Social Policy and Health in Australia - Essay Example

Social Policy [Name of the Student] [Name of the University] Social Policy and Health in Australia Introduction The advent of the Medicare Locals was on 1 July 2011. The Minister for Health Roxon, had announced that there would be 19 organisations spread over rural and urban Australia, in the first instalment. In New South Wales, the Medicare Locals are; Western Sydney Medicare Local, Hunter Urban Medicare Local, New England Medicare Local, and the Murrumbidgee Medicare Local[Med11]. Primary healthcare in Australia is chiefly provided via two parallel systems. The first of these is the system of Medicare, which delivers primacy care. This mechanism involves general practitioners who are provided remuneration for service. The other system is that of managed community health services. A semi – structured interview was conducted, in which 18 general practitioners participated. This endeavour was aimed at determining the relationship between local primary healthcare providers and the general practitioners[Wie11]. These interviews disclosed that the chief impediments to links were communication and information; access to availability of services; lack of awareness and understanding, among the general practitioners, with regard to the services made available in the state funded sector; and the unavailability of time to obtain information. It was reported by the general practitioners that they had to deal with the more intricate and challenging cases. All the same, this did not indicate the possibility of their collaborating with the state funded healthcare services, with regard to case management[Wie11]. In addition, it had been proposed to introduce 18 Medicare Locals in New South Wales, in the year 2012. This will constitute the maximum number of primary healthcare organisations, in any of the states or territories of Australia. It is the duty of these Medicare Locals to implement strategies that address the primary healthcare requirements of their populations [Sau12]. In addition, these organisations have to make certain that these healthcare services are available and effective. As such, Medicare Locals join forces with the prevailing services and groups and, wherever requires, they introduce improved or new primary healthcare services. These organisations make available solutions at the local level to the problems that arise at these levels. Furthermore, Medicare Locals have a significant influence in determining the manner in which health services are to be coordinated, so that patients derive the maximum benefit[Sau12]. Through social policy, human life as well as dignity are safeguarded by the society. Health care is deemed to be an important component of social policy, in addition to education and social welfare. It consists of decisions of the government concerning the following issues: cost, quality, delivery, accessibility and evaluation of packages funded by taxation. These programs are framed to improve the physical comforts of all the people in society, according special attention to children from ethnic communities and women[McG01]. The health condition of a nation can be considered the result of the health care policy that is existing there. The wellbeing of a person can be evaluated on the basis of security, accessibility to quality, availability of information, access to justice, and health awareness. The recent health care reforms consist of various delivery methods, such as the free market and for profit – system[McG01]. However, access to primary health care in Australia has been founded on the theory of neo – liberalism as a political attitude and the acceptance of reasoning in economic decisions. In general, the values pertaining to the concept of primary health care will be in at variance with neo – liberalism. This theory states that national and international life patterns should be made subject to the effects of the market; and that governmental involvement, in such matters should be minimised. In instances, where the neo – liberal political philosophy accords importance to national policy, financial statistics will be considered as the true measure of the success of government policy[Tal101]. The strategy related to the proper delivery of healthcare, should ensure that all the stakeholders coordinate with each other, so as to bring about the fullest engagement in planning and implementation of interventions for their better health, with regard to individuals. This system should be implemented in a manner that benefits communities, by improving the economic, cultural and social aspects of communities[Swe12]. In the context of Medicare Locals, the independent companies formed with federal funding have been asked to perform the almost impossible task of bringing together a health system that has been significantly splintered. These companies have been entrusted with the task of integrating the badly fractured primary care sector. This has to be achieved by facilitating