Putting health in local hands is a discussion paper from the Centre for Policy Development’s Effective Government Program.
Australia’s unique geography and system of governance has, over time, led to a health care system that is more fragmented unfair and wasteful than it might be. Shifting health care governance and funding to regional agencies that are more responsive to the needs of communities would improve both the fairness and effectiveness of Australian health care.
At present, access to health care services in Australia often reflects the inverse care law: ‘those who need the most health services receive the least, and those who need the least receive the most’.
The reform suggestions of the National Health and Hospitals Reform Commission in its final report will not be enough to solve the problems we face. Some will further entrench existing inequities and inefficiencies. For example:
Australia’s unique geography and federal governance model has, over time, led to a health care system that is unnecessarily fragmented, inequitable and inefficient. By shifting health care governance and funding to regional agencies that are more responsive to the needs of local communities we could dramatically improve both the fairness and effectiveness ofAustralian health care.
The authors of this paper propose the establishment of local Regional Health Organisations (RHOs) across Australia, with each responsible for the health care needs of a defined population within their region. The RHO governance and funding model will improve the provision of health care by:
This model proposes that all current health care funding from local, state and federal governments be pooled within a national agency and equitably distributed to RHOs on the basis of evidence about health care needs. Publicly available information on local health needs and health spending (regularly collected and updated in accordance with national standards) would inform decisions by RHOs about the appropriate allocation of services and resources in that region. This approach would benefit consumers, health professionals and governments as it would:
