What is national health reform delivering?

Health and hospital reform is designed to deliver better health care and better hospitals for the future. The changes aim to ensure all Australians receive seamless, high quality care, where and when they need it.

The reforms will mean:

More beds

Many older Australians are unable to access sub-acute care services in their community, and so are unnecessarily admitted to hospital. Sub-acute care, which includes rehabilitation, palliative care, mental health and geriatric services, in both hospitals and the community, can play an important role in improving health outcomes for many patients.

Under the reforms the Australian Government will provide $1.6 billion in capital and recurrent funding for the state and territory governments to operate 1,316 new sub-acute care beds nationally by 2013-2014. This will improve access to sub-acute care for patients in need, and reduce the pressure on public hospitals.

Reduced hospital waiting times

Emergency departments

Many Australians wait too long to be treated in public hospital emergency departments. Almost one-in-three patients wait longer than is clinically recommended before they are seen, while a similar proportion of those admitted to hospital wait more than eight hours for a bed.

As part of national health reform, the Australian Government is providing $500 million in funding from 1 July 2010 to improve emergency department outcomes so that patients are admitted, referred or discharged within four hours of arriving at an emergency department, where clinically appropriate. The new Four Hour National Access Target will be phased in over four years. An expert panel will be established by 30 June 2011 to advise governments on the effective implementation of the four-hour target.

The Australian Government is also investing $250 million in capital funding over four years, which started in mid-2010, to upgrade emergency department facilities and help hospitals to provide faster emergency department treatment.

Elective surgery

Many public patients in Australia wait longer than is clinically recommended to have elective surgery. The Australian Government is providing $650 million to fast-track elective surgery patients who have been waiting longer than clinically recommended. New targets have been set for waiting times for elective surgery patients and a guarantee that 95 per cent of surgery will be delivered on time by December 2015.

To help hospitals provide high quality elective surgery, the Government is also investing $150 million in capital funding over three years to improve elective surgery infrastructure, including upgrades to surgery and day surgery centres and the purchase of new surgical equipment.

An expanded number of GP services

Patients can at times, find it difficult to access the health services they need in their local community, including patients with chronic conditions who need care from multiple health professionals. This can lead to illnesses being poorly managed, with patients possibly experiencing complications and, sometimes, avoidable hospitalisations.

The Government is seeking to improve the care coordination for patients with chronic conditions, beginning with people with diabetes by piloting a Coordinated Care for Diabetes initiative. The pilot will test a new model of care that aims to provide greater flexibility and coordination in the delivery of primary health care services to improve health outcomes for Australians living with diabetes. The pilot will commence in July 2011.

The Australian Government will provide $98.6 million over four years to improve access to primary care services for older Australians. Increased incentive payments introduced in July 2010 are expected to lead to an extra 105,000 GP services being provided in aged care facilities. From July 2012, Medicare Locals will have access to flexible funding to target gaps in primary health care for older Australians, whether they live independently in the community or in aged care facilities. This is expected to result in an additional 190,000 services for older Australians.

To help reduce the pressure on public hospitals the Government will improve access to after hours care across Australia. From 1 July 2011, a new after hours GP telephone advice service will be available to provide medical advice and possibly help deal with medical conditions over the telephone. This service will benefit people living in areas with limited or no access to after hours care.

The new after hours GP telephone advice service will be an addition to the 24-hour nurse advice and information service that is already being provided by the National Health Call Centre Network (NHCCN) operating as healthdirect Australia.

The Government is also fast-tracking after hours GP care through Medicare Locals. From 1 July 2011, as Medicare Locals are established, they will work to improve access to after hours primary care services in their regions.

In addition, new GP Super Clinics are being opened in selected communities across Australia. They will be open for extended hours and be staffed by teams of health professionals, including doctors, nurses and allied health professionals. Thirty GP Super Clinics are either now open, providing early services or are under construction.

More training for more doctors and nurses

The Australian Government is investing $640 million over the next four years to train more doctors to tackle doctor shortages. This will reduce pressure on hospitals and make it easier for patients to access GPs and specialist doctors. There is a particular focus on ensuring that the needs of rural, regional and remote Australians are met through the health workforce programs.

Accounting for previous investments, there will be 1,375 more GPs practicing, or in training, by 2013 and 5,500 GPs undergoing training in the next decade. The Government will also double the number of places for medical students to train to become a GP, from 600 in 2007 to 1,200 in 2014, to ensure that there are enough GPs to meet demand in the future. On top of this, 680 specialist doctors will be trained over the next decade.

To increase the number of nurses in rural and aged care $128.4 million is being invested to establish a Rural Nursing Locum Scheme, expand aged care nursing training, provide incentives for aged care workers to upskill, and support the uptake of nurse practitioners in aged care.

