Through the consultations for this evaluation, stakeholders were asked their views on how MSOAP and VOS might be managed in the context of the proposed health reforms. The key health reforms mentioned by stakeholders were the creation of Medicare Locals and Local Health Networks. Most stakeholders suggested that the implementation of these was at too earlier a stage to identify possible mechanisms for integrating the programs into these structures. Stakeholder also tended to argue that these organisations will have other priorities in their first years of operation.
One general theme identified was that, as Medicare Locals are intended to play a significant role in planning primary health care services, they should be included in the planning processes for MSOAP and VOS. Our recommendations on the membership of advisory committee are intended to address this issue in the short term. In the longer term, there is the potential for Medicare Locals to play a more substantial role in planning and setting priorities for the programs.
A suggestion made by a small number of stakeholders was that funding for MSOAP should be devolved to Medicare Locals and that they should take responsibility for all relevant MSOAP functions. This approach was not mentioned for VOS. Another suggestion was that MSOAP funding should be devolved to regional Aboriginal and Torres Strait Islander health organisations. We have concluded that MSOAP is not at a stage where devolution to this level is appropriate. The reasons for this include that the program is complex and involves management of multiple relationships over the medium to long term. Continuity is a key ingredient to improving effectiveness.
Similarly, VOS is a very specialised and relatively small program, and a single national administrative group is the most appropriate arrangement for efficient and effective management. While the perspectives of Medicare Locals and Aboriginal and Torres Strait Islander health organisations should be given much greater prominence in planning and setting priorities for the programs, we suggest administration should not be devolved to these organisations at this stage.
Recommendations52. MSOAP Advisory fora and the VOS National Advisory Committee monitor the capacity for MSOAP and VOS to maintain its workforce and expand service provision.
53. A proportion of MSOAP and VOS funds be allocated to investigate and evaluate strategies that could improve aspects of the effectiveness of outreach services. Funding projects should be allocated, following a competitive tender process, to organisations or consortia capable of undertaking high quality applied research in this area. Advice on priority issues to be examined should be discussed and recommended by the MSOAP advisory fora and the VOS National Advisory Committee, but could include some of the topics outlined in the report.
54. The Department prepare an annual MSOAP and VOS statistics report which provides summary statistics of services supported under the scheme including patients seen.
55. As recommended previously membership of MSOAP and VOS advisory committees be enhanced to include representatives of Medicare Locals and Aboriginal and Torres Strait Islander health organisations. DoHA and the advisory committees continue to monitor the effectiveness of representation and engagement of these organisations, and recommend on change as appropriate.