Australian families to suffer if Canberra gets its way

17/8/03
All Premiers and Chief Ministers have signed a letter to the Prime Minister seeking a restoration of hospital funding and Canberra's cooperation in pushing ahead with vital reforms to the health sector.
The leaders called on the Prime Minister to discuss the Australian Health Care Agreement at the upcoming COAG meeting in Canberra on August 29.
"Health care has to be the most important issue facing all governments and communities, yet Mr Howard refuses to even discuss it," they said.
"The Federal Government is turning a blind eye to the difficulties facing our hospital systems.
"Through its failure to properly fund public hospitals, the Howard Government is stripping all Australians of their fundamental right to a decent health care system.
"The States and Territories need a funding increase over five years of not less than 27 per cent just to stay where we are. The Commonwealth, however, is only offering 17 per cent.
"The agreement on the table ignores the reality of our health system.
"It fails to recognise the impact of declining bulk billing rates, a rapidly ageing population and skyrocketing costs involved in running hospitals.
"The Commonwealth is misleading Australians when it says the new deal is better.
"The Prime Minister must come to the table and work with the States to find a solution to our future health challenges."
Letter signed by all Premiers follows.
Premier's office: 9222 9475

The Hon John Howard MP
Prime Minister of Australia
Parliament House
CANBERRA ACT 2600
Dear Prime Minister
We, the Premiers and Chief Ministers, are writing to you to reiterate our view that reform of the Australian health system needs to be discussed at the meeting of the Council of Australian Governments on 29 August 2003.
The health system is facing increasing challenges from an ageing population, a decline in bulk billing rates and increasing health costs. The future of the health system is now the most important issue confronting Australian governments.
All Premiers and Chief Ministers consider that current drafts of the 2003-2008 Australian Health Care Agreements are inadequate to meet the growing demands on the health system on two key grounds:

• A failure to engage with the national health reform agenda and the need to work together on 7 key priorities; and
• An insufficient increase in the Commonwealth contribution to meet the rising cost of providing health services.

As costs continue to rise, the burden of supporting the health system is increasingly falling to State and Territory Governments.
Our governments have worked cooperatively and constructively on issues of national significance, such as combating terrorism. Health is a responsibility that all our governments share and we now look forward to working with you on reforming the national health system for the benefit of all Australians.
All governments have an interest in overcoming the inefficiencies in the health system. Commonwealth, States and Territory Health Ministers have previously agreed on the elements of a health reform agenda. The proposals were developed with the assistance of leading clinicians and industry experts. They represent the best advice we have available on what is needed to serve the health needs of the community.
Health Reform
The States and Territories are seeking commitment from the Commonwealth to pursue the following reforms:
1. GP services and emergency departments.

There have been a number of successful trials of providing general practitioners in or near hospitals on weekends and after hours. These trials have helped to reduce pressure on emergency departments whilst ensuring that patients get the services they need. This is an example of governments working together and they should be extended.

2. The public hospital system and the aged care system

A national shortage of residential aged care beds means older people are being kept in acute care wards in public hospitals. This situation benefits neither older people nor public hospitals. Trials including the Multi Purpose Services are a good example of the Commonwealth and the States working together. We need to build on this.

3. Coordination of patient care

A continuum of care needs to be provided for patients so that there is no disruption to the service they receive arising from movements between inpatient, general practice and community based parts of the system.

4. Elective surgery

A national elective surgery access strategy should be developed to provide surgery for those who have been waiting a long time for procedures such as total hip replacements and total knee replacements.

5. E Health and the quality of care

The quality and transfer of health records for patients must be improved by taking advantage of new information and communication technologies.

6. Workforce issues

Further reforms are needed to overcome the shortage of GPs, nurses and other health professionals and to obtain a better distribution of all categories of health workers to ensure adequate coverage of rural and outer suburban areas. These sorts of practical proposals would make health service delivery more effective and efficient for both the Commonwealth and the States and Territories, and importantly they would improve services to the public. The current draft agreement only tackles the second of these issues with the proposed Pathways Home program, the details of which need considerable work. Ideally, there should be programs to tackle each of these priorities.

7. Remote Service Delivery

Indigenous Australians, particularly those in remote regions, have significantly lower levels of access to appropriate health services than other Australians. This includes access to primary health care and the Pharmaceutical Benefits Scheme. Reforms are needed to ensure that mainstream services are more responsive, that there is a health workforce equipped to address the needs of indigenous and remote Australians and that planning processes for health services involve indigenous Australians.
Level of Funding
The negotiations between officials have made little progress because the Commonwealth officers responsible for finalising the AHCA have been given no discretion to negotiate the core issues of concern to the States. Both the base for funding and the rate of its indexation are inadequate to provide for the continuation of current public hospital services for a growing population over the next five years. It offers 17 percent over five years. We need at least 27 percent, the figure from the 1998-2003 Agreement, just to stay where we are.
Our concerns are compounded by the clear intent on the Commonwealth's part to force the States and Territories to take up a larger share of the funding responsibility for health service delivery. Our basis for saying this is that the Commonwealth Budget Papers (Page 54 of Budget Paper No.2) clearly show the Federal Government removed $918 million from hospital funding in this year's budget, yet the Commonwealth persists in making misleading public claims that the proposed agreement is superior to continuing the old agreement.
We therefore ask that you reconsider your current position and allow an extension of the 1998-2003 agreement to permit further negotiations over these wider health reforms.
We need to demonstrate that all jurisdictions are committed to strengthening our health system so that it is well equipped to deal with the needs of our community. The effective and efficient management of Australia's health system has much wider ranging implications for the nation and is of such fundamental importance to the community that it should be listed for discussion at the upcoming meeting of the Council of Australian Governments.
Yours sincerely

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