Government Senators’ Dissenting Report
The need for reform
1.1
The Australian Health System is undergoing a major reform process after
more than a decade of lost opportunities under the Howard government.
1.2
As the Department of Health and Ageing website reports:
Health reform is designed to significantly improve and
modernise Australia's health system. This will mean the largest change to our
health, hospitals and aged care system since the introduction of Medicare.
1.3
The comprehensive package totalling $7.3 billion over five years to
reform Australia’s health and hospitals system, includes:
- Improving our hospitals;
- Better access to GP and primary health care services;
- Training more doctors, nurses and allied health professionals;
- Supporting aged care;
- Investing in prevention;
- Helping those with mental illness; and
- Modernising our health system.
1.4
The Australian Government is delivering fundamental health reform and
significant additional investments which are fully funded over the forward
estimates, wholly consistent with the fiscal strategy, and not adding to the
budget deficit.
1.5
The National Health and Hospitals Network will ensure future generations
of Australians enjoy affordable and universally accessible health care.
1.6
The Australian Government will become the dominant funder of hospital
services and have full policy and funding responsibility for GP, primary health
care and aged care.
1.7
The Australian Government will leverage its funding responsibility to
deliver more coordination, control and accountability at a local level. This
includes a new national performance framework to make the system more
transparent and drive improvements to ensure all Australians can access
high-quality, safe and efficiently run health care.
1.8
These reforms will deliver better health and hospital services by:
- Helping patients receive more seamless care across sectors of the
health system;
- Improving the quality of care patients receive through
performance standards and improved engagement of local clinicians; and
- Providing a secure funding base for health and hospitals into the
future.
1.9
In total, the Government will provide $7.3 billion over five years to
fund the new health reform initiatives. The initiatives will be introduced
progressively from 1 July 2010.
1.10
There was a consensus that the Australian health system has been
struggling to meet increasing demand for services with inadequate funding and
outdated structures. Dr Andrew Pesce, President of the AMA, stated that 'there
is no doubt that Australia needs health reform and it needs significant reform
of its health care system'.[1]
Ms Carol Bennett, Consumers Health Forum (CHF), also commented on the problems
facing health care in Australia and noted that the system is 'under pressure
and unresponsive to the needs of some people, particularly those with chronic
health conditions'. The CHF stated 'substantial reform is what is needed if the
system is to be responsive and sustainable into the future'.[2]
1.11
The problems facing the health care system are not something that has
emerged in the last two years. Under the former Federal Coalition government's
last health care agreement, state expenditure on health grew at a faster rate
than the Commonwealth's – the Commonwealth was not meeting its responsibility
and paying its fair share. In the 2003–04 Federal Budget the then Government,
and Health Minister Tony Abbott, significantly reduced the budgeted funding
across the forward estimates for the Australian Health Care Agreement. These
actions perpetuated the 'blame game' leading to poor outcomes, inadequate
funding, and less than optimal outcomes.
1.12
As a consequence of inheriting these systemic problems within the health
care system, the Rudd Government established the National Health and Hospitals
Reform Commission (NHHRC) to provide a long-term health reform plan for
Australia. The Commission provided three reports to the Government following
extensive and detailed consultations with stakeholders and users of the health care
system from across Australia, and the examination of submissions received. The
Commission provided the Government with 123 recommendations directed at
restructuring and improving the health care system.
The National Health and Hospitals Network reforms
1.13
On 20 April
2010, the Prime Minister, Premiers and Chief Ministers of States and
Territories, with the exception of Western Australia, reached an historic
agreement at the Council of Australian Governments (COAG), on health and
hospitals reform – the establishment of a National Health and Hospitals Network
(NHHN).
1.14
This
represents the most significant reform to Australia’s health and hospitals
system since the introduction of Medicare, and one of the largest reforms to
service delivery in the history of the Federation. The full details of the
Government’s reform package are available on the internet at www.yourhealth.gov.au.
1.15
The
Government states that the reforms will have three primary objectives:
- Reforming the fundamentals of our health and hospital system,
including funding and governance, to provide a sustainable foundation for
providing better services now and in the future.
- Changing the way health services are delivered, through better
access to high quality integrated care designed around the needs of patients,
and a greater focus on prevention, early intervention and the provision of care
outside of hospitals.
