Discuss about the Primary Health Care Reform.
Primary health care (PHC) can be described as the first level or point of contact of the communities, individuals, and families with the health and medical care system. The PHC or primary health care in Australia incorporates the concept of personal care in association with the health promotion, community development, and prevention of illness. It also consists of various interconnecting principles of access, equity, empowerment, collaboration in the inter-sectors, and community’s self-determination (Regmi, 2012). The PHC in Australia encompasses the knowledge and understanding of the economic, social, political, and cultural determinants of health. According to the world Health Organization, PHC can be defined as an essential and necessary health care, which is based on the scientifical, practical, and socially acceptable technology and methods. These healthcare services are accessible to each and every individual, families, and community via their full participation, as well as, at an expense that the country and its community can afford for maintaining their development (Gauld, 2011). Hence, PHC is the first stage of contact with the national healthcare system and hence, aids in bringing the health care services to the people and community where they live and work, thereby, constituting the first parameter of a continuing process of health care. The main purpose of this report is to discuss the primary health care reform in Australia along with its objectives, benefits, and strategy for improving the healthcare services.
Primary Health Care Reform in Australia
Primary Healthcare and its Importance:
The research has shown that both in Australia, as well as, in overseas a strong recognition is made that improving and strengthening the way of providing the primary health care is vital and crucial for determining the status of the healthcare system and for analyzing how well the current healthcare systems responds to the emerging and current pressures. Moreover, it has been observed that the health systems which are having strong and effective primary health care tends to be more efficient, with lower rates and incidents of hospitalisation, better outcomes of health of the individuals, fewer health-related inequalities, and lower rates of mortality in comparison to those systems that do not have primary health care (Jackson & Hambleton, 2016). The strong and efficient primary health care system improves the outcomes related to the patient’s health, reduces the expenses and costs, increases the satisfaction of the patient, as well as, reduces the health inequities in the healthcare setting. As primary health care is a fundamental and important aspect in maintaining the health status and efficiency of healthcare services, various reforms related to the primary health care have been established and followed by various countries and their healthcare systems (Millar & Beardall, 2001).
Primary Health Care Reforms in Australia:
For better understanding and knowledge of the Australia’s current status and position of health care and what changes are needed, the understanding of the development of the primary health care sector, its function and roles, performance and interaction, and component parts is very important. In Australia, the primary health care is delivered via Commonwealth, territory and state government and private funding, as well as, privately and publicly delivered services. It has been observed that various programs and reforms have been developed for increasing the provision of healthcare services and for overcoming the barriers of the healthcare practice in Australia (Nicholson, Jackson, Marley, & Wells, 2012). For instance, Medicare was established in October 1984 in Australia with the intent of providing a fair, affordable, and simple insurance system, which provided the coverage of basic health to all the Australians, and was built on the existing billing arrangements of the fee-for-service. Moreover, the Australian Government in the year 1973 formulated the Community Health Program. The main aim of the program was the development of a coordinated network of services and facilities for primary health care. It was designed to be locally managed centers of healthcare that operate on the health’s social model and consists of multi-disciplinary teams for responding to various kinds health problems in the community. The main aspect of the program was the provision of the primary medical care. Further, the development of the National Primary Health Care Strategic Framework by the Australian government was for tackling the health-related challenges and issues of the 21st century. It underpins the view of comprehensive primary health care and extends beyond the focus of 'general practice' related to the traditional responsibility of the Australian Government (Oliver-Baxter, Brown, & Dawda, 2016).
National Healthcare Reform in Australia and its Main Objectives:
The National Healthcare Reform agenda was achieved and established in August 2011 after long-term negotiations amongst the States and the Commonwealth. The main principles that underpin the National Healthcare Reform includes making of local decisions within overall system’s management, funding based on activity for hospitals, as well as, reporting of public performance. The National Healthcare Reform describes the shared understanding and intention of the Commonwealth, as well as, the territory and state governments for working in collaboration to improve the outcomes of health for all the Australians along with ensuring the Australian health system’s sustainability. Hence, the National Healthcare Reform agenda identifies and underpins the long-term goals and objectives of the State and Territory governments, and the Commonwealth (Davis & Somers, 2011). The main objectives of this reform is prevention, which means that Australians are born healthy and should remain healthy, primary, as well as, community health, which indicates that each and every Australian should receive appropriate and necessary affordable and high-quality community and primary health services, hospital and its associated care, which means that every Australian should receive required and appropriate hospital care, and provision of aged care for ensuring that the older Australians gets high and affordable aged health care services. Moreover, the National Healthcare Reform also has the objective of improving patient’s experience, which means that each and every Australian should gain positive health care experiences and should have a sustainable system of healthcare services. Further, the objective of the reform is improving Indigenous Health and promoting their social inclusion (Stitt & Aranha, 2012).
