Key Strategic Directions for 2005-06
Council of Australian Governments Initiatives in Health Workforce and Mental Health
At its 10 February 2006 meeting, the Council of Australian Governments (COAG) endorsed the National Health Workforce Strategic Framework and agreed on a number of actions designed to improve Australia’s health workforce and health education structures. The Department undertook additional work on the Strategic Framework for COAG’s consideration at its July 2006 meeting. This additional work has included: investigation on the number and distribution of training places; the organisation of clinical training and education; and accreditation and registration of health professionals. The Department is also progressing COAG’s agreement to a national assessment process for overseas qualified doctors.
The Department developed several mental health initiatives that were announced by the Prime Minister on 8 April 2006 for inclusion in a COAG National Mental Health Action Plan. Initiatives included: increasing the role of psychologists and other health professionals in primary care; a renewed focus on promotion, prevention and early detection and intervention of mental health issues; and increasing the health workforce available to address mental health issues. In June 2006, the Department completed the provision of one-off infrastructure funding to Lifeline to expand its telephony network to provide coverage across Australia.
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Support for Health Sector Electronic Clinical Communications
is an overarching national change management strategy aimed at improving safety and quality in health care, through a range of standardised electronic health information for health care providers and consumers.
The Department reviewed put in place a number of initiatives during 2005-06. These include:
- the establishment of the National E-Health Transition Authority by the Australian, State and Territory governments, which is charged with developing the standards and infrastructure for health and medical information management systems;
- the extension of the Broadband for Health program. This initiative supports investment in secure business grade and advanced broadband connectivity for general practices, Aboriginal Community Controlled Health Services, and community pharmacies, and has seen a steady increase in uptake for the duration of the program; and
- the implementation of the Managed Health Network Grants, as part of the Broadband for Health program, which provides funding for collaborative local e-Health projects. Due to the pioneering nature of the project, uptake was initially slow, however, the Managed Health Network Grants have since had an overwhelming response and a large quantity of applications have been received.
As a result of the Department’s work, over 7,000 consumers in the top end of the Northern Territory now have a fully functioning electronic health record; in Tasmania over 3,440 consumers who have been admitted or discharged from hospitals now have their general practitioners notified electronically; and in South Australia, some 52 per cent of health providers are now connected via Broadband for Health.
Enhanced Quality of Training for Doctors
The training of doctors has historically taken place in tertiary metropolitan public hospitals, to align with where the majority of health services have been provided. Changing patterns of disease and illness in Australia have affected the way health professionals work, including an increased usage of health care settings such as private consulting rooms, community centres and private hospitals. Opportunities for training in these settings, as well as in rural and regional hospitals, are increasingly being recognised as necessary to maintain the high standards of medical training in Australia.
The Medical Specialist Training Steering Committee explored how vocational medical training could be enhanced to incorporate this breadth of health care settings. The Department supported this initiative by providing secretariat services to the steering committee, as well as engaging expert advisory consultants to report on specific features for implementation.
In 2005-06, the Department funded training posts and infrastructure to assist selected overseas trained specialists to complete upskilling training in order to achieve specialist recognition. The Department also provided funding for the training and mentoring for overseas trained doctors to achieve Fellowship of the Royal Australian College of General Practitioners.
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Implementation of the Youth Mental Health Initiative
In 2005-06, the Department managed a Request for Application process to select a consortium to establish the National Youth Mental Health Foundation. The Department entered into contractual arrangements with the successful consortium in May 2006. The Foundation will enable better access to appropriate services for young people with mental health and drug and alcohol problems. The Foundation will focus on early identification and effective intervention for young people at risk and for those already showing early signs of mental health problems.
The new Foundation – ‘headspace’ – will run a program of service development grants, professional training, research and community awareness activities leading to better access, better care and better outcomes for young people. A major component of ‘headspace’ will be to implement the grants program for Youth Services Development, to enable organisations that already deliver youth mental health services to restructure so that they can deliver their current activities in a more targeted and coordinated way.