- Providing better care and better access to services for patients
right now, through increased investments to provide better hospitals, better
infrastructure, and more doctors and nurses.[3]
1.16
The
Government has included 94 of those recommendations of the NHHRC in the NHHN
reform package. There are also further recommendations still under
consideration including those pending the outcome of the Productivity
Commission report on ageing. As the Chair of the NHHRC told the Committee, the
Commissioners were supportive of the reform package:
...it
would be fair to say that we are all quite delighted that the vast majority of
what we put forward—which represented, as I said, the thinking of thousands of
people around Australia—was being acted upon. I think the investment that has
been envisaged is a very significant investment and similar to what we hoped
for.[4]
1.17
The AMA noted
that structural reform of our health system is very difficult and 'one that
governments have found easier to avoid rather than engage with'.[5]
This Government has not avoided this difficult task; and the outcome will be
that the health care system that is provided by this Government will be better
prepared, with an increased capacity to treat patients safely, and to meet the
demand of an ageing population and improving the capacity of all Australians to
access the best care and best medical technology in a timely and appropriate
way.
1.18
NHHN reforms
are a very significant investment by this Government to improve an ailing
health care system to the benefit of all Australians. Combined they represent
an investment of $7.3 billion over five years. Ms Leanne Wells of the National
Primary Health Care Partnership noted:
...the
$1.7 billion of new money for primary health care in the federal budget for
initiatives in after hours and aged care, some small investments in mental
health and in coordinated diabetes care, is a really good and fairly
unprecedented investment in primary health care.[6]
1.19
The NHHN
reforms establish new funding arrangements that will see the Commonwealth as
the dominant funder with the means and the motive to connect and integrate
health and aged care service across every person's life span. The reforms
strengthen primary health care and care in the community which will decrease
the level of hospitalisations and embed prevention and early intervention into
the health care system. As Dr Pesce of the AMA noted in his support for
proposals which he saw as 'really significant steps forward', these 'would
never have happened unless the Commonwealth had taken responsibility to adopt a
national approach to health reform'.[7]
1.20
The NHHN
reforms will provide a secure base for funding of vital health services –
something that the former Coalition Government and the then Minister for Health
Tony Abbott failed to provide. There will be much greater transparency on how
health services perform, not only the public sector but also the private
sector. For the first time, there will be a capacity to compare across the
sectors. As Ms Halton, Secretary, Department of Health and Ageing, commented:
This
transparency, together with greater clinical engagement, will drive continuous
improvement and create what the National Health and Hospitals Reform Commission
called 'an agile and self-improving health system'.[8]
1.21
The AMA
supported the changes to funding arrangements and the improvement to
transparency and accountability so that where and how health dollars are spent
can be identified, so that 'most funding will no longer pass through State
governments in a way that will allow it to be "reduced" before it
actually reaches hospitals'.[9]
1.22
Mr Bo Li of
the Australian Health Care Reform Alliance also supported the shift in funding
arrangements and stated that it 'is a good outcome for the health of
Australians'.[10]
1.23
The reforms
were welcomed by other organisations: the Australian General Practice Network
(AGPN) for example, stated:
We
support the overarching principles of the National Health and Hospital Network
Agreement, in particular the principles of a nationally unified and funded
system that is locally controlled, delivered and accountable through hospital
performance agreements and healthy communities’ reports.[11]
1.24
The Consumers
Health Forum welcomed the greater policy setting and performance measurement at
the national level with Ms Carol Bennett commenting:
It
offers us an opportunity to get some national consistency in the way our health
system operates, which is a bit different to the way it has been operating to
date. We believe that it can work and that it can work for the benefit of the
people who use the system, but we need to make sure that that happens and that
this is not a lost opportunity.[12]
Funding
and governance
1.25
The NHHN
reforms will implement a health system that is funded federally and run
locally. For the first time the Commonwealth Government will take the majority
funding responsibility for the entire health system. As Ms Halton explained to
the committee:
This
is a very significant structural change. It means that there will be one
dominant funder with the means and motive—and I believe this is important—to
connect and integrate health and aged care services for people right across the
life span, to strengthen primary care and care in the community so that
Australians do not have to find themselves unnecessarily in hospitals and,
importantly, to embed prevention and early intervention into our health system.[13]
1.26
The Commonwealth
will fund 60 per cent of the efficient price for all public hospital services,
and 60 per cent of capital, research and training in our public hospitals. The
Commonwealth will also take full funding and policy responsibility for GP and
primary health care services, and for aged care services.
