Australia's Healthcare Sector Reforming Health Care

Abstract

In a country as prosperous as Australia, it is somewhat worrying that the quality and availability of public healthcare is being compromised. 'Many Australians no longer have confidence that they can necessarily access healthcare services when and where they need them.' 1 Urgent reform is not only possible, but affordable and essential. O ver two years ago, the Commonwealth Chief Medical Officer, in addressing a health conference in London, had this to say: 'The results of our care and patient experiences of the health care system are too often less than ideal.....Our public healthcare systems never seem to have enough resources.....Access to care, while universal, is too often delayed.' 2 Such an alarming statement has not been challenged-in fact it is even more widely accepted today. Indeed, throughout wealthy countries (Organisation for Economic Cooperation and Development) we hear the same kind of systemic problems: • many doctors are disgruntled, overworked and professionally unsatisfied; • nurses are restless and in short supply; • popular demands for more health spending are universal ; • payers (of healthcare) are widely unpopular; • many patients feel vulnerable and uncared for; and • the politics of healthcare is ugly-governments retreat into obfuscation and the difficult issues are systematically avoided. Within Australia, healthcare is one of our major industries , employing 7.2% of the national work force. 4 The latest figures available show estimated total expenditure (public and private) on health in Australia in 2001-02 was $66.6 billion, or 9.3% of national GDP. 5 In the 2004-05 budget, $41 billion has been allocated to health and age-ing by the Commonwealth Government alone. 6 Peter Costello, the Federal Treasurer, recently went further, observing that 'when we look across the next forty years we find that the largest area of pressure in relation to Government spending is going to be in the health area.' 7 Figures just released support his projection, showing rapid growth in health expenditure over the last decade (4.6% per an-num). 8 Despite such prominence, perceptions of Australian healthcare and its workforce seem to frequently oscillate between positive predictions and dire warnings. 'Australia is not alone in this, with the United Kingdom, Canada and the United States experiencing similar cycles of variation in opinion.' 9 Why is this so? Common sense would dictate that such an extensive and expensive sector would be underpinned by a well considered, nationally consistent policy. 10 However , there is …