According to the National Healthcare Reform, the Commonwealth, as well as, the States and Territories will be involved in joint funding of public hospitals, mental health services, public health activities, sub-acute care, health services related to the Aboriginal and Torres Strait Islander, training of the health workforce, health research, blood and related products, and emergency responses. Moreover, besides joint funding, the States, and Territories will be involved in the funding of community health, food safety and its regulation, capital infrastructure, ambulance services, service planning, disability services, and environmental health. Further, the Commonwealth besides joint funding will also fund access to pharmaceuticals, access to the private medical and health care, access to health insurance, aged care services, education and training of health professionals, health services related to the eligible veterans, vaccines purchasing under the arrangements of national immunization, as well as, community controlled health care services of Aboriginal and Torres Strait Islander. Moreover, in the year 2016?17, it is estimated that the Commonwealth will be involved in providing funding about $18.7 billion for supporting the State health services, involving $17.9 billion in the funding of the National Health Reform and about $811.5 millions in payments of National Partnership. As the funding of the National Health Reform is estimated around $17.9 billion in the year 2016-2017, there is an increase of about 6.2% or $1.0 billion from the year 2015?16, which excludes the adjustment for the outcomes in the year 2014?15 (Budget.gov.au, 2016).
Strategic Implications of the National Health Reform:
The National Healthcare Reform agenda was focused on the collaboration of the Commonwealth, as well as, state governments and territory governments for working together to facilitate the sustainability and improvement of the primary health care system. The main goal and objectives of the agenda were to ensure safe and effective services for the patients in the healthcare setting and improving the patient’s health outcomes (Sweet, 2011).The strategic implications of the reform is focused on building a patient-focused primary health care system, improvement of the healthcare services access and reduction of healthcare inequity, increasing the focus on prevention and promotion of the health of Australians, screening, as well as, early interventions, improvement of the quality, performance, safety, and accountability of the healthcare services. For achieving these outcomes, the strategies adopted by the reform is establishment of formal planning and protocols between local hospital networks and Medicare Locals, identification of the health requirements of the individuals in different groups, development of interventions and plans, development of the multidisciplinary teams, maximizing the opportunities of Electronic Health Records, and undertaking the evaluation and research for identifying the best utilization of the technologies and healthcare services for improving the primary health care (Veronesi, Harley, Dugdale, & Short, 2014).
Opportunities for Further Development:
The joint funding of both the governments is a complex and fragmented responsibilities, hence, this is the area for further development in the National Healthcare Reform. Though the fragmented system of funding by the two governments have been reformed by National Healthcare Reform through various negotiations and cooperative arrangements or via unilateral action by both the Commonwealth or the states, further development is required (Donato & Segal, 2010). Moreover, further development of the reform areas includes empowerment of the patients and responsibility, integrated funding, and its management, optimized pathways for providing care, health networks that are information-enabled, as well as, prevention and wellness of the population. For universal access to healthcare services to all the Australians, the above-mentioned areas need to be developed further for improvement of the primary health care (Williams, 2011).
A large number of significant initiatives are observed to be undertaken in Australia for improving the performance of healthcare system over the past decade. The incremental, however, the persistent approach has been adopted by the Australia’s federal government for improving the healthcare systems. Moreover, the development of various reforms and divisions have allowed the engagement of the Australians with the general practices and hence, has continued the healthcare’s patient-centered ethos (Stephenson, 2010). The National Healthcare Reform developed in the year 2011, which affirmed the improvement of the primary health care was a significant and important milestone achieved in the healthcare setting. The National Healthcare Reform agenda is crucial for future development of the healthcare system and for ensuring the equal access of healthcare services to all the Australians. Moreover, this agenda will help in overcoming the complexity and fragmentation of the accountability and funding by improving the arrangements and distribution of funding between the Commonwealth, as well as, the States and Territory for better provision of the integrated healthcare services to all the individuals (Nicholson, Jackson, Marley, & Wells, 2012).
The effect of the primary health care in the healthcare setting not only depends upon the strategic implications but also on the ways by which these implications are achieved. For better and efficient outcomes the development of the therapeutic relationship between the patient and the healthcare practitioners is required. For better quality and performance of the healthcare services, the leadership, as well as, healthcare systems should focus on methods of achieving the best utilization of the people, knowledge, information, and the resources. Moreover, the focus should be increased on recognizing and tackling the social determinants of the health (Stephens & Ledlow, 2010). For better-aged care services and its provision to the aged people, the expansion of the community, as well as, home-based assessment and care options should be implemented. For gaining sustainability of the healthcare systems, the tackling of waste, as well as, inefficiency in the healthcare system should be carried out systematically. No doubt, there has been tremendous progress in the health status, but still, the flaws related to the funding, as well as, governance still continues to emerge. New innovative approaches should be followed and implemented like Medicare Select for better utilization of the private sector. The political leadership, as well as, strong engagement with the community and healthcare sector is required for achieving sustainable and high-quality primary healthcare systems in Australia (Bennett, 2013)
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