Problems and hanges in the Australian Health System - Essay Example

Pressures that will drive changes in the Health System Rachna Jalan Pressures that will drive changes in the Health System in the next 20 years in Australia Shortage of Medical Workforce The health care system requires intensive workforce. Of late, the present and future potential of the health care labour has come under question (Healy, Sharman & Lokuge, 2006b). It is uncertain whether it will be able to cope with such transformations like an ageing population, the emergence of new diseases, treatments and technological know-how, changing employment patterns, rising attention on rural and Indigenous health, trends in litigation and most importantly anticipation of slow rate of growth in the workforce because of poor fertility rates (Healy, Sharman & Lokuge, 2006b). “The health care sector is under considerable pressure given significant shortages of health professionals, including doctors and nurses, with these supply shortages projected to continue, prompting a search for both short-term and longer-term solutions” (Healy, Sharman & Lokuge, 2006b, p. 80). “There is widespread agreement that Australia faces a critical shortage of allied health professionals, and that changes are urgently needed in many areas affecting the allied health workforce” (Health Professions Council of Australia Ltd., 2005). The ABS Medical Labour Force Surveys in 2005 revealed a decline of around 1% in the number of generalist medical practitioners (Australian Institute of Health and Welfare, 2006, p. 316). According to another report which was conducted in 2002 by Access Economics, commissioned by the Australian Medical Association approximate overall shortage in the number of general practitioners remained between 1200 and 2000 (Access Economics, 2002, p. 9). The Australian government has adopted various strategies to increase the supply of doctors in the rural and remote areas (Department of Health and Ageing, 2005, p. 95). The Regional Health Strategy, “More Doctors, Better Services”, was introduced in 2000 with the same objective (Commonwealth of Australia, 2004). However, the maldistribution of medical labour is still problematic in Australia (Healy, Sharman & Lokuge, 2006b). Australia-wide shortages in various areas of nursing are being intensively felt (Healy, Sharman & Lokuge, 2006b). Crisis in the supply of nurses is observed in operating theatre, critical, intensive care, accident, emergency, cardiothoracic, neonatal care, midwifery, and mental health (Healy, Sharman & Lokuge, 2006b). The alarming rate of fall in the number of nurse trainees and the loss of trained nurses from the workforce is a matter of great concern for the Australian Health Workforce Advisory Committee (AHWAC 2004). Pressures will increase Amidst the present labour crisis, which may be cyclical, there exists a range of longer term, and largely structural, demand and supply pressures requiring confrontations (Productivity Commission, 2005): After a decade, the health employees are expected to handle a changed combination of disease burdens. For instance, on one hand where the share of stroke victims will probably fall, there will be rise in the number of victims suffering Type II diabetes and dementia. With rising incomes, people will be more willing to spend on health care for acquiring prompt and superior quality health services. Technological advancements will act as stimuli for rising demand for health care. This will seek for new workforce practices. The changing age profile of Australia along with its impact on the incidence of chronic disease will lead to changing care needs. With the increasing average age of health workers, there will be tendencies by the service providers to replace more of the retiring workers and to acquire extra labour to match the mounting demand. Health services being labour intensive, huge wage-related cost pressures are expected. The combined effect of these demand and supply pressures will be considerable on health care spending (Productivity Commission, 2005). It is being anticipated that by 2044-45 such spending account for a minimum of 16% of GDP with government outlays of around 10% of GDP (Productivity Commission, 2005). Financial Pressures The health care system in Australia is predominantly tax-funded financed through general taxation, encompassing a small statutory insurance levy and private payments (Healy, Sharman & Lokuge, 2006a). “Like other countries, Australia faces growing pressures on health funding because of the ageing of the population, technological changes and increasing patient expectations” (Department of Foreign Affairs and Trade, n.d.a). According to Bloom, financial crisis should be the starting point for reform of the health sector in Australia (2000). The stabilization