It is true that Labor has developed a really positive and progressive primary health care policy but do they really mean it? The "GP Super Clinics" may be a great idea but why is only the GP mentioned in the title when the most exciting feature of having multidisciplinary teams of GPs and allied health practitioners is not recognised. And co-locating them on hospital grounds (at least in Queensland) and having the State Health (Illness) Department (which has little involvement in primary health care and even less in preventative care other than whole of community education programs) run them seems to go against all the principals of preventative health. More devils may appear as more details are released. 9/10 for concept but about 3/10 for implementing it.

On 1/1/05, in NSW 17 area health services were merged into 8. The promise was a far more efficient service. It is difficult to know if we got it. What we do know is that there has been widespread disruption. Insecurity amongst the staff was rife. Projects months in the making had to be dumped. Alliances years in the building suddenly become irrelevant. The cost of the bureaucratic brainwave would be tens if not hundreds of millions of dollars.

Now we get Howard promising a return to the old system of having boards of directors overseeing localised health services. Good grief! Will there be any end to the grand plans?

I agree with healthwatcher, one of the worst features in health is the restructuring of services seemingly without end or point.

Sort out Federal State responsibilites and funding for health and aged care.

Provide more places at Unis for doctors nurses and other health professionals and training places in hospitals.

Provide additional funding for primary care - don't expect an already stretched acute sector to cope without more resources.

If taxpayers are subsidising private health cover why not (i) allow and encourage public hospitals to offer no gap private care and (ii) compel patients with private cover to use it when being treated.

Failing that we can always send our elective cases to Thailand - you could get a holiday, a new hip, and help the developing world all in one hit

Rudd and Goss scrapped Hospital Boards in Qld 15 years ago and replaced them with a bureauracy administered from Brisbane but with policy being implemented by regional authorities.

Rudd's pronouncements to date show this approach isn't working in Qld

yet

he wants to take over hospitals and have them administered from Canberra but (have policy) implemented, of course, by regional authorities.

ho hum what else is new. The big picture strokes change but the detail is still a mismash.

I think that, in addition to Boards, we must also include local government in the hospital planning process.

Why? Well they are the only level left out. Why don't they get involved too?

And don't forget the RSL, CWA and Scouts and Girl Guides. Surely they too have things to offer. How to make biscuits, drink beer and so much more.

Tony Abbott says an honorarium of $10,000 each for 750 hospitals times 10 Board members is peanuts. It's only $75 million for 750 more people involved in making sure hospitals don't work.

Think again. Guides and Scouts would work for the old "Bob a job" and RSL's would do it for a carton. The CWA would do it for a laugh. Why not include them too? It's only a few more million which we surely don't need to spend on patients.

In fact I'd recommend to Tony and Johnny that we follow the Yes Minister example of a hospital which worked perfectly, efficiently. Of course they had no patients but it was exceedingly efficient.

When you get right down to it surely it'd be better if government's just closed hospitals althogether as they just cause MP's too many problems don't they? Closing them would also cut down on the numbers of people the aged and not maintained infrastructure in Australia have to cater for. Why not? It'd save us heaps wouldn't it? And we wouldn't have so many of those dreadful parasites, sick people.

Civic Engagement is what the NEXT Model must be about. This is the ONE POSITIVE (thank GOD) both governments have heard. Yes, and we do NEED a LOCAL "gaze".

Problem... The Governments LACK of expertise at Community Levels. Without more OPEN TRANSPARENCEY through a call for ADDITIVE HEALTH PREVENTION through ALL Civic ENGAGEMENT. There needs to be a Collabrative Approach betwwen the services outside the walls of the Health Clinic's/Hospitals.

BUILD LOCAL CAPACITY.

As Said here; "The service, known widely as “Integrated Primary Care”, is delivered by primary care teams consisting of a full range of health professionals and frees up doctors to do what only doctors can do. This includes caring for sicker patients in a community setting who are currently sent to hospital. Such an approach can ease suffering, save us money and reduce the demand for hospital services."

On "bulk billing rates" unfortunately this is where I find so much inflated cost. The potentional of local GP's in helping to design rural services programes is enormous but fees and cost defeat much of the process in reality. ie: $58 on medicare for client to get regular Vit. B booster (injection) is counter-productive. It is a sample of where we need to build capacity. Where the specialists and GPs need to help build alternative Allied models so to integrate practical cost of this kind of thing. Presently, with respect it reminds me of how inflated insurance claims works if the company knows they have a affirmed case to quote.(No equity in Economic Expenditure)

I believe Health ought to focus on building LOCAL CAPACITY, and I don't agree with LOCAL HEALTH BOARDS. The Night-mare would attract even more CHAOS, and put smaller communities at even more adversity with the bigger-picture.

http://www.miacat.com
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