National Health Reform

A National Health and Hospitals Network for Australia's Future

Chapter 1: Listening to the community and experts

This reform plan is the culmination of rigorous and serious engagement with health experts, practitioners, patients and the Australian community.

This plan builds on the final report of the National Health and Hospitals Reform Commission (NHHRC), established by the Government to conduct the most comprehensive review of Australia’s health and hospital system in over 20 years. It also builds on the Government’s extensive consultations on health reform with the Australian people across 2009 and 2010.

National Health and Hospitals Reform Commission

In addition to making immediate investments to tackle immediate priorities and key pressure points in the health system, the Government in 2008 set in train long term system‑wide reform. The Government established the National Health and Hospitals Reform Commission (NHHRC) to conduct the most comprehensive structural review of Australia’s health system in 20 years, and provide evidence‑based advice on reform directions.

The NHHRC, chaired by Dr Christine Bennett, consisted of a panel of experts: Professor Justin Beilby, Dr Stephen Duckett, the Hon Dr Geoff Gallop AC, Dr Mukesh Haikerwal, Associate Professor Sabina Knight, the Hon Rob Knowles AO, Ms Mary Ann O’Loughlin, Professor Ronald Penny AO and Dr Sharon Wilcox.

The NHHRC’s final report — released in July 2009 — included 123 recommendations for immediate and longer‑term reforms of Australia’s health system. The NHHRC emphasised the need to focus reforms on three main goals:

1. Tackling major access and equity issues that affect health outcomes for people now;
2. Redesigning our health system so that it is better positioned to respond to emerging challenges; and
3. Creating an agile and self‑improving health system for long‑term sustainability.

National Health and Hospitals Commission final report – key recommendations

• An independent National Health Promotion and Prevention Agency
• A personal electronic health record and national eHealth system
• Commonwealth to assume responsibility for all primary health care policy and funding
• Comprehensive Primary Health Care Centres
• Voluntary enrolment for patients with chronic and complex conditions
• Primary health care coordination through Primary Health Care Organisations
• National Access Targets for timeliness of care
• Hospital funding tied to performance
• Introduction of activity based funding for all hospital services, with the
• Commonwealth paying a fixed percentage of the efficient price
• Public reporting of public and private hospital performance
• Range of measures related to choice in aged care
• National Aboriginal and Torres Strait Islander Health Authority
• Denticare
• One‑year dental internship program
• A National Clinical Education and Training Agency
• A permanent, independent and expanded Australian Commission on Safety and Quality in Health Careback to top

Consultation with health professionals and the Australian people

Following the release of the NHHRC’s report, the Government embarked on detailed consultation with health professionals and the Australian people on the report’s recommendations. Across 2009 and 2010, the Prime Minister, the Health Minister, other Government Ministers and senior government officials conducted more than 100 consultations with patients, health professionals and the public. A website, yourHealth.gov.au, was established to allow all Australians to contribute their ideas, experiences and comments on the health system. More than 1,460 contributions have been posted to the yourHealth website and the site has had over 1 million visitors.

Figure 1: Locations of Government’s health reform consultations

The Government has listened carefully to the expert advice and views put forward by the Australian community. Key feedback from consultations indicated a community desire for:

• a stronger Commonwealth Government leadership role, coupled with higher standards and increased funding for public hospitals;
• reduced health sector bureaucracy, simplified governance and accountability, and greater autonomy and flexibility at the local level;
• better access to primary health care delivered by a team of health care professionals;
• better public hospital services and waiting times;
• better access to health care in rural Australia and disadvantaged areas; and
• improved integration of information technology across our health system.

The Government also consulted with state and territory governments on the development of this Reform Plan through the Council of Australian Governments (COAG). At the COAG meeting in December 2009, the Commonwealth, states and territories agreed that long‑term health reform is needed to deliver better services, more efficient and safer hospitals and more responsive primary health care.

2010 Intergenerational Report

Another source of expert input has been the 2010 Intergenerational Report. The future challenges outlined in the Intergenerational Report are a catalyst for many of the measures to improve the productivity and financial sustainability of the health system outlined in this Plan.

The 2010 Intergenerational Report projected that growth in all categories of Commonwealth health spending would increase, driven by population growth and ageing, increased demand for health services, and new technology. Commonwealth Government health spending is projected to grow from 4.0 per cent of GDP in 2009–10 to 7.1 per cent of GDP in 2049–50. The report forecasts that rising health costs will be by far the largest contributor to increased Commonwealth Government spending to 2050, accounting for around two‑thirds of the overall increase in Commonwealth Government spending. This is consistent with and reinforces the conclusions of the previous two Intergenerational Reports, and provides further evidence that the ongoing sustainability of the system will be challenging.back to top