Reorganising Health Policy Making, Delivery and Financing

Abstract

The review of health policy, and the characteristics of the Australian health care system, presented in the previous chapters indicate the presence of many major problems. These include: the fragmentation of responsibilities between Commonwealth, State, and private organisations; the heavy emphasis on institutional treatment and care; large differentials in health status between the various socio-economic and ethnic groups; the relative neglect of prevention and health promotion; rates of provision of some medical services suggesting the presence of over-servicing; the proliferation of untested technologies; continuing conflicts between governments, the medical profession and others about health insurance; the absence of information about the quality of care; and frequent reorganisations of health administrations, and innumerable reports on the system, but little evidence of improvements as a consequence. A perception of widespread demoralisation among doctors, nurses and other health professionals, and of extensive deskilling in departments of health, are further issues that could be added to this formidable list.