closer cooperation among the General Practitioners, nurses, psychologists, physiotherapists, community health workers, allied health professionals, pharmacists and others[Swe12]. Furthermore, Medicare Locals have to establish better relationships between primary care, public and private hospitals, and services catering to the needs of the aged. These entities have to function as the adhesive in a system characterised by a funding mechanism and structural divisions that have been impervious to the efforts aimed at national health reform[Swe12]. As such, the Medicare Locals have been entrusted with a task at which the bureaucrats and politicians have miserably failed all over the nation. In addition, the Medicare Locals have been made responsible for bringing about a transition in the focus of primary care towards the health of the population. The emphasis has now been shifted to the health requirement of specific geographical areas. In the past, the focus had been restricted to the needs of patients. The social determinants of health stand to be adequately addressed, if this objective is realised. Some of these determinants are; housing, food supply, transport, education and work opportunities, support and social infrastructure. These laudable goals have to be achieved by Medicare Locals with meagre resources. For instance, the federal allocation for four years is just $493 million[Swe12]. This is dismally small, when compared to the scale of change that they are expected to achieve in institutional interests, and the extent of their responsibilities. This task should not be underestimated, and it constitutes a substantial and significant change for Australian primary care. The Medicare Locals will have to work in an extremely intelligent and judicious manner, as their resources are scanty[Swe12]. Moreover, in Australia, Medicare provides universal coverage. Medicare is a public insurance programme, and it is financed by the taxes collected by the government. It is of considerable use to the public, as it encompasses the major areas of medical care, such as prescription drugs, and hospital and physician services. Despite the fact that public hospital care is the responsibility of the territories and states, the federal government regulates and funds the majority of the health services[The131]. Around 50% of the Australians receive additional cover, via private insurance, and this is in addition to the cover provided by Medicare. Such private insurance cover is subsidised by the government. This cover extends to various services, such dental care and private hospitals. Moreover, the majority of the doctors are private practitioners, and the government pays them on the basis of a fee for service. The general practitioners provide the necessary recommendation for treatment under a specialist. Around 67% of the hospital beds are to be found in the government hospitals. Nevertheless, private patients can be provided with treatment in the government hospitals[The131]. Furthermore, doctors in private service are provided with payment for treating public patients, on an hourly basis. On the other hand, doctors in public hospitals are paid a salary and obtain additional remuneration for treating private patients. It is the objective of the government to introduce a novel management framework for the public hospitals. This structure will be built around the local area networks, thereby enhancing the contribution of the federal government towards public hospitals. It is also the intention of the government to reinforce primary care[The131]. This new system will implement reporting related to performance. Moreover, one of the more important programmes of Medicare is the Enhanced Primary Health Care Plan Scheme. Under this scheme, a discount with respect to health services provided by the Innovative Health & Rehab Exercise Physiologists can be availed by patients suffering from intricate medical conditions. The allied health initiative of Medicare encompasses the exercise physiology services[Med13]. This significantly improves the access of the public to professional services in the areas of disease prevention and physical rehabilitation. The Accredited Exercise Physiologists of the Innovative Health and Rehab design individual exercise programmes, which are specifically intended to manage chronic diseases, and preclude the development of new chronic ailments[Med13]. However, in the absence of clinical, organisational and corporate governance, it is not possible to ensure the provision of effective health service. In the context of Medicare Locals, corporate governance translates into a focus on features of a non – clinical nature. Some of these are, the financial and risk management systems[Acc121]. Such emphasis has the effect of guaranteeing that the health service complies with its funding and statutory obligations. The provision of primary care in the urban, remote and rural areas has been subjected to tremendous change. This has generated