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Primary health care is the basic unit of the medical sector as a whole in Australia and as such, its improvement is fundamental to the development of a comprehensive health care sector for any country. Australia’s primary health care sector comprised of general practitioners, practice and community health nurses, psychologists, psychotherapists, pharmacists, and dental health professionals, is among the most advanced systems in the world. Despite the favorable statistics in terms of high life expectancy rates, doctor-patient ratios, and hospital facility development, Australia still faces challenges that prevent it from being at the top of the list of countries with the most advanced primary health care sectors. This paper highlights the challenges that plague the sector and analyzes policy reforms that could address these challenges.
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Australia’s primary health care system is flanked by highly trained professionals and ranks fairly well among other countries in the world. With an average life expectancy of 82.4 years for both male and female citizens, Australia is ranked 4th in the world. Australia also compares well in terms of doctor per 1000 patient ratio and is considered among the highest in the world. Primary health care is not only the prevention and treatment of disease but also refers to the first point of contact a person makes with the health care system and is typically made up of several components which include health promotion, community development, and patient advocacy (Australian Medical Association, 2017). Services constituting primary health care in Australia are dispensed in general practices, allied health practices, community health centers, and community-controlled health centers for aboriginals. Primary health care providers are not confined to general practitioners, but also include nurses, psychologists, physiotherapists, pharmacists, and community health workers.
A number of challenges plague the sector including a rapidly aging population with special needs demanding to be met, a rise in chronic disease rates among the population, increased workforce pressures, inequities in access to health services as well as the need to adopt technology in health care in an increasingly changing world. It is in the Australian government’s interest to reform and improve the primary health sector given that it is directly related to the social and economic development of a country. This paper analyses the various reforms the government and the key players can implement in the primary health care sector.
Investing in and making the best use of the right workforce
It is important to give credit to the Australian government’s efforts in terms of expanding the primary health care workforce in recent years to highly competitive world standards. Regardless of this progress, it is a fact that several parts of the country, especially the rural areas, still face shortages of health practitioners such as local general practitioners, nurses, community health workers, and other primary health care providers. The government can remedy this situation by increasing funding directed towards the training of the relevant health practitioners, assisting health care providers in new technology adoption, and increasing the GP training program intake to 1700 places a year by 2018 (Australian Medical Association, 2016).
The expansion of the workforce should also include a concerted effort by the government to distribute the practitioners evenly between the rural and urban areas so that all citizens are accorded an equal opportunity and access to qualified professionals and ultimately an improved primary health care sector. According to the Australian Medical Association (2016), this can be achieved through the expansion of the Specialist Training Program to provide 1400 places a year by 2018 in rural areas, under-supplied and generalist roles. Ultimately, a consistent improvement and deliberate effort to institute critical reforms in the workforce will be an integral step in the overall objective of achieving a superior primary health care sector in Australia.
Instituting programs and systems to tackle chronic diseases and care for those affected
Having a comparatively high life expectancy means that the number of old people in society is at an all-time high in Australia, a situation that has led to the increase of complex conditions among the elderly in society. As taking care of people suffering from chronic conditions such as strokes, heart attacks, heart conditions, diabetes, and kidney disease constitutes a large percentage of a general practitioner’s job, it goes without saying that investing in systems that ensure that they are well taken care of, will save the patients the hustle of having to spend too much time in hospital and provide them freedom.
According to (Cutler & Olin, 2017) the government has devised a strategy that involves the setting up of Health Care Homes at a cost of approximately $104 million intended to accommodate close to 65000 voluntarily enrolled, chronic disease patients. This will ensure that even the financially strapped patients still get access to enhanced care from the general practitioners in the program and even though this plan is still underway and it is still possible that it may be underfunded, it gives hope to the citizenry and points to the government’s commitment to improving primary health care in Australia. The relevant players also ought to emphasize early detection and treatment as well as insist on the stoppage of actions that accelerate the risk of chronic diseases such as smoking tobacco, encouraging exercise in order to stem obesity in the country, and encouraging the consumption of balanced diet. These reforms will be instrumental in reducing the mortality rate resulting from chronic diseases and complex conditions in Australia.
Preventative health reforms
It has been said that prevention is better than cure and this age-old saying rings true in reference to the objective of improving the Australian primary health care sector. Australia spends $2billion on prevention annually and based on the cost-effectiveness of various health promotion and disease treatment means, it is best that the country spends more on preventive health. This is because such preventive programs reduce costs due to the decreased need to treat expensive conditions (Jackson & Shiell, 2017).
According to (Jackson & Shiell, 2017) a potent Australian example of how preventive health reforms do offer good value for money is the Accessing Cost-Effectiveness (ACE) which was used to assess the cost-effectiveness of more than 120 policy actions that reduce consumption of harmful goods and several proved effective in improving health as well as reducing overall costs. What this means is that health outcomes can be significantly improved at a cost lower than current health services costs.
