and preventative health focus. To do this requires more consistent and assured long-term funding to enable effective planning and capacity development that will deliver the best possible outcomes.
Strengthening primary health care and prevention
AHCRA believes that future Australian health care will need to be more heavily focussed on prevention and early intervention. Primary Health Care is seen to be a core principle of an effective health system that will reduce the burden for consumers/families while keeping pressure off hospitals to deal with later stage and more serious (and often expensive) conditions.
The cost of health care, especially acute health care, is rising at well over the inflation rate annually. This expenditure growth will place great stress on the health budgets of the states and territories and the federal government.
AHCRA believes a key solution is for Australians to become much better at preventing ill-health and promoting wellness, identifying and treating it early, and managing ongoing conditions in community settings.
There are more efficient options than allowing poor health conditions to develop that result in increasing episodes of expensive hospital care.
Among the measures needed are better infrastructure to facilitate multidisciplinary integrated services, especially in rural/remote settings. This involves better planning to create an integrated system that mobilises greater multidisciplinary care (best practice) with more flexible use of the available workforce in a diversity of roles.
More effective prevention of ill-health and promotion of well-being by consideration of the social determinants of health
To realise optimal health outcomes requires change that recognises the social determinants of health. These are the underlying social, environmental and ecological factors that research shows are closely associated with higher rates of ill-health. These factors must be addressed so that Australians’ health overall is enhanced, not damaged.
Strategies that have already shown substantial benefits include national policies on plain tobacco packaging. Other measures that promote healthy lifestyles should be explored such as health literacy, and access and equity considerations in education, housing, food, early childhood development, social inclusion and employment.