1.27
Importantly
the Government will move to fund hospital services on the basis of activity
based funding which the NHHRC recommended would create strong efficiencies in
the health system. However the NHHN reforms include commitments to ensure the
future of small rural hospitals – including using block funding where
appropriate. The Commonwealth has also committed to moving over time to fund
100 per cent of the efficient price of primary health care equivalent outpatient
services.
1.28
The
management and governance of health services will be devolved more to a local
level. The NHHN will introduce Local Hospital Networks to be responsible for
the management of hospitals which will increase the flexibility for the
hospitals to meet the needs of local communities. The reforms will also
introduce primary health organisations called Medicare Locals to drive
integration across local GP and primary health providers and increase the
availability of services – particularly after hours. One stop shops will also
be established across the country for aged care services.
1.29
In addition
new, higher national standards and transparent reporting will provide
Australians with more information than ever before about the national, state
and local performance of the health system.
1.30
Coalition
criticism of the Government’s decision not to introduce the National Funding
Authority, ignores the fact that the arrangements involving a joint
State-Federal funding authority in each State and Territory will actually lead
to greater transparency over funding arrangements as state hospital spending
will be subject to the same transparent conditions.
1.31
In addition
the Opposition Senators also wrongly and mischievously claim that there will
not be local governance and management of hospitals. As the NHHN agreement
makes clear, the day-to-day management of the system will clearly be a
responsibility of the Local Hospital Network – and the Government has made very
clear in its evidence that its preference is for the people on the Governing
Councils to be the best people for the job, which will no doubt involve local
clinicians, in many instances, serving on these councils.
Hospital
investments
1.32
In addition
to the above financial and governance reforms to the hospital system, the NHHN
reforms also include specific investments in hospitals. These are:
- $1.62 billion for sub-acute care. From 2010-11, the number of
sub-acute beds will ramp up to reach 1,316 additional beds in the public
hospitals system by 2013-14. The funding for these beds could be directed to
rehabilitation, step down, mental health and palliative care beds.
- $800 million for elective surgery. This includes $650 million in
upfront and reward funding and $150 million in capital funding, to help ensure
patients are seen within the clinically recommended time (fully implemented by
December 2015), and to provide a guarantee that patients who are overdue for
surgery will be able to receive the surgery in another public or private
hospital rapidly.
- $750 million for emergency departments. $500 million will provide
for the equivalent to an estimated 805,000 emergency department attendances in
2013-14 – these patients will be admitted, referred or discharged within the
new four-hour target. This also includes $250 million in capital funding.
- $200 million in flexible funding which states can invest in
emergency departments, elective surgery and/or sub-acute beds.
1.33
Committee
witnesses such as Catholic Health Australia described the extra investments in
hospitals as a “terrific outcome” given the social benefits:
Why
would we think that providing public elective surgery to patients within
clinically recommended times is terrific? It is because we are seeking to
ensure that all Australians, regardless of income level and regardless of their
socioeconomic status, have equitable access to health care when they need it.[14]
Primary
Health Care
1.34
The NHHN
reforms deliver on landmark reforms to primary health care, drawing upon the
work of the NHHRC and the Draft National Primary Health Care Strategy – both
aiming to treat more people outside of hospital, ensuring a better management
of conditions such as chronic diseases. Evidence before the committee saw this
as a key positive of the Government’s reforms:
...my
overriding comment would be that the reforms are welcome. The Australian Health
Care Reform Alliance has been a long-term advocate for change in the healthcare
system and particularly very keen to see a focus shifting away from a very hospital
centric system to a system that actually stops people needing to go to hospital
at the rate that we go.[15]
1.35
The reforms
include major investments in primary health care including:
- $449 million for coordinated services for people with diabetes;
- $355 million for 425 GP Practice upgrades and 23 new GP Super
Clinics; and
- $417 million to establish a national GP after hours service and
Medicare Locals.
