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 networks’.

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