Advancing Australia's healthcare system

Bupa Health Foundation's Executive Leader Annette Schmiede says we need national agreement on the direction of our future health system and finding solutions will require all of us to give some ground.

Blog by Annette Schmiede, Bupa Health Foundation Executive Leader

The Bupa Health Foundation held a lunch in Sydney recently for over 100 leaders from across the health sector. It was a very diverse group from government, providers, both public and private, industry and consumer associations. I am pleased to say it was a very successful event so I thought I would share some of my short talk that set the scene for the day’s discussion which was the Future of Healthcare.

On all measures, Australia’s health system comes up in the top group of health systems in the world. I have heard many senior people say if they had to choose any country in the world in which to be sick Australia is the one.

Despite this endorsement our health system is facing many challenges related to the increasing longevity and frailty of older Australians, the emergence of many people with multiple chronic diseases related to our modern sedentary lifestyle and diet of processed foods.

Ken Hillman, a professor of intensive care with many years of experience running ICU’s across Sydney, recently gave an interview on ABC Radio that summed up the stark change he has seen over his professional lifetime.

When he began his career in the ‘80s, most patients in ICU were young people with life threatening conditions that were reversible, such as trauma or infections.

Today, he said the majority are patients in their 80’s, 90’s, and even over 100, who are often receiving complex and invasive life prolonging treatments, when all they want to do is die at home in peace with their families.

Our health system is well designed to deal with acute care and trauma but it is struggling to appropriately care for the elderly and those with chronic conditions.

This is because our health system is not really a system.

We have multiple funders, including PHI, multiple providers from single practice GP’s right up to the most complex teaching hospitals.

Donald Trump had it right when he said: “Nobody knew healthcare could be so complicated.”

Governments in Australia have a history in Australia of undertaking national reviews of the health system, usually about every decade.

The last national review in 2008 was chaired by Prof Christine Bennett AO who was the chief medical officer of MBF at the time. Some of their recommendations around primary care and hospital funding and governance were taken up, but many were not.

We rarely undertake big system-shaping national health reform in Australia and this task is made even more complicated with our Federal-State structure.

Health reform is daunting because of the complexity. Any change must consider the reality of our current structures and arrangements: the public/private mix; how we finance healthcare; the role of private health insurance; how we pay for services; the under-resourcing of prevention; priority driven research; the list goes on.

It is further complicated when different stakeholders are focused on their needs and interests which may not be in the best interest of the system overall.

The need for national agreement on a health system that meets the needs of, and works for all consumers, is essential to healthcare for the future.

If we can reach consensus across a diverse group of stakeholders on this fundamental principle, we are far more likely to give the government courage to act on complex and sensitive reforms.

The Bupa Health Foundation’s recent lunch included former Health Ministers Nicola Roxon and Michael Wooldridge sharing their expertise and outlining their vision for the future.

They both believe the health system needs to be re-shaped, but we are still grappling with identifying the exact problem that needs fixing, and what success looks like.

Ms Roxon pointed to our major health reforms – like Medicare, Medibank, and tobacco controls – as successful because everyone wanted the same thing.

“Governments can’t make it happen if there isn’t enough agreement amongst these very difficult stakeholders,” she said.

Dr Wooldridge said Australia had some catching up to do in several areas.

“I would like to see an environment where there’s far more incentive to innovate than exists today and I’ll just give you one example. In 2000, we led the world in health IT. Today in 2017 health IT is an absolute unmitigated disgrace in Australia,” he said.

To hear two former Health Ministers, from different sides of politics, express bi-partisan ideas shows that we can build a wide coalition of support for a way forward.

Health Minister Greg Hunt has widely consulted across the entire sector as he develops his next wave of health reforms.

Bupa has been working with Minister Hunt to address affordability, which is our customers’ number one priority.

As a diverse health and care company operating in health insurance, aged care, dental, optical and many other areas, we have a broad view of our health system, and we see there are many opportunities to make the system more efficient by reducing duplication and eliminating waste as a start.

The Bupa Health Foundation is funding several research initiatives with a focus on health system sustainability starting with children in their first 1000 days to ensure they have a strong foundation to a healthy life.

A flagship project is the NHMRC (National Health and Medical Research Council) Partnership Centre on System Sustainability administered by Macquarie University and the Australian Institute for Health Innovation that began this year.

This is a multimillion dollar project that will focus on reforms across many areas of the health system with the aim of improving affordability and thus long term sustainability of the whole health system. The Bupa Foundation was instrumental in the establishment of this project and have invested over $2 million.

Finding solutions will require all of us to give some ground and see the big picture free from dogma and vested interests.  

We are all part of Australia’s changing population and health needs – funders, frontline service providers both public and private, academics and researchers, advocacy groups, consumers, professional organisations, start-ups.

We all need to have a voice in discussions about the future of healthcare and agree on a way forward.

The Bupa Health Foundation is one of Australia’s leading corporate foundations dedicated to health and has invested $30 million over the last ten years, including $13.5 million to the university sector through 49 projects across 17 universities.

The Bupa Health Foundation’s 2017 Annual Report can be read here.