1.36
The AGPN
recognised the benefit in the package for primary health care as the reforms
will build on the services that the divisions of general practices provide to
general practice as well as the initiatives for e-health, practice nurses and
support of GP access to allied health services. In particular they have
recognised the benefit of voluntary enrolment as a method for providing more
coordinated service for diabetes patients and would like to see the concept
extended further:
We
welcome enrolment, because we have advocated for voluntary enrolment for some
time. We think it is a really useful means of getting proactive care for people
with chronic disease. So there is definitely benefit, and it is a good first
step.[16]
1.37
The AGPN are
also supportive of the Government’s initiatives in regard to its GP Super
Clinic and GP practice infrastructure grants:
The
fact that it has an infrastructure component for existing practices to support
existing practices to expand and extend, so that they can house workforce like
nurses and allied health professionals, is very, very welcome and something
that we advocated for very strongly with the other GP groups through United
General Practice Australia.[17]
1.38
Unfortunately
the Opposition does not support this policy and would cancel the grants for GP
practices and for additional GP Super Clinics.[18]
Mental
Health
1.39
A $176
million package is a part of the NHHN reforms is devoted to specific mental
health programs – in addition to the sub-acute bed package referred to in
hospital investments. This includes:
- Doubling the number of headspace services from 30 to 60 ($78.3
million) which will provide early intervention and mental health support for an
additional 20,000 young people each year.
- Expanding the Early Psychosis Prevention and Intervention Centre
model ($24.8 million) with additional state contributions, up to 3,500 young
people and their families will benefit from improved detection and earlier
treatment and support.
- Supporting additional mental health nurse services ($13 million)
over two years for at least 11,700 extra sessions.
- Providing more flexible care under the existing Access to Allied
Psychological Services Program ($57.4 million) to provide care to up to 25,000
people with severe mental illness.
1.40
COAG also
agreed to undertake further work on the scope for additional mental health
service reform for report back in 2011, including the potential for further
improvements to the allocation of roles and responsibilities.
Aged
Care
1.41
The reforms
include landmark investments in aged care:
- the Commonwealth taking full policy and funding responsibility to
support the development of a nationally consistent aged care system covering
basic home care through to nursing home level care (except in Western Australia
and Victoria);
- $96 million over four years to improve access to primary care
services for people in aged care;
- improving the viability of community care providers ($10
million);
- 1,200 Consumer Directed Care packages, through which care
recipients have a greater say in how services are provided to them; and
- strengthening consumer protections in aged care and toughen
prudential requirements to protect residents’ savings ($25 million).
Workforce
1.42
As part of
the Commonwealth’s investment in the health system, there will be delivered a
$643 million investment in Australia’s health workforce. This investment will
train more doctors and support allied health professionals working in rural
Australia:
- 1,375 more general practitioners (GPs) practising or in training
by 2013, and 5,500 new GPs or GPs undergoing training over the next decade
($339 million);
- 975 places each year for junior doctors to experience a career in
general practice during their postgraduate training period ($148 million);
- 680 more specialist doctors over the next decade ($145 million);
- 1,000 extra clinical training scholarships for allied health
students over the next decade ($6 million);
- support for up to 1,000 allied health professionals over the next
decade to take leave, including to access professional development courses to
keep their skills up to date ($5 million).
E-health
1.43
The
Government considers the establishment of a secure national electronic personal
health record system or 'e-health' to be one of the most substantial reforms to
improve the health care system. The e-health reforms are fundamental to the
reform package – the Government's investment in e-health will improve patient
care, system effectiveness, patient safety and quality of care.
1.44
The e-health
reforms are grounded in the recommendations of the National Health and
Hospitals Reform Commission which noted in its final report that e-health
provides an opportunity to 'improve the safety and quality of health care,
reduce waste and inefficiency, and improve continuity and health outcomes for
patients'.[19]
1.45
The e-health
reforms have been welcomed by stakeholders:
- Ms Carol
Bennett of the CHF stated that e-health is an 'absolutely critical plank of
this whole health reform process';[20]
- Professor
David Penington supported e-health as an 'essential part of making health care
more accessible and more reliable so that information is available when people
require urgent care';[21]
- Mr Steve Sant
of the Rural Doctors Association of Australia (RDAA) argued that e-health has
the potential to 'provide some significant supports for rural doctors';[22]
- Mr Vern
Hughes of the Australian Health Care Reform Alliance (AHCRC) stated that the
introduction of e-health is 'fundamentally important to any kind of health
reform';[23]
and
- Ms Anne Wise
of the CHF argued that e-health was essential to an improved health system and
to 'the safety and quality of the health system as it is experienced by
consumers'.[24]
1.46
Dr Christine
Bennett, former Chair of the NHHRC, argued that e-health was a 'very important
if not vital part of the reform'. In recalling her experience in travelling
around the country with the NHHRC, Dr Bennett highlighted that the community
couldn't understand why there was no e-health record given so much was done in
the e-world. She noted that the NHHRC described the person-controlled
electronic health record 'as the single most important enabler of truly
person-centred health care' and that:
The
reason for that is that you are giving an individual access to their own health
information. That is the most important information they can have when making
decisions about their health.[25]
The
current situation in relation to health record keeping
1.47
This Government
has recognised that the current situation is inefficient and has the potential
to undermine good patient care. Indeed, Ms Carol Bennett of the CHF stated
that:
We
constantly hear stories from consumers about the chaos that they experience,
particularly those with chronic conditions, when they are being referred from
practitioner to practitioner. Their records are not kept in any kind of system.
