This is not health strategy; it’s “muddling through”, says John Menadue

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John Menadue, in Croakey – Crikey’s health blog, looks at the health reform journey to date, including some of the wrong turns taken & where we should be heading.
First published on Croakey, Crikey’s Health Blog on 15 July 2010

John Menadue, a prominent advocate for health reform, is scheduled to address a Queensland Nurses’ Union conference today, on health reform. You can read his speech in full below. (It is quite a bit longer than the normal Croakey post, but I thought it worth allowing readers the opportunity to see it in full).

In a nutshell, he gives an overview of the health reform journey to date, including some of the wrong turns that have been taken, and he highlights some of the wins and losses along the way. It could have been worse, he says – but it also could have been much, much better. And the journey has only just begun…

Menadue writes:

“Kevin Rudd said that the COAG reforms in health in April were the greatest since Medicare. That remains to be seen. At the very least, years of hard grind remain to make them work.

I am even more doubtful about what the Coalition has to say about health reform So far it comes to two main features – protecting private health insurance and establishing local hospital boards. Tony Abbott has also quite rightly proposed additional funding for mental health, but it will be at the expense of two programs that are very important for mental health – e-health and GP super clinics.

In considering what happened at COAG and preparing this address, I felt like the traveller who asked the way to Dublin. The Irishman told him, that if he were going to Dublin, he wouldn’t start from here. If I could continue the metaphor, I wouldn’t launch health reform with hospitals and premiers.

But the problem really began much earlier than COAG when Kevin Rudd said that he would consider a referendum to take over state hospitals. He would have been much better advised to propose a referendum on a takeover of all state health functions and so address the basic cause of much fragmentation, the split between hospital and non-hospital care.

An indication of the commonwealth government’s misunderstanding was obvious when it named the National Health and Hospitals Reform Commission. Surely health includes hospitals. Almost every photo opportunity of Kevin Rudd in his 103 reform consultations was in a hospital. I didn’t see any in primary care. So the hospital DNA was there from the beginning. The hospital obsession continued.

Read more online here

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