After years of hearing about what governments can’t do, shouldn’t do, or will inevitably stuff up if they try, it’s time to recapture a vision of the positive role of government, and put forward an agenda for public sector reform in the 21st century. At the heart of this vision should be a public service that works in cooperation with citizens to build a fair, sustainable and democratic society.

The CPD Public Service Program aims to develop a robust knowledge base about the state of the public service: its funding and capacity; performance in delivering community services; and attitudes toward and expectations of the Australian Public Service. Click here to read more.

CPD thanks the CPSU, the Becher Foundation and Slater & Gordon for their support of this program.

Health Sector Reform Part 2: Primary Care and Wellbeing

I have no doubt that we have over-invested in hospitals and treating sickness and under-invested in primary care and wellbeing. Primary care is the Cinderella in Australian health. There is ample evidence that we have got the cart before the horse in healthcare with our emphasis on hospitals and sickness. We have more hospital beds per capita than comparable countries – about 50% above the Canadian rate and 30% above the US rate. In some … more

Health Sector Reform Part 1: Workforce Reform

In early June 2005 the Council of Australian Governments meeting, the Prime Minister, Premiers and Chief Ministers acknowledged the need for health workforce reform. A report is expected from the Productivity Commission by the end of the year. My concern is that it will only be more of the same, more training the same way, and more employment the same way, when we really need root and branch change. We need to train and employ … more

HealthConnect – A Major Rethink Required?

The Commonwealth HealthConnect program is becoming controversial in the health sector, but it is an issue that requires wider debate in the community. This article briefly outlines the program and considers what its future should be. To declare my position, I believe that the introduction (and use by all clinicians) of advanced electronic health records is an essential step in improving the safety, quality and efficiency of our health system. The lost savings of not … more

 

Health Insurance & Medical Workforce Issues

Why health insurance is unsustainableStephen Leeder and Ian McAuley write, ‘The more private health insurance there is, the less control there is over health care costs’…more Medical Workforce Issues Dr Kerry Goulston writes, ‘Many specialists in the public system do not feel valued and are consequently losing their commitment and engagement with the public hospital system.’… more

Why health insurance is unsustainable

Private health insurance, in the form currently operating in Australia, is not sustainable. Each year premiums increase ahead of general inflation. Premiums have increased on average 7.5 per cent in the past four years and Australia’s largest private hospital operator has announced that consumers should expect private health insurance premiums to keep rising by twice the inflation rate every year. This is because private insurance has no capacity to control the costs of the services … more

Medical Workforce Issues

There has been a good deal of media interest in the shortage of general practitioners, particularly in rural areas. What has not received much attention is the lack of specialists, especially in our public hospitals, particularly those in rural and outer metropolitan areas. Australia is short of doctors working in the public hospital system. This shortage affects all specialities, but particularly general medicine, radiology and geriatric medicine. Why is this? There are a number of … more

 

Generic Medicines

Introduction Generic medicines are not usually newsworthy in Australia. They seldom achieve the level of public awareness that they do in the United States where many patients have to pay full cost for their medicines and selection of a generic product may result in a substantial cost saving. Several factors have made generic medicines newsworthy recently. The first and the most obvious is the publicity given to the mandatory (but rather small) 12.5 per cent … more

Is there a crisis in the NSW Public Hospital system?

I recently reviewed the file of a patient in a NSW public hospital. He was an elderly man who presented in a confused state. He was a chronic alcoholic with long-term, alcohol-related brain damage. His life involved going to his local club to eat two meals a day, and drinking himself into a stupor every night. He was single. During a lengthy hospital stay, he had one visit from a drinking mate. The likelihood he … more

This week in the Policy Portal

Two important articles have been added to the Health Policy Portal this week. Is there a crisis in NSW hospitals? by Brad Frankum Director of Medicine for Macarthur Health in NSW, Dr Brad Frankum, speaks from his heart about his concerns – a wasteful use of resources, media sensationalism, micro-management from above and professional abdication of responsibility. His insights are frank and disturbing. Brad Frankum’s article can be read here Generic Medicines by David Henry. … more