Annual Report - Outcome 13: Acute Care > Part 1 Outcome Performance Report

Major Achievements

Negotiated Memoranda of Understanding with each State and Territory government and approved their implementation plans under the Council of Australian Governments (COAG) initiatives to improve the care of older people in public hospitals.
Finalised a review of Australia’s plasma fractionation arrangements, as required under the Australia-United States Free Trade Agreement. The review identified a number of issues which will be addressed to ensure the continued sustainability of Australia’s national blood arrangements.
Released the Achieving Stability and Premium Affordability in the Australian Medical Indemnity Marketplace report into medical indemnity policy, which found that policy settings have been successful in stabilising the industry and improving affordability for doctors.

Challenge

Continued low rates of organ and tissue donation in Australia. In 2006, there were only 202 organ donors, a rate of 10.0 per million population. This was a slight decrease from the previous year.

Key Strategic Directions for 2006–07

Provision of Free Public Hospital Services to Public Patients Through the Australian Health Care Agreements

In 2006–07, the Department provided $8.7 billion to State and Territory governments to provide free public hospital services to the community under the 2003–2008 Australian Health Care Agreements. The agreements included a range of requirements and focused on particular issues such as patient elections and charges, and emergency department and outpatient services. They also covered pharmaceutical arrangements in public hospitals and the provision of pre-admission and aftercare to public patients. Under the Australian Health Care Agreements, the Department received data from all states and territories, which it analysed and published in The State of Our Public Hospitals report. The 2007 report was based on data collected in 2005–06.

Improved Hospital Care for Older Patients

The Department worked with State and Territory governments to implement COAG’s Improving Care for Older Patients Initiative. Bilateral Memoranda of Understanding were developed following extensive consultations. All jurisdictions now have a Memorandum of Understanding in place under the initiative. In addition, jurisdictions in consultation with the Department, identified a range of initiatives to help avoid unnecessary hospital and residential aged care admissions, reduce the length of older peoples’ stay in public hospitals and provide more appropriate care for those who need it. All implementation plans were approved by the Department and jurisdictions received their first year of funding in 2006–07.

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Rehabilitation Services

The Pathways Home Program, administered by the Department, provides funding to State and Territory governments under a five-year agreement to improve the rehabilitation and step-down services available to patients leaving hospital, in particular older patients. The program is delivered under the 2003–08 Australian Health Care Agreements. The funding is made available to jurisdictions on the basis of agreed plans. Funding under the program has been fully committed with the Minister for Health and Ageing approving the final allocation of monies to
the Northern Territory in 2006–07.

Highlights from The State of Our Public Hospitals 2007

In 2005–06, there were 755 public hospitals with 54,601 beds, enabling just under 4.5 million admissions to public hospitals. This was an increase of 4.4 per cent since 2004–05.
Public hospitals accounted for 61 per cent of all hospital admissions.
The median waiting time for elective surgery was 32 days with 81 per cent of patients seen within the recommended timeframe.
There were nearly 4.8 million emergency presentations to emergency departments in larger hospitals which was an increase of approximately 8.7 per cent since 2004–05.
The median wait to be seen in an emergency department was 24 minutes and 69 per cent of patients were seen within the recommended timeframe. Public hospitals accounted for 90 per cent of all hospital emergency admissions.
Four in every five babies born in hospital are born in public hospitals.
Eighty-four per cent of public hospitals were fully accredited, which accounted for 96 per cent of all public hospital beds.
Over 38 million outpatient occasions of service were provided by public hospitals, about 4.8 per cent more than in 2004–05. In addition, for the first time, data was collected on outpatient department presentations by specialist services.

Performance Management

The Department worked collaboratively with the states and territories to develop an improved framework for measuring hospital performance. Data collection on new performance indicators for emergency and outpatients services commenced in 2006–07 and will be reported on in future The State of Our Public Hospitals reports.

