A Healthier Future for all Australians - Final Report June 2009
Chapter 6. Reforming governance
6.1 Introduction
Governance is important. It is not a separate issue from practical measures aimed to improve service delivery and health outcomes. It is the means by which the Australian community can be sure that the health system is delivering what it is there for. Moreover, current governance arrangements are contributing directly to current weaknesses in the quality, effectiveness and efficiency of the Australian health system.206
In the strictest terms, governance refers to the structures and processes used to regulate, direct and control the health system.207 However, when people speak about governance, they tend to see it as something broader, something reflecting the values and history of the health system as well as its future.
We believe that governance is primarily about leadership and stewardship of the health system. Good leadership will set a clear vision and put in place the policy, regulation, financial management, programs and structures to ensure the best possible health of – and health care to – Australians. Good stewardship will make sure our health system is capable of delivering the best possible health care to future generations.
To ensure Australia’s health system is sustainable, safe, fair and agile enough to respond to people’s changing health needs and a changing world, we need to make significant changes to the way it is governed. We recognise that these high-level structural changes will not, and cannot, rectify all the problems with our health system. That is why we have made many recommendations in this report for changes to specific areas of health care. We believe, however, that some of the problems with the health system will only improve by reforming governance arrangements.
206 A Podger (2009), Submission 294 to the National Health and Hospitals Reform Commission Interim Report. Second round submissions.
207 J Dwyer and K Eagar (2008), ‘Options for reform of Commonwealth and State governance responsibilities for the Australian health system’, Discussion paper commissioned by the National Health and Hospitals Reform Commission, p 1.