Preventive health reforms are long-term measures that do not yield immediate results but do so incrementally over a period of years and as such implementation should be monitored and designed to be self-sustaining so as to gain more from them. The Australian government spends higher than most countries in the world in terms of preventive health reforms and as such is well-positioned to implement even better reforms in the coming years and attain its objective of world-class primary health care.
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Development and implementation of patient-centered care
The concept of patient-centered care is based on the premise that for the achievement of favorable health outcomes, it is imperative that the involved parties, who are the practitioners and the patients, are in harmony and that the patient’s wants and needs are taken into account and he is provided with the relevant education and support in order to make informed decisions and are actively involved in their own treatment and care (Melbourne Primary Care Network, 2016).
Patient-centered care ensures that patients have the tools needed to understand and handle the complex Australian health care system and this can be made practical through several dimensions such as ensuring that local health services respond to the people in its locality in a better way to their needs, involvement of family and friends and taking into account the concerns patients might have about issues such as spirituality and morality. It calls for patience and the ability of practitioners to listen and understand the patient’s points of view and to treat them with compassion and dignity.
The government can employ methods such as availing all information that is relevant to patients so as to accord them a chance to have options and choose the one they like best. Programs that reward those institutions with excellent patient-centered care can also be set up so as to provide motivation to practitioners to adopt these policies. Another strategy would be for the government to require that the practitioners collect and record patient data so that data can be compiled into central databases and analyzed in order to discover important patterns that are instrumental in providing patient-centered care (Consumers Health Forum of Australia, 2016).
Instituting patient-centered care programs is an important reform that is sure to catapult the Australian primary health care sector to greater heights in the coming decades.
Recognizing and enabling the pharmacists’ role in primary health reform
Pharmacists are highly qualified and learned professionals in Australia and yet remain unrecognized, which is sad considering their contribution to primary health care. The ability of pharmacists to adopt implement and sustain innovative models of practice makes them integral to the ongoing health care reforms in Australia. In order to integrate the pharmacists in ensuring developed primary health care, it is necessary that the government support several training opportunities such as the current rural training incentives in an effort to address the workforce shortages experienced in rural areas (Pharmaceutical Society of Australia, 2016).
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According to the Pharmaceutical Society of Australia (2016), the pharmacist’s role in society is diverse and it is possible to adapt it to the community setting. Practice pharmacists conduct several activities such as being assistants to patients who have medical inquiries from health professionals, mentoring new members, immunization, health assessments, and reviewing prescriptions among many more roles. Despite the important role the pharmacist plays in the medical world and society in general, he faces several challenges such as poor communication, lack of time, and adequate compensation for their output considering that most depend on remuneration they get from Home Medicines Reviews as well as lack of consultation opportunities with other specialists such as nurses, psychologists among others.
Considering the importance of pharmacists in society and in the primary health sector, it is the prerogative of the Australian government to undertake to institute extensive reforms in this branch of primary health care considering that failure to do so only continues to hurt patients with chronic diseases as they miss out on opportunities to access quality medicine and care from these professionals.
Private Health Insurance
The Australian government is actively involved in private health insurance as it uses its tax system that is geared towards encouraging the country’s high-income earners to pay a percentage of their income, typically around the range of 2%, to the already established Medicare in an effort to ensure its continuity. The government also employs the imposition of financial penalties that have led most citizens to opt for private health insurance as compared to the public system. Given that the Australian government spent $5.8 billion on the Private Health Insurance Rebate in the period between 2014 and 2015, it is important that the government in consultation with the private sector engage in productive reforms that ensure that Australians get the best private health insurance (Centre for Health Economics Research and Evaluation University of Technology, 2015).
According to a 2016 report by the Australian Competition and Consumer Commission, private health insurance policies fall short in quality as they are unnecessarily too complex for thorough comprehension by the average citizen and they do not provide an accurate evaluation of costs, and in the worst-case scenario include misrepresentation of the available products and their value. This is a major setback in efforts by the government to help its citizenry afford private health insurance and is a pointer to the urgent need for reform in this sector.
The Commonwealth government’s plan to review private health insurance by ensuring the creation of simpler products that meet consumer needs, continuing the allowance of the proportion of privately insured citizens to access public hospitals in addition to enhancing their ability to choose the doctor who attends to them according to individual preference, instituting better business practices, applying effectively the private health insurance rebate fund to effective treatments and promotion of better communication among policyholders is a step in the right direction as far as reforms in this aspect is concerned (Centre for Health Economics Research and Evaluation University of Technology, 2015).
