Health and social care reform on Consumer Commission agenda
The idea that the coronavirus pandemic offers at least one upside – a legacy of potential health care reforms such as telehealth – is a key factor in the CHF’s decision to establish the Consumer Commission: Beyond COVID-19.
Various parts of the health system have been bent to fit the shape required by the demands of coronavirus.
The expansion of telehealth is oft mentioned. There have also been other potentially long-term influences in such areas as federal–state health funding, primary health care, health insurance, elective surgery, and supply of medical kit like personal protective equipment (PPE) and ventilators.
But in addition to these, there are many other shifts we can, and should, be advocating for through a co-design process with consumers. We face a whole new outlook in which to re-imagine health care.
Equal access to care
Our expectation is that consumer experiences with health care during the pandemic will stimulate individuals with strong community links and ideas for a better future to apply to join the 20-30 strong commission.
Coronavirus, after all, has visited upon us a rare and society-changing phenomenon that not only threatens population health but also undermines the economy to an extent that may devastate the lives of many Australians.
CHF will be guided by the wisdom and insights of the Commission as we seek to be instrumental in shaping and presenting the consumer voice in the policy debate. It will consider the impacts of the pandemic on the future of health and social care, and contribute ideas and proposals to improve Australian health and social policy into the future.
A central purpose will be to develop tangible proposals to support equal access to healthcare and social welfare and reduce disadvantage in Australia.
Social policy key
Given the health and life-altering prospects likely to follow in the years during and after the pandemic, we seek to encourage research and long-term thinking about what we want and need from our health and social care.
As a health consumer organisation, our first focus is to think in terms of health priorities, but at what point, and how, do we move into social policy considerations given their influence on our health?
To be of enduring value, we need to encourage a consumer perspective that thinks through the deeper sources of ill-health – the social determinants.
Treating health issues in societal terms may be seen by critics as a bleeding heart cause. One way to respond to such thinking is by advocating for the virtuous circle of social security fostering health which in turn supports social security.
Society broadly accepts community-wide interventions such as vaccinations because of their illness prevention benefits. Yet the concept of a more holistic approach to social/economic factors associated with poor health and chronic illness invariably eludes political leaders focused on simpler vote-winning promises like more hospitals and new drugs.
A guide for more socially-based thinking in the post-COVID era comes in a report from National Voices, the English coalition of health and care charities.
Setting out five principles for the next phase of the COVID response, it states that as the mists start to clear, and we shift from responding to an acute crisis into ongoing management, a transparent, accountable, and consensual approach is crucial.
“’Nothing about us without us’ has never been more important, not least because, without it, trust is eroded, undermining long-term compliance with any new rules and recommendations, and in turn public health.”
Its five principles have universal application:
- Actively engage with those most impacted by the change, such as service cuts, lockdown, self-isolation, and difficulties accessing food and medicine.
- Make everyone matter, leave no one behind
- Confront inequality head-on. Mortality and morbidity are higher for those living in poverty and working on the frontline.
- Recognise people, not categories, by strengthening personalised care. Vulnerability needs to be rethought and broadened beyond narrow clinical criteria to include more holistic circumstances such as domestic violence, poverty, disability or overcrowding.
- Value health, care and support equally. People living with ill health or disability need more than medicine. They need care and support, connection and friendship.
The time is right
Given the pervading impact of the coronavirus pandemic on our health, society and economy, now is the right time for us to explore and initiate measures that recognise and respond to the real-world links between health and socio-economic circumstances.
The Consumer Commission has plenty of scope to propose changes that exploit the synergies of health and social care.
In Australia, formal links between healthcare and social supports are meagre, as shown by the recent CHF–Royal Australian College of General Practice taskforce report on social prescribing.
Federal Health Minister Greg Hunt has established a Primary Health Reform Steering Group and a National Preventive Health Strategy process.
I’m hoping the Consumer Commission will provide those two avenues, as well as other future policy development opportunities, with fresh ideas for health and social advance.