They have to continuously keep on top of what tests they have had. In some
instances they themselves virtually have to become practitioners to keep on top
of the information that they need to provide to their practitioners. It is
absolutely fundamental that we get some kind of electronic health records
system in place to support this range of measures, because if we do not we risk
continuing the disjointed arrangements that we have in place that at the end of
the day risk patients' safety and make their experiences in navigating the
system really difficult.[26]
1.48
Mr Hughes of
the AHCRA went further, and argued that the current system is primitive:
We
have no consolidated information system that is applicable across all of the
providers and practitioners in the health system. A person with a chronic or
complex condition will typically have 20 or 30 practitioners. They will have a
filing cabinet somewhere in their office with a few notes in it. Sometimes it
will be a bit more elaborate than a few notes. Those things scattered around in
the filing cabinets of a city somehow constitute an information system. It is
primitive—it is Neanderthal—and it is essential to remove it.[27]
1.49
Mr Hughes
drew a comparison with the banking system in arguing of the importance of
e-health to the health reform package:
If
you imagined a banking system trying to do banking operations without an electronic
system, it would be laughable; yet we have exactly that in health. So in my
book—and certainly from the point of view of parents, families and carers of
people with complex conditions, whom I represent—it is the most fundamental
requirement of reform.[28]
1.50
Mr Sant of
the Rural Doctors Association of Australia highlighted the difficulties faced
by doctors in rural communities without e-health and argued that:
Things
like sharing of medical records, particularly with things like grey nomads,
certainly have a potential to improve the health outcomes and remove costs. The
number of times where I have been told that a practice has an electronic copy
of the records of a patient, they have an electronic copy of their imaging,
their x-rays or the pathology results, but they cannot send that to the
hospital in the city because the hospital cannot receive it. So having those
e-health initiatives in place will help improve that; it will help improve the
costs, and it will help improve the outcomes.[29]
1.51
More than 97 per
cent of doctors are using software and, as Ms Jane Halton, Secretary,
Department of Health and Ageing noted, the e-health reforms will provide the
means to 'connect up what actually happens on an individual doctor's desk with
what is happening on other doctors' desks'.[30]
Ms Halton pointed to the current situation and the consequences of having
electronic records in sections of the health sector but not across it entirely:
Increasingly
people are starting to move things like pathology reports around electronically.
If I go to see my general practitioner here in Canberra now, if I have been to
have pathology tests, she will actually receive those reports electronically.
However, what we do not do is make that information available if, for example,
heaven forbid, I get knocked over in the basement of Parliament House as I take
the shortcut to the basement. If I run in front of one of those little trolleys
and have to be carted off to the Canberra Hospital Accident and Emergency
department, they cannot easily access my record. They cannot tell whether I am
diabetic—I am not, for the record. They cannot tell whether I am on any
particular medication. They do not know what my blood group is. They do not
know all the things that might be germane to whatever it might be that they
decide when I am there. They need to know a whole series of things about me
which, without access to an electronic health record, they are going to have
start from ground zero to work out. Not only will it save time; it will also be
a significant improvement in safety.[31]
The
benefits of e-health to consumers and the medical profession
1.52
Under the
previous Government, Australia was been very slow to develop e-health. For
example, Professor Penington noted that in Finland, 'they have e-health covering
all of their prescriptions and patient records over 30 years in full operation
this coming year'.[32]
1.53
This
Government has recognised the significant benefits of e-health to consumers. As
Dr Christine Bennett has noted, e-health means that any health professional
that a patient sees will have access to core information from other health
professionals:
Rather
than basically carrying around a cardboard box or a folder with whatever scraps
of information they can glean from their various health service visits, a
person would now have full access to a summary of all of their health
professional visits which they can then share, if they choose, with the health
professionals they are seeing. This will both empower the patient and make them
more involved in their health care and the healthcare decisions. It will also
reduce waste and duplication of tests, protect against adverse drug events when
prescribing doctors do not realise that someone is on a different drug and they
have not got it quite right, and make things more efficient when people go into
hospital.[33]
1.54
Mr Hughes of
the AHCRA also highlighted the importance of placing the consumer at the centre
of e-health in terms of control over their own information:
What
is laudable in the government's intention is that this will be person
controlled. I think it is very important that the government hold to that
commitment so that a consumer is able to authorise who may access that
information. It must not be a prerogative of a provider or practitioner to
assume that they can access it. Placing the prerogative with the consumer is an
empowerment and a very important shift, but the government will face pressures
from hospitals and other practitioners to drop the person controlled dimension.
