NHS on the cards for an ailing Australian health system

A new report is recommending a Federal takeover of the Australian public health and dental system - the report by the National Health and Hospitals Reform Commission (NHHRC) says the health system is under strain and in need of a new prescription.

The NHHRC report, 'A Healthier Future for All Australians', details 123 proposed changes and has called for a major shake-up of the national health system, with the Commonwealth taking over the funding of most services.

The Federal Government's health review has recommended a Commonwealth takeover of primary care and outpatient services, as well as a public dental system.

The proposed changes are focused on better preventative measures, improved access for all Australians, and building a more sustainable long-term system - all at a cost of between $2.8 and $5.7 billion a year, with a five-year capital injection of between $4.3 and $7.3 billion also needed.

A public dental system - Denticare - would also cost $3.6 billion a year but the NHHRC says around $4 billion a year would be saved by 2032 if the key recommendations are implemented.

The report says a healthy population and an efficient and effective health care system are essential to maximising the wellbeing of the nation and the productivity of the economy and workforce and urges state governments to continue to consult and engage with the community, health professionals and health services to ensure the success of the reform agenda.

Health Minister Nicola Roxon has described the recommendations as far-reaching and says the report has recommended some of the biggest changes since the introduction of Medicare.

The commission calls for the Federal Government to fund and control all primary health care services and establish primary health care centres and to have the new system up and running by 2015 and also says all Australians should have universal access to dental care and that Denticare Australia should be funded by a 0.75% increase in the Medicare Levy.

The commission wants COAG leaders to agree to a Healthy Australia Accord, which would allow for the primary health care takeover and left the way open for a full takeover of the public hospital system by the Commonwealth, with the Federal Government funding 40% of the cost of patients being admitted to public hospitals for acute care.

The commission says the Government could then increase this share incrementally over time to 100% and suggests that by 2012, every Australian should have an electronic health record that is controlled and owned by them.

The report has strongly focused on how quickly patients are treated and has called for the adoption of National Access Targets which would stipulate how soon patients requiring a range of care, including mental health, coronary surgery and cancer treatment and those presenting at emergency departments, should be treated - it is suggested that these targets should be linked to some funding received, with rewards for improved performance.

The Commission has made several recommendations focusing on preventative measures and wants the Government to establish 10-year goals for national health promotion and prevention and form an independent National Health Promotion and prevention Agency.

It has also made several recommendations for improving health for Indigenous people, such as improving the affordability of fresh food and recruiting more Indigenous people to the health work force and also recommends the creation of a new National Aboriginal and Torres Strait Islander Health Authority to be the single purchasing body for health care services for Indigenous Australians.

The commission also wants to improve mental health services, including better earlier intervention for people who are acutely mentally ill and says more money should be spent on support services for those with mental illness.

The NHHRS report is the result of 16 months of work by 10 health policy experts who say Australia has a "fragmented health system with complex divisions of funding responsibilities and performance accountabilities between different levels of government".

The report provides a blueprint for the largest reforms to healthcare system since the introduction of Medicare in the 1980s and calls for the "next generation" of Medicare, where the Federal Government will be responsible for bringing together state-funded primary health care services and medical services under a national scheme.

The government is expected to trial or "road test" the recommendations with the public.

Under the scheme, all Australians would automatically belong to a government operated health and hospital plan, which could be a national plan or a plan operated by a state government with people able to move to another health plan, government-operated or a commercial provider plan.