Health system fails some of Australia's most vulnerable and disadvantaged



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“We already have one of the best health systems in the world but it is under pressure, and it continues to fail some of the most vulnerable and disadvantaged Australians,” Federal Department of Health Secretary, Martin Bowles has told a CEDA Brisbane audience.

Speaking on the reforms needed for the long term sustainability of Australia’s health system, Mr Bowles outlined the pressures facing Australia’s health system, particularly for disadvantaged communities, those in aged care, with chronic illnesses and relying on mental health systems.

“Reform is needed – we understand the compounding pressures and the strains they are putting on health budgets; whether they’re of national government level, state or territory government; mums or dads or individuals,” he said.

As part of a review of primary healthcare, mental health and dental care, Mr Bowles said they were examining the 5700 items on the Medicare Benefits Scheme, some of which have not been updated for 30 years. 

“The review is being done over a number of stages, we’ve initially targeted a two year period. It’s already recommended the removal of 23 low volume items from the MBS that are seen not to be clinically effective,” he said.

Mr Bowles also discussed the importance of implementing new novel ways of thinking and new systems for Australia’s ageing health system, such as involving a larger focus on mental healthcare and emphasis on greater communication, digital healthcare and useability.

“Implementing them will require new ways of thinking, new ways of doing things. We will need to do old things better and we will need to innovate,” he said.

“All of these reforms require strategic cultural change; strategic compromise not confrontation, a shift from the ‘us and them’ mentality, that I think has divided us for many years.”

“But when we are successful, these reforms will bring the biggest change to the health system that we’ve seen in many decades.”

Mr Bowles also outlined other initiatives for the funding of Australia’s health system, from alternatives to Medicare’s fee for service implementation to better responses to complex and chronic conditions to mental health at a primary care level.

“I think we all agree that people with chronic and complex conditions should have ready access to health services. They should be able to get coordinated and multi-disciplinary team care where there are different health care providers, and we need to make sure they are talking to each other and working together for the benefit of the patient,” he said.

“A new stepped care approach coupled with more regionally responsive and flexible funding arrangements will better support patients to get the care that suits their needs. A regional approach again led by primary health networks will plan, integrate and commission mental health services at a local level in partnership with the relevant services and with a new flexible primary mental health care funding pool.

“Without change, eventually the pressure could overcome us.

“We have a unique opportunity, a rare window, for constructive reform, to ensure our health system stays among the best in the world but we need to have the courage to try new and innovative ways of doing things. It is not beyond us, so let’s embrace the opportunity.”