Your Local or mine?


The latest offerings in the
health policy arena are more a triumph of linguistic sculpting than serious
restructuring. Policy announcements are crafted to resonate with particular
audiences and ring with comfortingly familiarity to others. In what is clearly
an effort to incorporate popular rhetorical catchphrases (think ‘blame game’,
‘fragmentation’ and ‘efficiency’) so as to achieve as much political currency
as possible, the words ‘local’ and ‘regional’ have appeared almost
simultaneously in Abbott and Rudd’s health policy announcements this year. In
what might seem like a cynical appropriation of Abbotts ‘local hospital boards’
idea, Rudd has followed up no more than a fortnight later with ‘local hospital

To those of us who have
been advocating local solutions to the health care crisis, there appears to be
some hope that merely throwing around a few phrases may prove sufficiently
distracting so as to enlist support. But while Abbott’s local boards offer
little other than shifting some political risk away from governments (although
curiously here it would be the states who would benefit most), Rudd’s hospital
networks are a nice touch in linking up acute services, but do nothing to
better integrate hospitals with other parts of the health system (like primary
health care, for example, or aged care).

That is best achieved by my
kind of local: regional health organisations, that link all parts of health
care. Established as the nucleus of the health system, regional health
organisations with local governance structures (that includes not just
clinicians, but all health care stakeholders and most importantly, consumers),
funded from a national pool of all health care funding, provided to RHOs and
delivered according to health care need, are best placed to ensure the delivery
of appropriate, responsive, effective services – now that’s my kind of local!

Fiona Armstrong is a
public policy analyst and a long standing advocate for comprehensive health
reform. She is a co-author of the 2009 Centre for Policy Development Policy
Paper Putting
Health in Local Hands: Shifting Governance and Funding to Regional Health

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