What could the health system look like if the Coalition was in power?

With an election pending, there has been a lot of noise from the Opposition about potential policies and reforms. In a parallel universe, what would the Australian health system look like if the Coalition was in power?

Recent proposals  from the Federal Opposition include cutting funding from current Labor health reforms including…

• Medicare Locals
• GP infrastructure to upgrade primary care facilities 
• A national e-health system
• 24 hour GP phone helpline grants

…and using this cash to roll out a $1.5 billion plan to improve mental health services, including:

• 20 new early psychosis intervention and prevention centres 
• 60 additional Headspace sites for young people with mental illness  
• 800 early intervention beds

Whilst Tony Abbott claims Labor has been inactive in mental health reform, Nicola Roxon was quick to hit back against the proposals, saying national hospital and health reforms will be at risk if Labor is voted out of office

“It’s very important we do not neglect mental health and one of the disappointing aspects of the Government’s health reform proposals is that there’s been so little on mental health.”

Tony Abbott

 “The Coalition’s policy is undermined by the fact it is funded by cutting Labor’s health reforms, such as GP super clinics and e-health.”

Nicola Roxon

What are the stakeholders saying?

The AMA is currently sitting on the sidelines and waiting for further updates on what funding would be left for GPs, whilst the Mental Health Foundation of Australia expects the Federal Government to announce its own mental health reforms in the near future.

Australian of the Year, Professor Patrick McGorry, has called on the Federal Government bring physical and mental health together under a new mental health plan, whilst speaking at the National Press Club last week.  

The Coalition said last week they would unveil their primary care policy before the election, in response to concerns about how much (if any) funding would remain for primary care.

With a few months to go until an election, there is plenty of time for further announcements, proposed reforms and complete u-turns, so watch this space!

As predicted, health is high on the priority list in this year’s budget. A total new investment of $7.3 billion in the National Health and Hospitals Network over five years hit the headlines yesterday, funded by major reforms and tax increases across three economic sectors.

Where have the savings been made?

The 2010 Federal budget – a healthy balance?

Increases in tax revenue across three core sectors will be used to fund the pledged health reform. As pre-announced in the media two weeks ago, taxes on tobacco have increased by 25%; a $9 billion Resource Super Profit Tax on the mineral industry was announced last week; and significant reforms within healthcare through the Pharmaceutical Benefits Scheme (PBS) and a new Community Pharmacy Agreement are predicted to deliver a total $2.5 billion in net savings over five years from 2010-11.

PBS reform plans began back in 2007 and are expected to generate about $6 billion in savings. Designed to take advantage of patent expiry, cuts to the price of prescription medicines are expected to generate $2 billion savings to the Government and about $300 million to patients over four years. Economic experts at the post-budget discussion suggested that leaning against the steady growth in PBS spending seen in recent years was an appropriate measure.

Where is the money going to be spent?

Whilst tax increases are not always popular and reforms can take time, the cuts will help fund the Government’s new health commitment. These savings will provide an additional $2.2 billion to meet the needs of Australia’s healthcare system, including:

1. $355 million for almost 450 GP ‘Super Clinics’
2. $417 million to enhance after-hours services, making them more streamlined
3. $523 million to provide practice nurses in all GP surgeries  
4. $467 million to rollout the national e-Health strategy, introducing individual electronic health records

Distilling the debate down to a grassroots level, patients may receive cheaper scripts, better access to GPs and practice nurses, shorter waiting lists for elective surgery and emergency department care, and better chronic disease management.

The current Government has placed a major focus in the national health system in an election year and time will quickly show the outcome of its decisions.