The Future of Healthcare

General
Date: September 2005

Introduction

The future of health care is always a difficult area for anyone to propose reforms with there being a multitude of often competing interest groups.

It is important however that the union seek to set an agenda in this regard rather than merely react to the ideas of other groups. This policy paper sets out some areas where the union should take a position in terms of the future direction of health.

1. Funding

Health care providers are constantly struggling to provide services required with limited resources.

The states have shown that the Howard government cut over $1 billion dollars from the health care agreements directly effecting the operation of public hospitals around Australia.

The HSU believes that additional funding is required for the health sector. To this end, the HSU believes that the Medicare levy should increase by at least 0.5% which amounts to around an additional $1.7 billion to provide additional funding to the health care system.

2. Public Private Partnerships

The HSU is opposed to the introduction of PPP's. Whilst acknowledging that capital infrastructure needs to be continually updated, the union does not believe that PPP's provide the best way of providing the capital in that they are often plagued with escalating costs, conflict, high consultancy fees, poor service and secrecy.

3. Contracting Out Public Sector Services

The union continues its strong opposition to contracting out and privatisation which has been used to lower the standards of care for patients and clients in the health industry. The HSU strongly advocates for the direct employment of all health workers and the continued direct employment of public sector health workers by the public sector.

4. Workload and Workforce Issues

4.1 Medicare and Bulk Billing

The Government should fund an increase in the rebate for those doctors who voluntarily commit to bulk billing, out of hours services and home visits at their practise.

That is increased fees for doctors should be based upon their commitment to provide bulk billing and after hour's services thus making health care more affordable and assisting in taking the load off busy public hospital emergency departments.

The Government needs to allow public hospitals to employ GP's who can bulk bill in bulk billing clinics adjacent to hospital emergency departments. The affect of this is to immediately free up resources in accident and emergency so that they can deal with true emergency cases rather than provide a doctor surgery service because of a lack of bulk billing doctors and after hour services in the area.

The union supports the introduction of a Medicare hotline that allows people to phone for advice on health issues before heading off to an emergency department. The aim of the hotline is not to diagnose but to look at available options for the consumer that may include alternatives to visiting the local hospital. The overseas experience of such schemes has been very encouraging in this regard.

4.2 National Training Company

A tripartite national training company made up of government representatives (federal and state), unions and employers should be set up to identify, supply or contract out training needed to address critical skill shortages in the health industry.

A tripartite organisation that is properly funded would have the support of all major elements within the industry and would be able to look at global solutions to training and skill shortage problems in there totality.

4.3 Waiting Lists at Public Hospitals

Despite the high levels of care provided in public hospitals and the private health insurance initiatives, waiting lists and chronically busy public hospitals are a feature of the health industry. Private hospitals can provide the necessary capital infrastructure needed to directly assist this very problem.

The union is proposing that the most effective way to reduce waiting lists is for the public sector to directly contract beds from the private sector.

This can only occur where there are agreed comparable staffing levels, wages and conditions so that the quality of care can be maintained regardless of where the public patient is being seen.

4.4 Ambulance Paramedic Practitioners

The creation of an ambulance paramedic practitioner would allow specialist ambulance officers to medicate, triage, stitch, refer to x-ray etc patients both at the scene of a call thus avoiding the need to transport to a busy hospital;

In addition, ambulance officers often spend hours with their patient on a trolley in an A & E department waiting for beds and a nurse to triage their patient. Currently the Ambulance officer is not allowed to do this yet they are required to look after their patient whilst they wait.

It is suggested that the introduction of an Ambulance Paramedic Practitioner would dramatically assist the flow through of patients in an A & E department.

Such a classification could see Ambulance Paramedic Practitioners working on the road as well as in A & E.

This classification creates a specialist highly qualified Ambulance Officer who has the skills to be a first response emergency worker not just at the seen of an accident etc but also in a busy A & E department. The added benefit is that by having the ambulance officers based in and A & E department is in rural settings an ambulance officer would have more opportunity to maintain and upgrade their skills.

4.5 Direct Carers in Acute Settings

In aged care the personal care assistant/worker has performed many direct care duties. It is proposed that a similar career classification be formally introduced in the acute sector to assist in looking after patients and providing quality care.

Such employees should have a minimum qualification s (e.g.cert 3) .

4.6 Health practitioners

The union believes that the creation of a health professional practitioner could assist in the better treatment of a patient and would complement the already existing nurse practitioners.

5. Interface and Bureaucracy Between Service providers and different levels of Government

The union supports the establishment of a national health reform commission which will bring together all the major players, including the Commonwealth, all state and territory governments, local government, the heads of major statutory authorities, a representative group of managers from major public hospitals and health services, consumers, doctors, nurses, and other health professionals, health unions, and the private health sector to develop an action agenda for the reform of the health system.

That flowing from the national health reform commission, a new body with similar representation is established to assist in the ongoing overseeing of the deliver, reform and improvement of the health industry.

Further, it is proposed that geographical structures that have the task of implementing the delivery of health in specified geographical areas be created. These structures would feed into the national structure and should allow for the smooth integration and implementation of government's strategies in relation to health care through a single agency rather than providers attempting cobbling together health delivery through all levels of government.

This effectively would stop the buck passing between governments through the creation of a homogeneous health system based upon the collective consensus of major parties in the health industry.

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© 2003 Health Services Union (HSU)
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