Hawker Britton Occasional Papers and Media

National Health and Hospitals Reform Commission – Final Report

July 2009

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Key recommendations:

  • The Federal Government to fund and control all primary health care services and establish primary health care centres, with the new system up and running by 2015.
  • All Australians should have universal access to dental care and that Denticare Australia should be funded by a 0.75 per cent increase in the Medicare Levy.
  • COAG leaders to agree to a Healthy Australia Accord, which would allow for the primary health care takeover. A ‘partial takeover’ option would also have the Federal Government pay 40 per cent of the cost of patients being admitted to public hospitals for acute care. The ‘full takeover’ option would see this figure increase incrementally over time to 100 per cent.
  • By 2012, every Australian should have an electronic health record that is controlled and owned by them.
  • Adoption of National Access Targets to improve the times taken to access key health care services.
  • Establishment of 10-year Healthy Australia Goals for national health promotion and prevention, and the creation of an independent National Health Promotion and Prevention Agency.
  • Improving health for Indigenous people by improving the affordability of fresh food and recruiting more Indigenous people to the health work force.
  • Improving mental health services through better earlier intervention for people who are acutely mentally ill.

The Prime Minister today released the final report of the National Health and Hospitals Reform Commission (NHHRC). On 25 February 2008 the NHHRC was established by the Federal Cabinet to develop a long-term health reform plan for Australia –a key Labor election commitment. 

On 16 February 2009 Dr Christine Bennett, the Chair of the NHHRC, released the Commission’s interim report. The interim report was designed to generate debate across the health care system and within the community as a whole, and the Commission received over 240 submissions providing feedback to inform the development of the final report.

The final report, A Healthier Future for All Australians, includes 120 proposed reform directions across the spectrum of health service delivery coving a range of issues including governance, preventative health, indigenous health, hospitals, aged care, mental health, primary health care, workforce and rural health.

The Prime Minister said that the Government would consider the recommendations of the report and conduct detailed, direct consultations with major hospitals, rural and regional hospitals and representatives of the health sector over the next six months.

In late 2009 a meeting of the Council of Australian Governments (COAG) will be convened to deal explicitly with health reform. Following this, COAG will meet in early 2010 where a reform plan will be put to the States. If no agreement is reached, the Prime Minister indicated he would seek a mandate from the people (via a referendum) on health reform.

The Prime Minister also noted that the government faces serious fiscal restraints due to the global financial downturn, and that any reforms to the health system must be made in this context, particularly over the coming years when measures will be put into place to return the Budget to surplus. Consequently, while much of the reform debate will be about improving service delivery, debate will also centre on how to improve efficiency and ‘do more with less’.

Finally, the Prime Minister flagged two reports due by the end of 2009 that will inform policy decisions for the future: the Henry Tax Review and the Inter-generational Report. These reports will provide information about Australia’s long-term fiscal outlook, and will provide further context for the consideration of health reforms.

Key recommendations
The commission's report details more than 120 proposed changes which focus on better preventative measures, improved access for all Australians, and building a more sustainable long-term system.

Some of the key recommendations include:

Taking responsibility
Individual and collective action to build good health and wellbeing.

Connecting care
Comprehensive care for people over their lifetime.

Facing inequalities
Recognising and tackling the causes and impacts of health inequalities.

Driving quality performance
Leadership and systems to achieve best use of people, resources and evolving knowledge.

The commission estimates its changes would cost between $2.8 and $5.7 billion a year, with a five-year capital injection of between $4.3 and $7.3 billion also needed. The proposed public dental system, named ‘Denticare’, would also cost $3.6 billion a year. The commission estimated that about $4 billion a year would be saved by 2032 if the key recommendations are implemented.

The NHHRC Final Report (June 2009) is available online at http://www.nhhrc.org.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report.

Hawker Britton’s Occasional Paper on the interim report (February 2009) is available at http://www.hawkerbritton.com.au/hawker-britton-media/federal-act/national-health-hospitals-reform-commission-interim-report.htm.

A copy of the Prime Minister’s statement will shortly be available at www.pm.gov.au.

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