Improved Quality of Care
The Department, through its research and secretariat support, assisted the National Health Priority Action Council (NHPAC) in 2005-06 to develop an integrated chronic disease strategy. The NHPAC was responsible for advising the Australian Health Ministers’ Advisory Council (AHMAC) on the coordination and progress of the National Health Priority Areas (NHPAs). It reported to the Australian Health Ministers through the AHMAC on action in, and across, NHPAs. The National Chronic Disease Strategy was endorsed by the Australian Health Ministers’ Conference in November 2005.
The National Chronic Disease Strategy package comprises the following:
- the National Chronic Disease Strategy – an overarching framework for improving chronic disease prevention and care;
- the National Service Improvement Frameworks – disease specific frameworks structured to reflect the continuum of care from prevention through to end of life care. These have been developed for asthma; cancer; diabetes; heart stroke and vascular disease; and osteoarthritis, rheumatoid arthritis and osteoporosis; and
- the Blueprint for nation-wide surveillance of chronic diseases and associated determinants – a framework for local and national public health surveillance of preventable chronic disease and the determinants of chronic disease.
The strategy will guide policy to prevent chronic disease where possible and improve care across Australia.
To support the choice of people with a terminal illness to be cared for at home, the Department provided funding for specific research to enable the continued addition of medicines for palliative care to the Pharmaceutical Benefits Scheme (PBS). This resulted in a further 40 items being added to the special palliative care section in the PBS during 2005-06. The Department also established the Palliative Care Clinical Studies Collaborative. This collaborative will facilitate multi-site clinical research work with pharmaceutical companies to support further submissions for palliative care medicines on the PBS.
Through the Local Palliative Care Grants Program, the Department awarded grants to 117 community projects during 2005-06. The projects will help local communities provide better support to palliative care patients and their families. For example, the refurbishment and redecoration of Mt Olivet Hospice Inpatient Unit and Home Care Service facility in Queensland has resulted in a more relaxed, home like environment for patients and families, and includes a dedicated area for children. Another example is Bear Cottage children's hospice in New South Wales, where funding has been used to modify an existing hospice vehicle. This will make it easier and more comfortable for children and their families to travel from their homes to Bear Cottage and other palliative care services.
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Establishment of Cancer Australia
Cancer Australia was established as a statutory agency under the Public Service Act 1999
in May 2006. An advisory council of the new agency was appointed in March 2006 and includes cancer experts and eminent professionals.
Cancer Australia will provide national leadership in cancer control; guide improvements to cancer prevention and care; oversee a dedicated budget for research into cancer; and make recommendations to the Australian Government about cancer policy and priorities. Cancer Australia will also have an important coordination and liaison role between the wide range of groups and providers with an interest in cancer.
Implementation of a Global Centre of Excellence
The Australian Government committed funding for an Islet Cell Transplantation Program in Australia as part of the research effort to find a cure for type 1 diabetes. In 2005-06, the Department reached an agreement with the Juvenile Diabetes Research Foundation to establish and run this program.
The program will refine the islet cell transplantation procedure, which is considered to be experimental at this time. The evidence suggests that it offers one of the most promising avenues to an eventual cure for those living with daily insulin therapy for type 1 diabetes. Research will also be conducted on the health outcomes for people following transplants, and the effectiveness of the transplant procedure.
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Safety and Quality
The Australian Council for Safety and Quality in Health Care, established in January 2000 for a five-year term, ceased operation on 31 December 2005. The Council was successful in leading national efforts to improve the safety and quality of health care provision in Australia. It reported annually to all Health Ministers and was supported by all state and territory jurisdictions.
The Council was succeeded by the new Australian Commission on Safety and Quality in Health Care, which commenced operation on 1 January 2006. The Department assisted with the transition from the Council to the new Commission.
Like the former Council, the new Commission is funded by and reports to the Australian Health Ministers’ Conference. The Commission is housed within the Department for the purposes of providing a formal framework for the staffing and financial management of the Commission.
Major priorities for the Commission include improving the safety and quality of hospitals and primary health care and greater engagement of the private sector. One of its first tasks will be to improve national reporting on safety and quality. The Commission will work closely with the states and territories in addressing these priority areas.
Work completed this year includes:
- development of a common medication chart – a national chart for the prescribing, supply and administration of patient medications;
- distribution of consumer information called ‘10 tips for safer health care’;
- implementation of correct site surgery procedural protocol; and
- national sentinel events reporting – the first report is expected to be completed in August 2006.