Greater support for practice nurses

An additional $390.3 million over four years will provide support for a broader and more flexible role for practice nurses under the Practice Nurse Incentives Program (PNIP). Accredited general practices and Aboriginal Medical Services will be eligible for an incentive to offset the costs of employing a practice nurse.

This will contribute significantly to the delivery of primary health care services, improving patient’s access to clinically-appropriate primary health care services and helping to ease the pressure on GPs.

More aged care beds and places

As part of national health reform, the Australian Government is improving aged care services by delivering an extra 5,000 aged care beds and places, and 1,200 care packages. This includes providing up to $300 million in zero real interest loans from 2011-12 to provide 2,500 extra aged care places and redirecting $280 million for 2,000 flexible aged care places from 2010-11 to the states and territories to support long stay older patients.

An additional $122 million is being allocated over 2010-11 for 286 new sub-acute beds in Multi-Purpose Services.

To improve care recipient’s quality of life, independence and satisfaction, opportunities are being provided for care recipients to be more active in shaping their care through 1,200 Consumer Directed Care packages in Commonwealth-funded community care programs.

Better aged care services

For the first time, the Australian Government will take full policy and funding responsibility for aged care services, ending the fragmentation and cost shifting. The new aged care system will cover all elements of aged care, from basic in-home care to high level residential care. This means that older Australians will have access to the same, consistent, high quality aged care services, where and when they need it. Overall Australian Government funding for aged and community care will be $10.8 billion in 2010–11.

The Australian Government is providing $38.3 million over the next three years to transition services for older people under the Home and Community Care Program to direct management by the Australian Government (except for in Victoria and Western Australia where further negotiations are underway).

The Government is also investing $36.8 million over four years from 2010-11 to improve information, access and assessment services so that navigating the aged care system is easier for older Australians and their families.

The Government is providing $310 million (including approximately $100 million in new funding) to fund education and training and to provide better support for aged care workers while they undertake training. This will improve the care older Australians receive and underpin the sustainability of our aged care system as Australia’s population ages.

The Government is also providing additional support for aged care services in rural and remote areas, including a $10.1 million funding boost to rural and remote community care providers. This will allow Multi-Purpose Services to be established in larger regional communities, and enable transition care to be provided in suitable rural and remote hospitals to allow services to expand in these areas.

Better protections for care recipients

Consumer protection in aged care is being strengthened by providing $50.6 million to better equip the Aged Care Complaints Investigation Scheme to improve the response to complaints from residents and family members.

$21.8 million has also been committed to strengthening the current prudential arrangements for aged care accommodation bonds.

Building an aged care system for the future

The Government will provide $7.0 million over four years to assist aged care homes to improve their business practices. This will allow providers to benchmark their services against other providers, introducing comparative competition and helping to control costs for the Australian Government and residents. All 1,140 aged care providers will participate in the industry wide benchmarking exercise and business advisory services will be available to assist aged care providers to improve business practices.

Improved access to health care

The current primary health care system is fragmented and this can make it hard for patients to get the treatment they need. The Government is introducing primary health care organisations (Medicare Locals) to better connect health services so that health professionals are supported to deliver coordinated primary health care in their local area.

Under the 13 February COAG Heads of Agreement, the Australian Government is bringing forward the establishment of Medicare Locals. Approximately 15 Medicare Locals will commence in July 2011. A further 15 will commence in January 2012, with the remainder starting in July 2012.

Hospitals will be managed locally through Local Hospital Networks. These new networks will assist doctors and other health professionals in the hospital system to provide health services tailored to the needs of their community and work closely with Medicare Locals to help patients receive more seamless care.

To help reduce the pressure on public hospitals the Government will improve access to after-hours care. From 1 July 2011, a new after hours GP telephone advice service will be available to provide medical advice and possibly help deal with medical conditions over the telephone. This service will benefit people living in areas with limited or no access to after hours care, and alleviate pressure on emergency departments by providing an alternative source of medical advice where appropriate.

The new after hours GP telephone advice service will be an addition to the 24-hour nurse advice and information service that is already being provided by the National Health Call Centre Network (NHCCN) operating as healthdirect Australia.

From 1 July 2013, the availability of local face-to-face after hours primary care services will be increased through the work of newly-established Medicare Locals. In addition, all new GP Super Clinics will be required to provide extended hours coverage as a condition of funding.

Integrated GP and primary care

The Australian Government is investing over 650 million to establish 64 GP Super Clinics and to upgrade around 425 existing general practices, primary care and community health services, and Aboriginal Medical Services to improve access to integrated GP and primary health care.

GP Super Clinics will open for extended hours and be staffed by teams of health professionals, including doctors, nurses and allied health professionals.