It’s vital that the Australian government seriously considers this kind of reform if it is to bring about major improvements in its primary health care sector.
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The development and adoption of Digital Health strategy and technology
Technological advances have been played a big role in revolutionizing other sectors of the economy such as manufacturing and telecommunications and the primary health care sector has not been left behind. Digital health can be defined as the electronic management of information related to patient health in an effort to dispense healthcare that is safer in a more efficient manner and at better quality standards (Snowdon, 2016).
The use of patients’ digital information has been proven to be a basis for high-quality health care given that it encourages the better treatment and handling of patients with chronic and complex conditions due to shared data and the ability to make informed treatment decisions as well as an acute reduction in hospital admissions or readmissions (Australia’s National Digital Health Strategy, 2016).
Given that almost 80% of Australians own a smartphone, ensuring that health information websites are developed and updated regularly is set to improve the primary healthcare sector in Australia which can be seen in the widespread adoption of the My Health Record which has been applied to supporting trials of new models to care for patients with chronic conditions which is only a sure sign of the implementation of electronic medical records throughout the public hospital system. A National Digital Health Strategy is critical at this point in time as it wields the unparalleled potential to enable the sharing of data in the Australian health care system thus supporting initiatives that incorporate care and is critical to catering to the needs of the patients (Australia’s National Digital Health Strategy, 2016).
Among the many advantages that will accrue to the Australian primary health care sector is the ability of health consumers to get information that enables them to make the right decisions and affords them the chance to have options, and will help improve the relationship between patients and practitioners as they can collaborate in sharing personal health information and making diagnoses, treatments, and recommendations for a better lifestyle. Adoption of technology through the National Digital Health Strategy is without a doubt a major milestone in the reforms in the primary health care sector in Australia and will place the country at the top of the list of countries with the most advanced primary health care sectors in the world (Kelsey, 2016).
Ensuring improved access and reducing inequity
An advanced primary health care sector is identified by its ability to provide high-quality healthcare to all its citizens in an equitable manner to all its citizenry. The Australian primary healthcare system still has room for improvement in this regard, considering the disparities demonstrated by the fact that Australians living in rural areas do not have access to the high-quality health care as their metropolitan counterparts (Thomas et. al., 2015).
This situation is exacerbated by the disheartening fact that Australians living in rural areas are more likely to have shorter life spans despite the relatively high national life expectancy of more than 80 years and are exposed to higher levels of infection. It is therefore crucial that access to better primary health care is devolved to the rural areas so that the government can be able to achieve its objective of health care reforms and an advanced world-class primary health care sector.
The Australian health sector can institute several potential policy pathways such as creating systems that promote long-term relationships between consumers and general practitioners to enhance individual and family well-being, advocate for the development of multidisciplinary teams made up of general practitioners, practice nurses, community health workers, and allied health and Aboriginal health workers which encourage members to collaborate and develop their clinical skills and investigate feasible funding models that ensure focus is placed on the overall health of the population and where possible avoids the possibility of hospitalizations (National Primary Health Care Strategic Framework, 2013).
Through these and other strategies, the Australian health care system can effectively ensure that primary health care is truly universal and benefits every citizen in an equitable manner and consequently achieve the objective of an advanced primary health care sector.
Improving health care quality, performance, monitoring and evaluation, and accountability
The quality of primary health care in Australia depends on the ability of the players to commit to providing the best service to their customers, the patients. Setting up systems that check on the performance standards of the health professionals ensures that every member of the primary health care sector is aware of what is expected of them and is able to set achievable goals in line with the laid-down plan and that the objective of providing quality health care is met (Quality Improvement and Change Management Unit, 2014).
The key players in the primary health care sector should seek to collaborate and engage in ensuring that performance frameworks are formulated in a way that clearly shows whether primary health care services are being utilized as they ought to be which is an oversight mandate of the National Health Performance Authority (NHPA) and also work together in information and data sharing so as to support the improvement of performance in the primary health care sector (National Primary Health Care Strategic Framework, 2013).
Australia’s primary healthcare sector is highly competitive and rivals the healthcare sectors of fellow first world countries such as the US and Canada and is closer to the advanced healthcare systems of Germany and the UK and as such, deserves a pat on the back for the significant progress made in the past few decades. As it has the highest life expectancy rates in the world, Australia shoulders the burden of being able to provide superior primary health care systems to its aging population, and thus the proposed policy reforms above will play an integral part in ensuring the sector advances even farther and contributes effectively to the provision of better quality health care services and achieving favorable health outcomes in the long run. By applying strategies that ensure equal distribution of resources in the form of health professionals, medicine, and facilities without discrimination on basis of social factors such as social status, education, employment, or geographical location, Australia is set to enjoy the most advanced primary health care sector in the world and with that, a socially happy and economically productive population.
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