No Need to Delay Health Reform

The Australian Financial Review

By Jennifer Westacott
Chief Executive
Business Council of Australia

Today’s Council of Australian Governments meeting will once again test the mettle of government leaders on their commitment to creating a sustainable healthcare system.

It is disappointing when all the challenges are so well known and the general strategies for addressing them are basically accepted that we see governments continuing to waste time and money arguing over what most taxpayers would regard as minor bureaucratic issues.

What matters is not which government pays or who owns what but the quality of outcomes that are delivered, whether they are sustainable, whether they serve all Australians equitably and how good our healthcare system is relative to other systems around the world.

For the past three years, business leaders have been calling for the reform process to begin. The Business Council of Australia sees no reason why the fundamental principles of achieving improved health outcomes and productivity in the healthcare sector should not be embraced by all political leaders.

The initiatives the federal government is trying to put in place are modest steps in the journey of reform. For even these to be jeopardised by intergovernmental wrangling is galling.

We know that up to 20 per cent of health resources are wasted. We know that the level of adverse events and variable outcomes is too high and would not be tolerated in any other sector. And we know that by reshaping healthcare facilities and services to better suit the changed pattern of illness in Australia, by creating stronger incentives for people to stay healthier for longer, and by adopting technologies that allow us to use the skills of our health professionals more effectively, we can make sure Australians have access to a sustainable world class health system into the future.

Front and centre is the need to address the system’s long-term sustainability in the face of well-recognised challenges. These include on the debit side: rising demand driven by the increase of chronic disease and our rising expectations of the healthcare system; projected workforce and skills shortages; and the fact that public resources are not unlimited. On the plus side, we are enjoying greater national wealth and the new possibilities offered by technological advances.

The longer we delay reform, the more likely it is that deficiencies and weaknesses already evident in a system under strain will become overwhelming. This will constrain our ability to undertake a phased and rational adaptation process.

The establishment of the National Health Performance Authority and independent pricing authorities is the very least patients and taxpayers should expect in improving the transparency and accountability for the dollars spent and the outcomes achieved. 
Our goals won’t be achieved through bureaucratic, “command control” structures and regulation that cannot accommodate inevitable, ongoing change.

We must shape a top quality healthcare sector around skills, systems and facilities that can meet challenges as they arise and, at the same time, take advantage of technological and other advances.

This will involve building strong, independent and trusted regulatory institutions of the stature of the Reserve Bank of Australia that can supervise a market in transition and assure patients and taxpayers of the integrity of providers.

At the same time, we need to empower citizens and patients to make more informed health decisions based on good and timely information.

Progress made by the most recent Australian Health Ministers round is encouraging. It’s time now for COAG to settle the reforms and move on to implementation. As the COAG Reform Council has identified, that’s a far bigger issue for managers to focus on.