Department of Health's FOI release - challenges ahead for health reform

Parliament house flag post

Department of Health's FOI release - challenges ahead for health reform

Posted 10/12/2010 by Rebecca de Boer

Various government departments have made publicly available incoming government briefs that have been released under Freedom of Information. Despite sections of the briefs having been blacked out they provide an insight into the workings of government and the advice provided to Ministers in the post-election environment. The Department of Health and Ageing’s (DoHA) incoming government brief provides an overview of the health system and arrangements for implementing health reforms begun during the previous parliament. The brief also lists key decisions for the Minister to make in the first four months.
Some of these decisions have been made and legislation has already passed, for example, the establishment of the Australian Commission on Safety and Quality in Health Care and the changes to the Pharmaceutical Benefits Scheme (PBS) to give effect to the Memorandum of Understanding (MOU) between Medicines Australia and the Government.

The incoming government brief also gives an indication of how implementation of the National Health and Hospitals Network (NHHN) is progressing and the timeframe for implementation of some of the proposed arrangements such as Medicare Locals and Local Hospital Networks. There has been some media commentary on the incoming government brief with respect to mental health, Pan Pharmaceuticals and private health insurance. This post will focus on the health reform arrangements.

The incoming government brief highlights the significant number of decisions that need to be taken by the Government to give effect to the NHHN. For example:
  • The boundaries for Medicare Locals (see A1.02) as well as the approval of the roles, functions and governance arrangements for these organisations (see A1.01). However, it is expected that around 15 Medicare Locals will commence by July 2011 (see A1.02). Medicare Locals are independent organisations responsible for the coordination of primary care services for a defined geographical region
  • Finalisation of the numbers and boundaries of Local Hospital Networks with Health Ministers by 31 December 2010 (see A1.01)
  • Agreement on what constitutes primary care and what functions will be transferred to the Commonwealth (see A1.01). This also has implications for funding arrangements
  • A decision about recommendations to the COAG December 2010 meeting on whether ‘community health promotion and population health programs, drug and alcohol treatment services, child and maternal health and community palliative care’ should transfer to the Commonwealth or ‘undergo strong national reform efforts within current roles and responsibilities’ (see A1.01)
  • Finalisation of the terms of reference for the Independent Hospital Pricing Authority is outstanding (see A1.15)
  • What the arrangements should be regarding the treatment of private patients in public hospitals (see A3.04). The broader question of the role of private hospitals in the NHHN was not canvassed in the incoming government brief.
  • Implementation arrangements for States that have not yet signed the National Partnership Agreement (NPA) on Improving Hospital Services . Tasmania has not yet signed this agreement. At the time the brief was written, Victoria had not yet signed this NPA but the Victorian Government signed it prior to entering caretaker mode. It was also noted that issue of how to address funds that had been nominally allocated to Western Australia (WA) under this NPA had not yet been resolved.
One of the premises of the NHHN was that the Commonwealth would have full policy and funding responsibility for primary care. Yet primary care, and what constitutes primary care, has been a matter of contention from when the NHHN was announced. The lack of agreement on this matter was reflected in the NHHN Agreement (B34), and it does not appear that it has been resolved since. The incoming government brief suggests that this was to be discussed at the next COAG meeting in December 2010, which has however been deferred to February 2011.

Apart from commentary about internal implementation governance arrangements (see A1.01), such as the arrangements among central agencies and state health and treasury departments, the incoming government brief does not address the proposed governance arrangements for the NHHN. The lack of clarity about the linkages among the new national governance authorities of the NHHN was however highlighted the Treasury Red Book (Part 3).

The implementation plan for the NHHN detailed a series of key milestones and dates for implementation of the reform. Delays might be likely given the postponement of the December 2010 COAG meeting and the many key issues yet to be resolved detailed in the incoming government brief. The WA government continues to oppose the health reform deal agreed at the April 2010 COAG meeting and the new Victorian Coalition Government is examining its position. The New South Wales Opposition Leader has recently indicated that, if elected, he would not be surrendering Goods and Services Tax (GST) revenue (a key source of funding for the deal) to the Commonwealth.
There also have been debates in the Parliament and elsewhere about the GST arrangements for the NHHN and the federal Opposition has indicated that it will not support the legislation to give effect to these changes.

The slow progress on implementation of the NHHN and the need for more clarity on key issues such as primary care and governance as well as the political opposition from the federal Opposition and some States would suggest that there are further obstacles ahead for the health reform effort.

