Primary Health Care Reform in Australia - Report to Support Australia’s First National Primary Health Care Strategy
1. Introduction
This Report provides, for the consideration of the Minister for Health and Ageing, presentation and analysis of the issues on which the Draft Strategy is based.
The Report and Draft Strategy have been prepared by the Australian Government Department of Health and Ageing, assisted by the External Reference Group (ERG), further informed by a large number of submissions and discussions, including with representatives from state and territory health departments.
The Draft Strategy is a high level action plan. This Report supports and expands on the issues which have determined the Key Priority Areas in the Draft Strategy.
Related reform processes
The Draft Strategy was developed in the context of the historic Council of Australian Governments’ (COAG) National Healthcare Agreement – Intergovernmental Agreement on Federal Financial Relations (NHA).1The NHA between Commonwealth and state/territory governments, announced in November 2008, is framed with the objective of improving health outcomes for all Australians and the sustainability of the Australian health care system. The NHA defines the objectives, outcomes, outputs and performance measures, and clarifies the roles and responsibilities that will guide the Commonwealth, states and territories in the delivery of services across the health sector. Importantly, the NHA recognises that primary health care involves Commonwealth and state/territory responsibilities but depends on the significant role of private providers and community organisations.
The NHA affirms the agreement of all governments that Australia’s health system should:
- be shaped around the health needs of individual patients, families and their communities;
- focus on prevention of disease and the maintenance of health, not simply the treatment of illness;
- support an integrated approach to the promotion of healthy lifestyles, prevention of injury and diagnosis and treatment of illness across the continuum of care; and
- provide all Australians with timely access to quality health services based on their needs, not ability to pay, regardless of where they live in the country.2
The Draft Strategy is a priority reform area identified under the NHA which also sets the policy direction to better connect hospitals, primary and community care to meet patient needs, improve continuity of care and reduce demand on hospitals.
The development of the Draft Strategy has been undertaken alongside complementary health reform processes including the work of the National Health and Hospitals Reform Commission (NHHRC) and the National Preventative Health Taskforce.
Alongside these processes, initiatives in the 2009-10 Budget including those responding to the Maternity Services Review; the Rural Workforce Audit; the review of Commonwealth-funded rural health programs; and the review of rural classification systems, changes for nurse practitioners and the Closing the Gap National Partnership, contribute to primary health care reform in Australia.
Process
Development of this Report and the Draft Strategy has been informed through the release of, and stakeholder consultation on, the Discussion Paper. This Report draws on the information and views presented in the more than 260 submissions received in response to the Discussion Paper alongside other evidence and analysis. The Discussion Paper proposed 10 Elements for an enhanced primary health care system. These 10 Elements (Chapter 4) capture the directions reflected in the NHA.The ERG, chaired by Dr Tony Hobbs, included a range of primary health care experts from around Australia: Mr Peter Fazey, Professor Mark Harris, Associate Professor Noel Hayman, Professor Claire Jackson, Ms Judy Liauw, Professor Lyn Littlefield OAM, Ms Anne Matyear, Mr Mitch Messer, Dr Vasantha Preetham, Dr Rod Pearce, Professor Hal Swerrisen and Dr Barbara Vernon.
External Reference Group
From left to right: Mark Harris, Claire Jackson, Tony Hobbs, Barbara Vernon, Lyn Littlefield, Noel Hayman, Rod Pearce, Peter Fazey, Mitch Messer, Judy Liauw, Anne Matyear (Note: Hal Swerrisen and Vasantha Preetham are not pictured above)
Further details regarding the ERG and the stakeholder consultation process are included at Attachment A.
1 Council of Australian Governments, 2008. National Healthcare Agreement – Intergovernmental Agreement on Federal Financial Relations, available from: http://www.coag.gov.au/intergov_agreements/federal_financial_relations/docs/IGA_FFR_ScheduleF_National_Healthcare_Agreement.pdf (accessed June 2009).
2 ibid.