of finances particularly in mixed public-private health care systems requires indomitable efforts (Bloom, 2000). The total expenditure on health by all levels of government and the private sector has been estimated to be around 9.5% of Australia’s gross domestic product (Department of Foreign Affairs and Trade, n.d.a). Due to the provision of limited budgets and mounting health expenditures, the Commonwealth and State governments are shouldering huge cost pressures (Healy, Sharman & Lokuge, 2006c). The consumers are experiencing increasing out-of-pocket expenditures (Healy, Sharman & Lokuge, 2006c). There exist hindrances to better coordination and accountability in financing and service provision, especially between the Commonwealth and States (Healy, Sharman & Lokuge, 2006c). Providing cost-effective health services is becoming one of the principle aims of the present health care reforms in Australia (Healy, Sharman & Lokuge, 2006c). Improvement in the coordination and accountability in the funding and provision of services also needs substantial attention (Healy, Sharman & Lokuge, 2006c). Like various other OECD nations Australia health system has adopted market-like reforms such as budgetary incentives, funding hospitals according to performance and treating patients as customers (Healy, Sharman & Lokuge, 2006a). Endeavours to cut down expenses have been the chief determinants of changes over the last decade in the Australian health care system (Healy, Sharman & Lokuge, 2006a). The appropriate level of Commonwealth funding which is often considered insufficient to cover the mounting hospital costs is a debatable issue (Healy, Sharman & Lokuge, 2006a). International Influences International tie-ups of Australia encompass the World Health Organisation (WHO), the Organization for Economic Cooperation and Development (OECD), health ministries in other nations and independent research institutes (Department of Foreign Affairs and Trade, n.d.b). The Foreign Investment and Review Board (FIRB) propose foreign corporations to invest in Australia and examine requests by foreign companies (Wynne, 2000). It was blamed by the health department in NSW for not undertaking investigation of Tenet/NME in 1991 when it arrived in Australia (Wynne, 2000). “Australia’s human-use pharmaceutical industry is dominated by subsidiaries of multinational pharmaceutical firms, though there are large Australian-owned enterprises within the industry” (Healy, Sharman & Lokuge, 2006a). Australia owns very little large-scale production of active ingredients of manufacturing (Healy, Sharman & Lokuge, 2006a). According to the 2001-2002 sales analysis of Australian manufacturing around 43.6% of products were completely imported, 18.1% were completely imported in bulk and packaged locally while 33.6% were prepared and enclosed locally from imported components (Healy, Sharman & Lokuge, 2006a). According to some section of the society, the privatization of health system is actually the result of American influence. “Failure to pay medical bills is the single most common reason for personal bankruptcy in the privatised United States health system. That is the direction in which we are heading” (Woodruff, 2006). This Americanisation of the Australian health system is being considered as a disaster by many (Woodruff, 2006). Conclusion From the above discussion, we can realize the pressures that will drive changes in the health system in Australia over the next 20 years. Not only are the pressures of health workforce crisis immense, the loads of finance have also emerged to be a matter of concern for the country’s health system. Australia that is not untouched by the international influences is also revealing sings of change, which will be exposed over the next 20 years. According to a senior Registered Nurse who has served a public hospital system for more than 17 years “There is currently a funding shortage in the health system where the health department puts restrictions on the type of personnel that can be involved” (Lopez, 2000).. References Access Economics (2002). Preliminary health care for all Australians: an analysis of the widening gap between community need and the availability of GP services. Report, February 2002, Canberra, Australian Medical Association from Access Economics Pty Ltd. AHWAC (2004). Annual Report 2003-04. NSW, Australian Health Workforce Advisory Committee. Australian Institute of Health and Welfare. (2006). Australia’s Health 2006. Canberra, AIHW. Bloom, Abby, L. (2000). Health Reform in Australia and New Zealand. Melbourne: Oxford University Press. Commonwealth of Australia (2004). Federal budget 2004-05, health budget health fact sheet 4 – a continuing commitment to rural, regional and remote Australians. 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