The Department organised the 2006 Biennial Health Conference ‘Exploring and Debating Acute Care Provision’ held at the University of New South Wales in November 2006. This conference was funded under the Australian Health Care Agreements to share information on public and private hospital financing, e-Health, patient perspectives, data classifications and health workforce issues. The conference was attended by around 320 stakeholders, including representatives of State and Territory governments, and provided a forum for debate and discussion on current trends and ways to improve the provision of acute care services in Australia.

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Safe Supply of Blood and Blood-Related Products

In 2006–07, the Commonwealth contributed 63 per cent of funding under the National Blood Agreement to the National Blood Authority. In 2006–07, all governments together contributed a total of approximately $650 million towards Australia’s blood sector. The Department chaired the Jurisdictional Blood Committee and provided ongoing policy and funding advice to the Minister on blood issues.

The Department also provided advice to the Minister on strategies to improve the safety of fresh blood products. In March 2007, Health Ministers jointly agreed to the implementation of universal bacterial testing for platelets and the staged implementation of universal leucodepletion (the removal of white cells from blood products), by 2010–11.

In 2006–07, the Commonwealth, and State and Territory governments agreed to increase funding for the Australian Red Cross Blood Service to allow increased plasma collections from 308 tonnes in 2005–06, to 329 tonnes in 2006–07, supporting Australia’s self-sufficiency policy to source blood components and plasma from within Australia to meet appropriate clinical demand.

Review of Australia’s Plasma Fractionation Arrangements

The Department completed the review of Australia’s plasma fractionation arrangements in 2006–07, in line with the Commonwealth’s commitments under the Australia-United States Free Trade Agreement. The review report was publicly released in December 2006. At that time the Commonwealth recommended to states and territories that future fractionation arrangements should be made through tender processes in line with its free trade agreement commitments. As there was no consensus for change among jurisdictions, the current arrangements will continue. The Department will continue to work with states and territories to address other blood sector issues identified in the review recommendations. The Review of Australia’s Plasma Fractionation Arrangements is available on the Department’s website at <www.health.gov.au>.

Improving the Rate of Organ and Tissue Donation in Australia

National Reform Agenda on Organ and Tissue Donation

All governments agreed to a National Reform Agenda on Organ and Tissue Donation in July 2006, to increase the rate of organ and tissue donation in Australia. To assist with implementation of the Reform Agenda, the National Clinical Taskforce on Organ and Tissue Donation was established by the Minster for Health and Ageing in October 2006, with funding and secretariat support provided by the Department. The taskforce has consulted widely within the organ and tissue sector on increasing community awareness of organ and tissue donation and expanding registration options on the Australian Organ Donor Register. The taskforce also looked at enhancing clinical data reporting; improving nationally consistent processes for identifying potential organ donors; and developing national consistency in transplantation waiting list processes. The taskforce will provide its final report to the Minister for Health and Ageing in December 2007.

Raising Community Awareness

To help raise people’s awareness of the important need for organ and tissue donations, the Department engaged a consultant in 2006–07 to undertake a market research project to inform the development of a national communications strategy. The aim of the strategy will be to increase the number of registrations of consent to donate on the Australian Organ Donor Register. Currently, 5.5 million people are on the register.

The Department supported a range of organ and tissue donation programs during the year, including the Australian Transplant Games held between 16–23 September 2006. Support was also provided for the promotion of the National Schools Competition on Organ and Tissue Donation in 2007, and the launch of the Australian Organ Donation Awareness Week 2007.

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Implementation of the 2005 Medical Indemnity Policy Review Panel Recommendations

The Government released Achieving Stability and Premium Affordability in the Australian Medical Indemnity Marketplace in February 2007. This is the second review into medical indemnity by the Medical Indemnity Policy Review Panel. The Department provided secretariat and policy research services to the panel which made 12 recommendations to ensure the continued stability and affordability of the medical indemnity industry. This in turn ensures doctors have access to fair, affordable and secure medical indemnity insurance and places downward pressure on insurance premiums.

The Government accepted all of the panel’s recommendations and the Department has been working to implement the recommendations in consultation with the medical indemnity industry and state and territory jurisdictions.