Appraisal of Reform Proposals for Primary Health Care in Australia - Case Study Example

Appraisal of reform proposals for Primary Health Care in Australia Appraisal of reform proposals for Primary Health Care in Australia (Name) (Course) (Institution) (Instructor’s name) (Date) Introduction Global economies are finding it mandatory to have healthy populations to be able to improve their state of economies, eradicate poverty, improve the living standards of its people, improve its public infrastructures and combat modern day challenges, which are associated with the rapid changes in the social, political, legal, economical, financial, ecological and technological dynamics (Markle, 2007). Therefore, provision and sustainability of efficient, effective and quality health care and health care facilities for all has necessitated health reforms globally (Flood, 2003). The case of healthcare issues is no different in Australia. In the recent past, the Australian government has been under pressure to enact primary health care reforms in order to ensure effective and efficient health care is not only affordable to its citizens but also is readily accessible (Deeble, 2010). There is need to sufficiently and proficiently meet the health care needs expectations, hopes and preferences of Australian populations. This report will candidly assess and highlight the reform proposal for primary health care in Australia. Description of the reform policies in PHC in Australia The National Health and Hospital Reform Commission (NHHRC) that was, formed in 2008, is charged with the responsibility of developing, proposing and implementing the primary health care reform agendas (A.D.H.A., 2009). The main actors in development and implementation of the reforms include the health service providers, the Australian government, the political parties and the scientific society (Deeble, 2010). The proposals for reforms in primary health care in Australia rotates around moving away from government interventions, encouraging fair competition among health care providers, and utilizing available healthcare structures (D.H.A. 2010). Despite the broad adoption and acceptance of Medicare, there is need for more owing to the increase in population, rapid increase in chronic ailments, increased costs of accessing quality specialized health care, medical progress, availability of modern technological solutions and increased awareness among patients (O.E.C.D., 1994). The need for reforms is, necessitated by the increased duplication and growing wastage since health care is, sponsored by the state and federal government (Luck, 2011). In addition, there is a tendency for preference for curative rather than preventive health care measures, varying costs, lack of appropriate and adequate incentives to ensure secure and superior health care service delivery and disjointed comprehensive, continuity and co-ordination of care (N.P.H.C.S. 2009). Other proposed reforms includes endorsing preventive health care systems, developing integrated essential care centers in high priority regions in the country by use of innovative service delivery models, improving dental services, and taking care of the aging population, forms part of the proposed reforms (Johnson & Stoskopf, 2010). In addition, training and employing skilled professional medics and development of e-health records and systems will allow effective coordination and continuity within and across related health sectors (Raffell, 1997). Funding and/or organization of primary health care services Financing structures are, based on the effectiveness of the PHC systems, recognizing and bridging healthcare loopholes and concentrates on improving affordable healthcare interventions. The main reform proposals is to make one level of the government the main sponsor to health care in public health care facilities and establishment of a variety of small-scale health care systems under the directive of local medical personnel using DRG and activity-based funding rather than the accustomed block funding. Moreover, a reduction of up to 30% of government’s Goods and Services Tax revenues. This will be, used to finance public health care facilities, the State will be, charged with the task of financing and implementation of the reform policies for not only primary health care provision, but in GP. It is imperative to align financing of healthcare to the needs of the population. It is, anticipated that upon implementation of the above mentioned reform proposals, there will be improved quality of health care and health care service delivery, increased health care equity, coordination, continuity and effectiveness of care (Luck, 2011). Policy developers, PHC providers, and financiers in order to promote best health practice and supervise care service delivery, they need the right performance information. Effective functioning of care delivery models is dependent on having a blend of monetary enticement and funding systems. The proposed reforms challenge the dependence on fee-for-service care systems and instead encourage use of activity-based funding, financing structures that promote efficient integration of health related sectors, promote improvement and address current healthcare gaps. Funding systems proposed are supposed to rely on performance information, promote health equity, and encourage evidence-based information framework in order to know what is effective and what is not. Funding systems proposed is supposed to ensure sustainability and consistence in order to meet the healthcare needs. Nevertheless, the proposed reforms in primary health care may not be as effective and may result in more faults finding about the deteriorating quality and effective care delivery. This is because both the federal and state governments still finance health care, there is no guarantee that the 30% cut on Goods and service tax revenues will be, followed to the letter. The quality of care may remain unchanged since the primary health care reforms are at an upper level than would be projected to influence quality (Duckett, 2008). Considering the three to four small health care systems targeted, the level of equity of care will be, greatly compromised, since ease of use to specialized care by people not covered by tertiary level healthcare systems will be, reduced. Efficiency can only be, realized by ensuring consistent funding based on the service offered and the size of the healthcare system (Dwyer, 2004). Reform proposal on the access and equity to primary healthcare Among the key reasons for developing and implementing the primary health care reforms in Australia is to bridge the health gap between Aboriginal and Torres Strait Islanders and the inability of majority of Australian population to easily and affordably access quality care when and where they may require it (Willis & Reynolds, 2008). Equity and access to quality care is, needed to match present State’s main concerns for these two groups of Australian nationals (Mcmurray. 