Comments on Arthur Sinodinos “Captain Rudd still hasn't set course for reform”, 22/04/2010, http://www.theaustralian.com.au/news/opinion/captain-rudd-still-hasnt-set-course-for-reform/story-e6frg6zo-1225856600217
Although the health reform agreement is not perfect especially all healthcares are not quite integrated, it should have significant structural reform components in it if the activity based funding and local hospital board are well implemented.
They will increase efficiency and productivity as well as effectiveness.
Of course, further reforms will be needed once the local hospital boards are working well. They may provide a step towards an integrated local health boards to integrate all health.
There will also be a need to consider how small hospitals can be integrated into a whole health system, so the regional distribution of hospitals are optimised to best serve the nation’s and regional health.
Further, there should be some formula to encourage efficiency quasi-activity based funding for small hospitals, taking into account their scale and local population.
Of course, Arthur has a point that the health reform agreement now is quite different from Rudd’s original plan. The agreement, however, is better than Rudd’s original. The argument that States are still involved is misinformed and misconception. States, albeit their shortcomings, are still better positioned to manage hospitals than the Commonwealth from Canberra – more remote from the public and patients needs with no or little complex services experience.
What the change in the plan means is that the original plan was not as good as it could and should have been – a reflection of a gap in its original development and the government’s limitations in its capacity in developing best policies.