Local communities will benefit from improved access to a broad range of services under the one roof, allowing for greater coordinated patient care.

In addition, upgrades to existing primary health care facilities will improve their capacity to deliver team based care.

Improvements to the mental health system

Young Australians are much more likely to suffer from a mental illness than people of other ages. Of those young people who suffer from mental illness, many do not receive adequate treatment, or fall through the gaps in the health care system.

Under national health reform, the Australian government is providing greater funding towards hospital costs, which will benefit those areas of public hospital services where gaps continue, such as in mental health.

The Australian Government is improving the mental health system by investing $78.8 million over four years from 2010-11 in delivering up to 30 new headspace youth-friendly services. A successful mental health service model, Early Psychosis Prevention and Intervention Centre model, is also being expanded to support at-risk young people in the early stages of psychosis.

The Government will also help patients by providing more mental health nurses and directing $118.5 million to expand the Access to Allied Psychological Services (ATAPS). The funding for ATAPS includes $58.5 million for Flexible Care Packages to provide clinical and case coordination services to better support people with severe mental illness in the community, delivered through Medicare Locals, and $60 million to provide non-clinical services to complement the Flexible Care Packages measure.

Too many mental health patients end up in hospital because they can’t access appropriate care, including in sub-acute facilities in the community. The Government’s new $1.6 billion investment over four years in sub-acute beds will help to support more people with severe mental illness to access the care that they need.

Under national health reform, the federal and state and territory governments have agreed also to pursue further reform in mental health over the next three years.

Building a national, secure e-Health system

Australians will be able to check their medical history online and give access to this information to their health care service provider through the introduction of personally controlled electronic health records.

The Australian Government’s $466.7 million investment in building an eHealth system will revolutionise the delivery of health care in Australian. It will boost patient safety, improve health care delivery, and cut waste and duplication. Key elements of the system have already been established, with every Australian health care consumer and provider now having an Individual Healthcare Identifier. From July 2012, Australians will have the option of registering for a personally controlled electronic health record, which will be a secure record, containing important information, such as a health summary.

With a patient’s consent, the personally controlled electronic health record system will allow authorised healthcare professionals to view a summary of an indvidual’s key clinical health information, like symptoms and conditions, treatments, medications, test results, allergies and alerts.

The national, secure eHealth system will help reduce adverse drug events, medication errors and poor transitions as patients move from one health care setting to another.

Reducing the incidence of smoking

Tobacco smoking is one of the single largest causes of premature death and disease in Australia.

To discourage smoking the Government has announced a comprehensive package targeting smoking and its harmful effects.

This includes a 25 per cent tax increase on tobacco from 30 April 2010 and, in a world first, the introduction legislation to ensure all tobacco products are sold in plain packaging by 1 July 2012.

To reduce smoking rates amongst high-need and highly-disadvantaged groups the Government is providing $27.8 million over four years to communicate the dangers of smoking. This includes, Break the Chain— the first ever national advertising campaign across television, radio and newspapers, urging Indigenous Australians to break the chain and quit smoking. These initiatives form part of Australia’s largest ever national public education campaign to encourage Australians to stop smoking, which started in February 2011.

Sustainable funding for the future

Under the new Heads of Agreement on national health reform, the Australian Government will pay 50 percent of the growth in hospital costs.

This will be done in two stages, increasing to 45 percent in 2013–14 and to 50 percent in 2017–18. Coupled with the introduction of activity-based funding, this will deliver a more cost effective and sustainable hospital funding system.

The Government is also introducing a new funding model to pay public hospitals. From 1 July 2012 hospitals will be funded based on the activity they undertake rather than via block funding. In some instances, payments to smaller regional hospitals and some highly specialised services will continue to be paid through block grants.

Activity based funding, or funding for each activity that a hospital performs, will be based on a national efficient price set by the new Independent Hospital Pricing Authority. The efficient price combined with indicators of safety, quality and access to services, will help identify hospital performance and drive improvements.

New transparent reporting of spending on health care will also provide Australians with more information than ever before about the national, state and local performance of the health and hospital system.

Engaging consumers

An important element of national health reform is the engagement of consumers. Local Hospital Networks and Medicare Locals are required to take into account the views of communities and consumers in responding to local health needs. In many cases this will mean a consumer representative is included on the governing board. It is also anticipated that advisory bodies set up to advise these boards will include a consumer perspective.

The Consumers Health Forum (CHF) has been funded to conduct a three-year project, Our Health, Our Community, aimed at providing resources to assist health consumers who may be involved in these roles or may simply want to be more informed about health issues.

The Our Health, Our Community project includes the development of a Consumer Health Platform that uses digital communications and platforms to engage health consumers in health reform.

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Page last updated 09 November, 2010