In this election year, health and aged care is top on the agenda, with dramatic changes sweeping through the nation as states and commonwealth lock horns on responsibilities, task sheets and GST. The million dollar question circling the hallways of hospitals and clinics alike is: will the proposed model by the Commonwealth Government end the blame game between feds and state?
Like education or environment, health is a wholly integrated sector. Each division creates knock-on effects on other divisions (e.g. shortage of doctors cause longer waiting for surgery which causes lack of beds in acute care, which increases pressure on primary care and aged care). Because of the integrative nature of the health sector, the only way to completely end the blame game is for the total funding and total control system to be assumed by States or the Commonwealth.
While the proposed takeover will see much more transparency in the process (that patients will be able to see if hospitals aren’t delivering on the benchmarks or the Commonwealth isn’t delivering on the funding), it just means that there is more transparency in where the issues lie, not necessarily an end to the issues. Currently the responsibilities are:
- Commonwealth funding 60 per cent of the efficient costs of health services
- 100 per cent of primary care and aged care
- Community mental health as well as alcohol, drug, maternal and child services have all been left with the states.
Money was supposed to go directly from the Commonwealth to the networks, bypassing the states. But in a major concession, Mr Rudd has had to agree that the funds will now be funnelled through the state based pools.
Money appears to be focused on certain areas, e.g. hospitals, at the expense of others, e.g. primary care. This could result in increased hospitalisation rate. Certain aspects of the health are being taken care of, but shortfalls could impact on the whole health system.
Australian National University health policy expert Robert Wells said, “This is really more a package about making it easier for people to get into hospital than it is a package about helping people stay out of hospital.”
There needs to be a clear set of guidelines and responsibilities. The federal government will have a stake about what happens in the hospitals. The states will have a stake, and the local hospital networks will have a stake. And regulators get a stake. A bit like the current system; except in triplicate.
As we look forward to an election in the next half of the year, Ellis Jones will continue to provide regular insight on the different aspects of the health reform, from the Productivity Commission into Caring for Older Australians to the Aged Care Access Initiative. Stay tuned!