2010). There is need to ensure PHC is made available through an incorporated care system that offers standardized effective and efficient care to all people by filling in healthcare gaps and meeting the requirements of indigenous and non-indigenous Australians (Crooks & Andrews, 2008). This ensures efficient and dependable referral systems, integrated interventions that address specific healthcare needs and situations of all people especially the disadvantaged ones (Rivers, 2010). When addressing access and equity, PHC proposed reforms also addresses the need to make available quality care for the chronically ill and the elderly, which forms the highest burden in healthcare systems. Proposed reforms are, expected to tackle existing variance in accessibility and outcomes of patients at any hour of the day, servicing under-serviced subgroups and those unable to receive care due to geographical, social status and health status implications (N.P.H.C.S. 2009). Through proposed reforms on access and equity, there will be increased sustenance of supple care delivery models, use of efficient and affordable e-healthcare systems, promoting innovation through reliance of performance information, mobilizing, and training PHC providers about cultural awareness care deliveries, hence filling the healthcare gap especially for vulnerable communities and groups (D.H.A. 2010). Proposals for changes to structure Among changes required to ensure proposed reforms regarding promoting access and equity includes PHC organizations establishing programs that fill gaps within various groups, financing programs that improves connectivity across sectors, endorsing PHC labor force in under-supplied regions and upholding cultural responsiveness in healthcare delivery (N.P.H.C.S. 2009). Changes required to ensure better management of chronic and infectious diseases are promoting patient-centered interventions, endorsing individual-management frameworks, and aligning the funds for chronic illness with the needs of individual patient and those of the community (Bodenheimer, et al., 2002). Changes needed to ensure increased health prevention initiatives includes actively educating the public on preventive measures, encouraging early testing for all and promoting the need to be aware of one’s health status and training them on nutrition, exercising and living healthy (Crooks & Andrews, 2008). Finally, changes to help integrate quality, safety, responsibility and improved performance includes collaboration between the society and PHC providers about monitoring care infrastructures and processes, allowing for transparency through opening lines to receive response and feedback, encouraging use of e-health care systems/records, regular training of PHC providers and conducting performance appraisal (Osbourne, et al., 2004). Implications for PHC providers, consumers, and the rest of the health system Upon implementation of PHC reforms, PHC providers are, expected to improve on their skills, knowledge, and thereby allowing proper consultation, minimized delays, proper diagnosis, management and treatment of patients (Mcmurray. 2010). This will initiate patient satisfaction. With the reforms, the PHC providers will have increased job satisfaction, increased motivation and less work burnt out, hence low staff turnover (D.H.A. 2010). For the consumers who are the patients, they are expected to easily access quality health care whenever and wherever they may need it, are able to register increased satisfaction with care services offered, will trust public health care setups than traditional herbalists. Moreover, patients will experience fewer delays, and stress owing to effective and efficient co-ordination and continuity of care (Watson & Ovseiko, 2005). For the indigenous and non-indigenous population, they will be able to have equity in health care consumption (A.D.H.A., 2009). With the reforms, the entire health care systems will experience a face-lift. All Australians will be fit and healthy; they will obtain correct quality care even at the grass root levels of the Australian society, improved access and availability of specialized health care and development of a sustainable, reliable, efficient and effective health care network in private and public health sectors (Dwyer, 2004). The gap between Aboriginal and Torres Strait Islanders will be, closed, effective management of chronic and infectious diseases will be a reality, and prevention measures will be, implemented and efficient allotment of resources within health care systems will be, achieved (A.D.H.A., 2009). Monitoring the reforms and relevant performance measures Effective monitoring of reforms proposed will entail contrasting and measuring the end results to the set proposed reform agendas and objectives (Borowski, 2007). This will be, depicted through agreement between federal and state governments on issues regarding funding, allotting 30% of GST to finance public hospitals, continuous establishment of small local hospitals to increase access and equity to health care and ensuring activity based and DRG financing is in use. In addition adoption of electronic healthcare systems to aid in record keeping, information retrieval, information sharing between health related sectors and facilitating smooth health care co-ordination, continuity and referral systems (D.H.A. 2010). If there will be no consensus between the various levels and main actors involved with the development and implementation of proposed reforms, a referendum is the only way out. This will allow the entire Australian population a chance to voice their opinions and ideas about the way forward, hence, resolving the stalemate. Strengths and weakness in the evaluation of the proposal This assessment has its strengths in highlighting the changes that are, needed in order to make the proposed reforms function effectively within the healthcare systems in Australia. Moreover, this evaluation has highlighted what part of the reforms may not work and what can be, done to ensure the reforms are a success. However, the evaluation has its shortcomings since the proposed reforms may not necessarily have the anticipated outcomes owing to shifting paradigms in healthcare systems stemming from reluctance by concerned stakeholders to embrace change, inadequate integration frameworks, poor implementation strategies and political interference among others. Recommendations Effective collaborations among key stakeholders to ensure full implementation and continuous monitoring reform process Integration of technological solutions used in effective resource allocation and innovation in healthcare provision Development of patient-centered healthcare initiatives devoid of geo-political and social-cultural interference within and across neighboring regions of Australia Advocating for individual accountability for one’s health, by eating, exercising and living right. Conclusion Primary health care reforms in Australia are, anticipated to help increase access to equitable care services for all, promote patient-centered health initiatives, promote continuity and co-ordination of care, ensuring safe, effective, and efficient management of healthcare systems and promoting occupation health and safety standards for medical workers. Moreover, allow universality, affordability and efficiency of PHC. This will call for collaboration of involved stakeholders, allocation of adequate and necessarily human and financial resources, promoting preventive healthcare measures and allowing proper co-ordination among health related sectors. References A.D.H.A., 2009. Primary health care reform in Australia; report to support Australia's first national primary health care. Sidney: Department of Health and Aging. 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