(Image sourced from: www.phcris.org.au/infobytes/health_reform.php)


Thank you for your comment. If it does not require moderation, it will appear shortly.
Facebook LinkedIn Twitter Add | Email Print

FlagPost

Flagpost is a blog on current issues of interest to members of the Australian Parliament


Parliamentary Library Logo showing Information Analysis & Advice

Archive

Syndication

Tagcloud

Refugees asylum immigration Australian foreign policy Parliament climate change elections women social security Australian Bureau of Statistics Employment indigenous Australians Sport illicit drugs people trafficking taxation Medicare welfare reform Australian Defence Force higher education welfare policy United Nations health financing gambling Asia Middle East criminal law disability Australian Sports Anti-Doping Agency World Anti-Doping Agency United States federal budget school education forced labour aid statistics Australian Electoral Commission WADA income management Industrial Relations emissions trading dental health Australia in the Asian Century steroids detention Private health insurance OECD ASADA labour force transport Law Enforcement Australian Federal Police people smuggling poker machines National Disability Insurance Scheme Australian Crime Commission 43rd Parliament slavery election results Papua New Guinea Australian Public Service constitution International Women's Day corruption Afghanistan Fair Work Act child protection Aviation debt federal election 2013 parliamentary procedure ALP New Zealand Newstart Parenting Payment political parties Census politics High Court skilled migration voting Federal Court terrorist groups Higher Education Loan Program HECS governance youth paid parental leave environment foreign debt gross debt net debt defence capability customs Senate doping health crime health risks multiculturalism aged care Gonski Review of Funding for Schooling sex slavery sea farers Special Rapporteur leadership United Kingdom UK Parliament Electoral reform banking firearms public policy Population violence against women domestic violence mental health China ADRV terrorism science research and development social media pensions welfare ASIO intelligence community Australian Security Intelligence Organisation accountability public service reform Carbon Pricing Mechanism carbon tax mining military history employer employee fishing by-election European Union same sex relationships international relations coal seam gas family assistance planning Senators and Members United Nations Security Council Australian economy food vocational education and training Drugs health reform Indonesia children codes of conduct terrorist financing health system money laundering early childhood education Canada Financial sector national security fuel disability employment Tasmania integrity transparency Australian Secret Intelligence Service sexual abuse federal state relations World Trade Organization Australia housing affordability bulk billing water renewable energy children's health health policy Governor-General US economy export liquefied natural gas foreign bribery question time speaker superannuation expertise climate Intergovernmental Panel on Climate Change Department of Agriculture Fisheries and Forestry food labelling Pacific Islands reserved seats new psychoactive substances synthetic drugs UNODC carbon markets Indigenous constitutional recognition of local government local government consumer laws PISA royal commission US politics language education baby bonus Leaders of the Opposition Parliamentary remuneration Australia Greens federal election 2010 servitude Trafficking Protocol energy forced marriage rural and regional Northern Territory Emergency Response ministries social citizenship human rights emissions reduction fund; climate change child care funding refugees immigration asylum procurement Indigenous health e-voting internet voting nsw state elections 44th Parliament 2015 ABS Age Pension Death penalty capital punishment execution Bali nine Bali bombings Trade EU China soft power education Fiji India Disability Support Pension Antarctica Diplomacy by-elections state and territories workers Bills anti-corruption fraud bribery corporate ownership whistleblower G20 economic reform innovation standards NATO Members of Parliament Scottish referendum Middle East; national security; terrorism social services Criminal Code Amendment (Misrepresentation of Age to a Minor) Bill 2013 online grooming sexual assault of minors ACT Assembly public health smoking plain packaging tobacco cigarettes Asia; Japan; international relations Work Health and Safety Migration; asylum seekers; regional processing China; United States; international relations fiscal policy Racial Discrimination Act; social policy; human rights; indigenous Australians Foreign policy Southeast Asia Israel Palestine regional unemployment asylum refugees immigration political finance donations foreign aid Economics efficiency productivity human rights; Racial Discrimination Act employment law bullying asylum seekers Animal law; food copyright Australian Law Reform Commission industry peace keeping contracts workplace policies trade unions same-sex marriage disorderly conduct retirement Parliament House standing orders public housing prime ministers election timetable sitting days First speech defence budget submarines Somalia GDP forestry world heritage political engagement leave loading Trade; tariffs; safeguards; Anti-dumping public interest disclosure whistleblowing Productivity Commission regulation limitation period universities Ireland cancer gene patents genetic testing suspension of standing and sessional orders animal health live exports welfare systems infant mortality middle class welfare honorary citizen railways disciplinary tribunals standard of proof World Health Organisation arts international students skilled graduate visas temporary employment visas apologies roads Italy national heritage NHMRC nutrition anti-dumping Constitutional reform referendum Rent Assistance competition policy pharmaceutical benefits scheme obesity evidence law sacrament of confession US presidential election international days DFAT UN General Assembly deregulation Regulation Impact Statements administrative law small business Breaker Morant homelessness regional engagement social determinants of health abortion Youth Allowance Members suspension citizen engagement policymaking workplace health and safety Trafficking in Persons Report marine reserves hearing TAFE Victoria astronomy resources sector YMCA youth parliament alcohol Korea rebate Australian Greens presidential nomination Racial Discrimination Act entitlements political parties preselection solar hot water Financial Action Taskforce Horn of Africa peacekeeping piracy Great Barrier Reef Stronger futures political financing Hung Parliament political education social inclusion Social Inclusion Board maritime early childhood National Quality Framework for Early Childhood Education and Care Murray-Darling Basin Iran sanctions Norway hospitals republic President Barack Obama Presidential visits ANZUS qantas

Show all
Show less
Back to top