novel roles for the healthcare professionals, whose basis is primarily in the community. Unambiguous communication and supportive infrastructure are essential for the proper functioning of multidisciplinary teams, engaged in the task of providing primary healthcare. A number of innovative models relating to the provision of healthcare have emerged, consequent to the initiatives and policy developments in the Australian government [Cha121]. These changes are expected to provide improved access to services, in addition to providing a better integrated approach to healthcare. . Conclusion In a health care system funded by the government, the important delivery mechanisms are hospitals, healthcare professionals and public funds. Medicare Locals would coordinate their efforts with the General Practitioners, nurses, associated health professionals, indigenous health organisations and the Local Hospital Networks. The objective behind this collaboration would be to recognise and address lacunae in the local health services, and to assist patients and professionals to access this intricate system more efficiently. As such, the Medicare Locals are truly path breaking, as they provide a once in a generation opportunity to implement a health sector that is truly multidisciplinary and coordinated. The two parallel Primary health care systems discussed above, have to commingled, and their integration and coordination have to be improved, if Medicare Locals is to emerge successful. According to the theory of neo – liberalism, health care in Australia accords importance to political attitude and reasoned economic decisions. According to this theory, life patterns should be made subject to the effects of the market. As such, this would minimise government involvement. In such cases, success of the government policies could be evaluated primarily on the basis of economic considerations. In an interview disclosed by Wiese et al, with respect to general practitioners, in order to assess their relationship with the primary health care providers, it was stated that there are many hindrances to the discharging of their duties in a smooth manner. Some of these impediments relate to communication and information; access to availability of services; lack of awareness and understanding, among the practitioners. With regard to Medicare Locals it was observed that proper governance is lacking in providing effective health care. For any healthcare policy, to be successful, involvement of all the stakeholders is necessary. Lack of communication, absence of awareness and understanding of opportunities are hindrances to the success of health care organisations. References Access to Allied Psychological Services. (2012, July). Clinical Governance Framework. Retrieved February 22, 2013, from Australian Medicare Local Alliance: http://www.amlalliance.com.au/__data/assets/pdf_file/0019/43174/ATAPS-CGF-Final-for-website.pdf Chamberlain – Salaun, J., Mills, J., & Davis, N. (2012). The General Practice Team and Allied Health Professionals. In M. L. Caltabiano, & L. Ricciardelli, Applied Topics in Health Psychology (pp. 505 – 516). Wiley – Blackwell. McGregor, S. L. (2001). Neoliberalism and health care. International Journal of Consumer Studies, 25(2), 82 – 89. Retrieved from International Journal of Consumer Studies - Special edition on ‘Consumers and Health’. Medicare ‘Enhanced Primary Health Care Plan Scheme’. Retrieved February 22, 2013, from Innovative Health & Rehab: http://www.ihr.net.au/medicare.pdf Medicare Local Network Announced. (2011). The Lamp, 68(6), 10. Saunders, C. (2012, March). Understanding and Working with NSW Medicare Locals. Retrieved February 22, 2013, from General Practice NSW: http://www.ncoss.org.au/resources/120410-GP-NSW-Fact-Sheet-Working-with-MLs.pdf Sweet, M. (2012, April 4). Medicare goes local in search of “disruptive innovation”. Retrieved February 24, 2013, from Inside Story: http://inside.org.au/medicare-goes-local-in-search-of-disruptive-innovation/ Med11: , (Medicare Local Network Announced, 2011, p. 10), Wie11: , (Wiese, Jolley, Baum, Freeman, & Kidd, 2011, p. 995), Sau12: , (Saunders, 2012), McG01: , (McGregor, 2001, p. 82), Tal101: , (Talbot & Verrinder, 2010, p. 23), Swe12: , (Sweet, 2012), The131: , (The Health Care System and Health Policy in Australia, 2013), Med13: , (Medicare ‘Enhanced Primary Health Care Plan Scheme’), Acc121: , (Access to Allied Psychological Services, 2012), Cha121: , (Chamberlain – Salaun, Mills, & Davis, 2012, p. 512), The Health Care System and Health Policy in Australia. (2013). Retrieved February 22, 2013, from The Commonwealth Fund: http://www.commonwealthfund.org/Fellowships/Australian-American-Health-Policy-Fellowships/The-Health-Care-System-and-Health-Policy-in-Australia.aspx Wiese, M., Jolley, G., Baum, F., Freeman, T., & Kidd, M. (2011). Australia's systems of primary healthcare - The need for improved coordination and implications for Medicare Locals. Australian Family Physician, 995 – 999. Read More