The Senate Select Committee on Health’s interim report on Australia’s health system has described as a “fallacy” the Abbott government’s claims about the effectiveness of the Medicare system.
The committee, whose members are drawn from the Coalition, Labor and the Greens, is engaged in an Australia-wide series of site visits and hearings, which included Lismore on 15 September.
Comments in the interim report released this month are tuned to the nation’s current health debate: “Since coming to power the Abbott Government has repeatedly called into question the sustainability of Medicare … The evidence given to this committee and documented in this report reveals the fallacy of such claims, particularly with regard to GPs and the Medicare Benefits Scheme.”
Regarding the effectiveness of health expenditure, it said “Compared with other countries, Australia performs strongly across a range of important health indicators... life expectancy for Australian women is the sixth highest globally, and for men it is the seventh highest.
“At the same time Australia's spending on health as a percentage of GDP (9.1 per cent) is lower than comparable OECD countries such as the United States (17.0 per cent), France (11.2 per cent), Canada (10.6 per cent) and New Zealand (10.3 per cent), and equivalent to the United Kingdom and Spain (both 9.1 per cent).”
It said the proposed $7.00 GP co-payment had raised repeated concerns: “The overwhelming sentiment of witnesses was that the $7 co-payment will have a negative impact on the health and wellbeing of all Australians and is practically unworkable.”
While Canberra has now fallen into line with this view – the proposal was scrapped on 9 December 2014 – it remains to be seen what other recommendations it will accept before the Committee tables its final report in June 2016, a federal election year.
The report criticized the government’s handling of the Medicare Local program, saying, “With regard to the closure of 61 Medicare Locals the government’s failure to meet any of its own deadlines about the establishment of Primary Health Networks (PHNs) reveals the flawed nature of the process it has set in train. The government's lack of communication and consultation with vital participants in the health sector is of ongoing concern.”
Other criticisms include cuts to hospital funding and the abolition of the Australian National Preventative Health Agency: “It has been estimated that for every dollar spent on health promotion and prevention five dollars in healthcare expenditure alone is saved…
“Australia invests just two per cent of all health expenditure in health promotion and disease prevention programs — low by international standards. The government's plans to abolish ANPHA, coupled with its decision to cease the National Partnership Agreement for Preventative Health, will exacerbate this situation.”
The interim report made these recommendations (Executive Summary p13-20, Recommendation 21-23).
The government should immediately abandon its plan to implement the $7 co-payments.
The government should restate its commitment to Activity Based Funding and associated reforms.
The government should drop its plans to abolish ANPHA and reinstate the National Partnership Agreement on Preventative Health.
If the goal of better integration of primary care is to be achieved, the committee recommends that the Primary Health Networks tender must include:
• a clear statement of the population health needs to be addressed, including clear outcome measures;
• a statement of the population health data expected to be collected or used;
• a statement on the outcomes Primary Health Networks will be expected to achieve to improve access to primary care and improve primary care integration for the whole population, in particular for disadvantaged groups; and
• a requirement that the integrity of the data collected by Medicare Locals will be preserved.
The committee expresses its concern that the government's decision to abolish 61 Medicare Locals and establish 30 new Primary Health Networks is resulting in loss of frontline services and will see significant cuts to services and programs at the local level that are aimed at improving population health, better integration of primary care services and keeping people out of hospital.
The committee recommends that the government, as a matter of urgency, ensures certainty in regards to the maintenance of the suite of services supplied by Medicare Locals, particularly in areas of rural and remote Australia where access to medical facilities and services is less comprehensive than the level of access in metropolitan areas.
The committee recommends that the government must take immediate steps to reinstate funding to indigenous health organisations and ensure that the particular health challenges facing Aboriginal and Torres Strait Islander Australians are effectively analysed and responded to.
The committee recommends that the government should cease its planned merger of the Organ and Tissue Authority and the National Blood Authority.