I’ve been working in the Australian healthcare industry for a few years now, and in all honesty, it’s slow progress. When it comes to tackling the critical long term challenges to fix some major holes in the healthcare system, it starts from the ground up.
During Australian Healthcare Week 2014, we thought it was time to get some of the Australian healthcare leaders in a room to discuss some of the key burning questions on everyone’s lips.
Several clear areas stood out, so here they are – the five questions that everyone in healthcare should be thinking about to revolutionise our system and drive real positive change.
So who was involved?
- Leonie Hobbs, Senior Consultant, Carramar Consulting
- Kathy Campbell, ICT Manager, VCCC
- Rob Clarke, WSP Independent
- David Johnston , eHealth Consultant,
- Claire GrooMbridge, Facility Planner, Hunter New England Local Health District
- Sandra Roggeveen, CEO, Dzhon
- Stanton Kroenert, Manager, Woods Bagot
- Damien Crough, Business Development Manager, Hickory Group
- Ian Mitchell, Principal, Conrad Gargett Riddel
- Don Garner, Group Leader – Health, Sinclair Knight Merz
- John Goodchap, National Manager – Health, Hansen Yuncken
- Steve Trevenar, Head of Business & Strategy Healthcare & Scientific Research, Lend Lease
- Debra Barbas, Clinical Services Manager, St John of God Murdoch Hospital
- Rohan Wilson, Architectural Director, DesignInc
- Mark Halpin, Director – Infrastructure Management, The Townsville Hospital
Where should the money be going?
- It doesn’t grow on trees
The Australian dollar is limited; nationally we spend $130 billion dollars a year on healthcare, which is 10 per cent of GDP. With substantial cuts announced in the Budget, it’s clear the pot isn’t getting any bigger. So where should we be spending the money? And perhaps more importantly – where are we going to get it from?
One of the biggest challenges is making sure the funds go where they will have the most benefit; it’s not necessarily the specialist treatments and big exciting stuff. There are two sides to this coin. Firstly, who should get treatment and who shouldn’t; secondly, we need to stop focusing on sickness and focus on health.
The table discussion centred primarily on the last 10 per cent of people’s lives and those that lead an unhealthy lifestyle, leaving the two intrinsically linked.
We’re currently spending 90 per cent of funding on that last 10 per cent. We’re also focusing on funding facilities, with not enough action being taken to manage demand.
The simple truth is, the growth rate is unsustainable and people’s lifestyle choices are smashing acute health services.
Some major reform is needed to incentivise people to stay healthy. Our current spend needs to be shifted; all agree that it’s currently imbalanced. Chronic Disease management was also thrown into the mix as a better way to spend money, with more of a focus on long term quality life.
Whether this starts with taxes on unhealthy foods, in a similar manner to cigarettes and alcohol, or wider initiatives around the planning and development stages of community – building in the opportunity for healthy lifestyles.
- Shifting public perception
The general consensus is that people have the wrong perception of healthcare.
We all enjoy and expect good quality healthcare in Australia, but as we know, it’s not sustainable.
Although the national reform agenda is seeing small amounts of change, it’s nowhere near where we need to be.
One of the potential solutions comes in the form of private health and private insurance. More competition in the area enables it to be available at a reasonable cost. Previously seen as a luxury for the wealthy, few have a realistic concept of the cost.
- Getting money into the system
As announced in the Budget, the Federal Government could potentially widen the gap to accessible healthcare with confirmation that patients will be charged with a GP tax.
The Government confirmed in its Budget announcement that the much speculated and controversial general practice co-payment model will be implemented.
From July 1, 2015, visits to the doctor will cost everybody $7 with the introduction of a Medicare co-payment. The co-payment will be waived for children and those on concessions only after 10 visits a year. The co-payment will raise $3.4 billion in the first four years, while upfront payments and a tightening of eligibility for the prescription drugs on the Pharmaceutical Benefits Scheme will raise another $1.3 billion.
It’s the continuation of a long debate around co-payment.
Another $1.6 billion will be cut from health by freezing indexation of income thresholds, which determine eligibility for the private health insurance rebate, the Medicare Levy surcharge and other Medicare services.
There are a few problems hindering injections of cash into the health system; inefficiencies from whole-of-regime litigation, excessive tests, limited working hours and supply and demand from private insurers.
The group explored one of the key areas – working hours.
Many facilities are still limited by the 8-5 pool, leaving people with no choice other than to go to hospital. Can we have 24-hour general practices, reducing the demand on hospitals in the same way many health insurers do?
If the health facility functioned on a 7-day-a-week approach with staffing and services, would we be able to provide better care and reap back costs that outweigh operational running fees?
The day public facilities expand the operating hours is the day we can stop building new operating theatres. There’s a trend for more 24/7 facilities – let’s fund the infrastructure but then use it efficiently. A private facility in Brisbane ran its MRI 24/7 – ends up being cheaper to come after-hours.
Public health is getting better with new targets, but it’s some of these efficiency-driving measures that could make the real difference…a little more on that later.
Want to know the other 4? Read the full report here: 5 questions that will make or break Australian Healthcare