It may drop it. It will depend on the extent to which consumers fight for it.[34]
1.55
In the aged
care sector, the benefits of e-health will also be significant. Professor
Penington commented:
E-health
can provide telemedicine with the provision of processes to monitor
performance, to monitor falls and new technology even IT can make it simple for
people to keep in contact with their families and their friends rather than
having them isolated in the home. Those things are necessary and rehabilitation
hospitals, the so-called sub acute hospitals, ought to be part of supporting
those people with physiotherapy and nursing care most of the time rather than
them being dropped into the acute hospitals, sitting there unable to move back
to their homes, and blocking beds that are necessary for support of emergency
care and the like. There needs to be a more rational approach to aged care and
it is primarily a matter of improving quality of life for elderly people who
are going to continue to grow in number at a very steady rate over the next 20
or 30 years.[35]
1.56
Ms Jane
Halton, Secretary, Department of Health and Ageing, highlighted that an
electronic health record system mean will change the way people do their work –
patients will not have to repeat their details every time they see a new
practitioner, and practitioners will be confident that the details for a
patient are accurate. In addition, e-health will enable people to take a more
active role in their own health and allow them much more control over how they
manage their health issues. Ms Halton concluded:
The
electronic health record is fundamental to all of that. We are very careful and
mindful about the issues in respect of privacy. One of the things that we are
always reminded of is that people regard privacy as being the most fundamental
consideration, so we are building a system that will very carefully protect
people's privacy. The ability to actually have health join the information
technology revolution is absolutely fundamental to making the whole package
succeed.[36]
1.57
The
Government's aim to implement the e-health measures now will ensure that there
is a consistent approach across Australia. The Government does not want to see
different proprietary systems in different jurisdictions that do not
communicate with each other. Such an occurrence would fail to deliver the
maximum possible benefits to health consumers. As Ms Halton noted:
It
is about everything from ensuring that the email gets through to that what is
in the email is understandable and is then loaded into the one record that can
be read and understood by anybody you enable access to it. That actually
underpins why it is important to do this now.[37]
1.58
Unfortunately
this measure does not have bipartisan support and in their budget reply the
Liberal and National Parties have decided that they would not support the
funding for e-health investments.[38]
Such a nearsighted decision misses this important opportunity for reform of the
health system and improving the safety and quality of the outcomes for
patients.
Conclusion
1.59
The National
Health and Hospitals Network represents the most significant change to the
health system since the introduction of Medicare. Sadly reform has stalled over
the past decade as hospital budgets were tightened as a result of the Howard Government
not playing its part in the funding of Australia’s hospitals and the blame-game
became the norm in health.
1.60
These reforms
provide a circuit breaker for the system, which otherwise would be unable to
face the coming challenges of the ageing population and the increase in chronic
disease.
1.61
The
Opposition Senators on this committee claim, for political purposes, that
little is changing, yet the clear evidence to the committee from a wide range
of witnesses is that there are very strong reforms being implemented that will
have a very positive effect on the health of Australians. This is in comparison
with the position of the Opposition which is to cut vital investments in
e-health and GP practices and Super Clinics which would deprive Australians of
much needed health infrastructure.
1.62
We
wholeheartedly support the Government’s reforms reached at the COAG meeting as
driving important structural change, transparency, additional funding,
resources and local governance.
1.63
The
structural change, transparency, additional funding resources, and local
governance will lead to improvements for all who use the Australian Health
System.
Senator Helen Polley
Senator for Tasmania |
Senator Doug Cameron
Senator for New South Wales |
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