A Healthier Future for all Australians - Final Report June 2009
Tackling major access and equity issues
Equity, or ‘fairness’ to use everyday language, must be at the heart of the Australian health system. In our report we focus on five priorities for improving access and equity.
Improving health outcomes of Aboriginal and Torres Strait Islander people
Our first priority acknowledges the unacceptable health outcomes of Aboriginal and Torres Strait Islander people. To address this, we are recommending a radical change to how we take responsibility for improving the health of our first Australians. We want all the funding for Aboriginal and Torres Strait Islander people to be aggregated. We want a new National Aboriginal and Torres Strait Islander Health Authority (NATSIHA) to take this funding and actively purchase and commission the very best health services – services that are effective, high quality, culturally appropriate and meet the needs of Aboriginal and Torres Strait Islander people, their families and their communities.
Further, we want this Authority to demand and hold all health services to account for providing the right services for Aboriginal and Torres Strait Islander people. This also means that we need to invest more than we do now, so that the Authority can ensure that spending actually matches their greater health needs. This will be critical in helping ‘close the gap’ in health outcomes between Aboriginal and Torres Strait Islander people and other Australians.
Poor nutrition – particularly low fruit and vegetable intake – is an important determinant of the health gap among Aboriginal and Torres Strait Islander people. But many are living in remote areas with limited access to affordable healthy foods. To help tackle this, we are recommending an integrated package to improve nutrition in targeted remote Indigenous communities.
We must also strengthen the vital role of Community Controlled Health Services, train and recognise an Indigenous health workforce and a workforce for Indigenous health, and up-skill our health workforce to provide culturally appropriate services.
Improved care for people with serious mental illness
Our second priority for improving access and equity is better care for people with serious mental illness. We set out ways to ensure there is a range of treatment and support services for people with a mental illness, connected across the spectrum of care. We recommend an expansion of sub-acute services in the community and propose that all acute mental health services have a ‘rapid response outreach team’, available 24 hours a day, which can provide intensive community treatment and support, as an alternative to hospital-based treatment.Support for people living in remote and rural areas
The recommendations under our third priority are directed at addressing the problems for people living in remote and rural areas of having a universal health entitlement under Medicare, but not gaining universal access due to the limited availability of doctors in remote and rural communities.We are proposing that under-served remote and rural communities be given ‘top-up’ funding to an equivalent amount of funding on a per capita basis as communities with better access to medical, pharmaceutical and other primary health care services. We are also supporting increased funding for patient travel and accommodation, strategies to improve health workforce supply, and clinical training opportunities in remote and rural areas.
Improved access to dental health care
Improving access to dental health care is our fourth key priority for improving access and equity. Nearly one third of all Australian adults avoid or delay visiting the dentist due to costs; there are more than 650,000 people on public dental waiting lists; and the dental health of our children is worsening.To address these problems, we are recommending a new universal scheme for access to basic dental services – ‘Denticare Australia’. Under Denticare Australia, everyone would have the choice of getting basic dental services – prevention, restoration, and the provision of dentures – paid for by Denticare through either a private health insurance plan or through public dental services. We are also recommending internships for graduating dentists and oral health professionals to provide broader clinical experience and training, as well as to expand the public dental workforce.
To improve the dental health of Australia’s children we are recommending the national expansion of preschool and school dental programs.
Timely access to quality care in public hospitals
Our fifth priority is to take action now to improve timely access to quality care in public hospitals, particularly care in emergency departments and access to planned surgical and medical care.We recommend that public hospitals with major emergency departments be funded to ensure beds are available at all times for people needing to be admitted from the emergency department. For patients, this would mean quicker access to a hospital bed in an emergency and less crowded emergency departments with care being provided more quickly and safely.
Waiting times for planned surgical and medical care in public hospitals have increased over the last few years. The Commonwealth Government has committed $150 million annually up until 2010–2011 to reduce waiting lists. We propose extending this additional funding beyond 2010–2011. We are also recommending extra funding to address unmet need that will present once existing waiting lists are cleared.
