Abstract
The Australian health system has been the subject of multiple reviews and reorganisations over the last twenty years or more. The year 2004–2005 was no different.This paper reviews the reforms, (re)structures and governance arrangements in place at both the national and state/territory levels in the last year. At the national level some progress has been made in 2004/05 through the Australian Health Ministers' Council and there is now a national health reform agenda, albeit not a comprehensive one, endorsed by the Council of Australian Governments (COAG) in June 2005. Quality and safety was an increasing focus in 2004–2005 at both the national and jurisdictional levels, as was the need for workforce reform. Although renewed policy attention was given to the need to better integrate and coordinate health care, there is little evidence of any real progress this last year. More progress was made on a national approach to workforce reform.At the jurisdictional level, the usual rounds of reviews and restructuring occurred in several jurisdictions and, in 2005, they are organisationally very different from each other. The structure and effectiveness of jurisdictional health authorities are now more important. All health authorities are being expected to drive an ambitious set of national and local reforms. At the same time, most have now blurred the boundary between policy and service delivery and are devoting significant resources to centrally 'crisis managing' their service systems. These same reasons led to decentralisation in previous restructuring cycles. While there were many changes in 2004–2005, and a new national report to COAG on health reform is expected at the end of 2005, based on current evidence there is little room for optimism about the prospects for real progress.
Highlights
The Council of Australian Governments' (COAG) 15th meeting on 3 June 2005 in Canberra endorsed a national health reform agenda with an unusual level of national consensus
The Prime Minister had announced in October 2004 a Task Force headed by Andrew Podger, the previous head of the Department of Health and Ageing (DHA)
At that time Minister Abbott had outlined the problems of the health system from the point of view of the Australian Government when he addressed the Committee for Economic Development of Australia Conference in February 2005
Summary
23 April 2004 29 July 2004 29 July 2004 29 July 2004 28 January 2005 28 January 2005 public review of Australia's health care system, as the first step in the development of an integrated reform program. The clinicians recommended that a way to progress a number of the important items on the Reform agenda was to conduct a trial in each state and territory of specific services that integrate community-based and hospital based-services, suggesting coordinated chronic care and integrated aged care as possible cases [16]. The structure and effectiveness of jurisdictional health authorities is becoming increasingly important in determining whether reforms are achieved in areas such as clinical governance, quality and safety and others included in the National Reform Agenda. This is especially the case given that, at the same time, the centralised authorities will continue to devote considerable resources to responding to each new 'crisis' in their service system. No doubt other jurisdictions will be watching in an attempt to learn the lessons
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