The changing landscape of national health reform: challenges and opportunities

Transcription

1 The changing landscape of national health reform: challenges and opportunities Professor Christine Bennett AO Dean, School of Medicine, Sydney The University of Notre Dame Australia; Board Chair, The Sydney Children s Hospitals Network

2 The changing landscape of national health reform: challenges and opportunities Professor Christine Bennett AO Dean, School of Medicine, Sydney The University of Notre Dame Australia Former Chair of the National Health and Hospitals Reform Commission 2014 NSW Health Symposium 19 th June

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4 Changing political landscape 4

5 A long-term blueprint for reform Four reform themes Taking responsibility Connecting care Facing inequities Driving quality performance 123 recommendations for action 108 accepted / 14 noted / 1 rejected 44 being implemented, 61 in part, 17 no action (March 2013) 5

6 Taking responsibility Individual and collective action by people, families, communities, health professionals, employers, health funders and governments 6

7 Taking responsibility ANPHA abolished Tobacco, alcohol and obesity reduced investment Healthy kids, healthy communities, healthy workplaces NPA ceased Healthy Communities Report WHO social determinants 7

8 Taking responsibility - PCEHR General Practice Hospitals Private Health Insurance Pharmacies Progress review and further investment 8

9 Connecting care Comprehensive care for people over their lifetime 9

10 Connecting care strengthening primary care GP Superclinics program ceased Primary health care organisations (Medicare Locals) transition to Primary Care Networks Voluntary Enrolment Diabetes pilot no results available yet Sub-acute care NPA ended June 2014 GP copayment - $7 per visit 10

11 Connecting care aged care 11

12 Facing inequities Recognise and tackle the causes and impacts of health inequities 12

13 National Disability Insurance Scheme DisabilityCare Australia support for people with permanent and significant disabilities, their families and carers Continuing to progress 13

14 Driving quality performance Leadership and systems to achieve best use of people, resources, and evolving knowledge 14

15 Australia s health system Source: NHHRC A Healthier Future For All Australians, Final Report June 2009 pg 47 15

16 Commonwealth-state funding shares 16

17 Health financing sustainability Source: A National Health and Hospitals Network for Australia s Future Delivering better health and better hospitals,

18 National Health Reform Agreement 2011 Intergovernmental compact on health reform package National Partnership Agreements: prevention, subacute care, waiting list reductions Introduction of efficient activity based funding (ABF) with Commonwealth increasing share of growth from 2014/15 Commitment to performance monitoring States established local hospital networks (>55) Commonwealth formed 61 Medicare Locals - primary healthcare National bodies: APHRA, ACSQHC, ANPHA, HWA 18

19 Federal Health Budget National Partnership Agreements - ceased Removal of minimum growth guarantee 45% share of growth 2014/15 only to 2017/18 Abolish or merge national bodies: HWA DoH ANPHA abolished ACSQHC, IPHA, NHPA, AIHW new performance and productivity agency Medicare Locals transition to Primary care Networks New copayments Medical Research Future Fund 19

20 May 2014 budget changes to reforms Health Measures Total $m 2014/ /18 Medical research MBS -5,512.2 Primary care networks - Hospitals -1,958.8 PBS Workforce 72.0 Mental Health 2.5 Dental Prevention programs ANPHA abolish -6.4 Flexible funds PCEHR Indigenous Affairs rationalisation

21 Changes in the fiscal gap since the Budget Source: NSW Budget Statement

22 Projected Commonwealth share of NSW Health funding Source: NSW Budget Statement

23 Commonwealth moderating spending growth From the Government will index public hospitals funding by a combination of growth in the Consumer Price Index and population. State and Territory governments are responsible for managing public hospitals, and are therefore best placed to improve efficiency in the hospital system. The changes in this Budget will provide a platform to consider longer term arrangements in the context of the White papers on the Reform of the Federation and the Reform of Australia s Tax System. Source: Commonwealth of Australia, Budget Health 23

24 Rationalising roles and responsibilities Source: Report of the National Commission of Audit Volume 1, Appendix,

25 Challenges Changed Commonwealth funding contribution widening the fiscal gap Uncertainty and reduced transparency National prevention leadership Health workforce planning national, public/private ACSQCHE - across public and private sectors Copayment pressure on public hospitals 25

26 Opportunities PCEHR and HealtheNet Prevention State leadership Primary Care Networks shape agenda for integrated care Copayments? States enter primary care ABM Portal smart use of data Health Productivity and Performance ensure breadth and relevance White papers on the Reform of the Federation and Tax Reform Medical Research Future Fund 26

27 Medical research future fund Source: Commonwealth of Australia, Budget Health 27

28 References Australian National Preventive Health Agency Australian Bureau of Statistics - Australian Institute of Health and Welfare - National Disability Insurance Scheme - National Heath and Hospitals Reform Commission Report - NSW Budget Papers Budget Paper No. 2 Commonwealth of Australia, Budget Health Towards Responsible Government - Appendix to Report of the National Commission of Audit Volume 1,

29 Questions & Discussion 29