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2010-04-18

Health reform - the way farward

The federal and state leaders are going to meet on Monday on health reforms, especially the Rudd health plan. But it does not appear they are likely to reach an agreement based on current state of play.

Both Rudd and Brumby plans only covers public hospital mainly. Health needs to be integrated.

The nation needs health reforms badly and it will be a pity if they can’t achieve agreement on a reform plan.

I think a health reform plan should have the following:

Principle: national cooperative approach to health, with clear funding mechanism, administrative, and service delivery responsibilities and resolution mechanisms

Ministerial Council on health - National health board in charge of national health and national and bilateral health issues

National and State pool of all health funding – including public hospitals, primary and other cares, the Commonwealth will have dominant funding role

Secretariats for State health – up to eight groups, one for each state and territory, including Commonwealth representatives to replace State departments of health, with much fewer personnel

State in charge of administration of health through the secretariat

Local health boards – responsible for local/regional health delivery, secretariat determines how they should be setup

National agreement on:
Size of health funding pool and Commonwealth and State shares - basic formula to link to their perspective revenue shares, a default mechanism for each party to vary its contribution and the other party to respond by a certain proportion if agreement can’t be reached.

A default mechanism individual State obligation if it fails to deliver agreed health outcomes

A default mechanism for resolving situation if an individual local network fails to deliver agreed outcome, or agreement can’t be reached between State secretariat and the local network

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