Monday, February 16, 2009


Red News Readers,

These proposals if implemented properly would certainly improve access to affordable primary health care, but they don't create or fund one more bed in a public hospital. They would in the longer term stop people deteriorating to the point where they need hospital care but the crying need now is for more beds in public hospitals, staffed by skilled and experienced staff, who are adequately resourced, and supported by a more caring and less budget focussed bureaucracy.

Jenny Haines

Proposal for one-stop-shop health centres

Mark Metherell, smh

February 16, 2009

ONE-STOP-SHOP health clinics aimed at reducing reliance on hospitals are proposed by the Rudd Government's reform team as a centrepiece of a federal takeover of community-based health.

The National Health and Hospitals Reform Commission is calling for a radical revamp of Australia's public health services and a bigger federal role in community-based health care, dental services and aged care.

The commission will release a 400-page interim report today containing proposals for a shake-up in health which will be refined in its final report to the Government in the middle of the year.

Some aspects could be developed by late next year.

While the Government-appointed commission will call for a federal takeover of primary care services, the commission is guarded on the issue of federal control of public hospitals, raising it as an "option".

This is despite a pledge by the Prime Minister, Kevin Rudd, to assume financial control of hospitals if states fail to improve their performance by midyear.

The commission has proposed the establishment of "comprehensive primary health care centres" - a larger-scale version of the Government's plans for 31 GP super clinics - to provide one-stop-shops for care by GPs, nurses, diagnostic services, family and child health and other professionals such as physiotherapists, psychologists and podiatrists.

The commission says the Commonwealth's primary care role should include the takeover of largely state-run community health centres, services such as those for women and children, sexual health and alcohol and drug treatment programs.

Another proposal by the commission is to provide young families and patients with chronic and complex conditions with the option to enrol in a single primary health-care service to improve continuity and co-ordination of care.

The commission says present state-federal funding arrangements impede the provision of "connected, comprehensive primary health care".

"Strong primary health care must also drive quality performance through ensuring the 'right care in the right place', including by reducing avoidable hospital visits and admissions by focusing on early intervention and supported self-management," the report says.

It poses the ideal of a connected health system which responds to changing needs, from infancy, through mental health services for young people, co-ordinated care for those with chronic diseases, and support for frail older people living in their homes.

Handing the Federal Government sole responsibility for primary health-care funding would give clear responsibility and accountability for a coherent national policy with identified goals and strategies supported by adequate funding.

The Australian Medical Association is likely to resist the primary health-care centres. It has previously criticised the quality of such care and says it would compete with GPs' practices.