More than ever the COVID experience has brought home to us how inextricably the population’s health is linked to economic health.

We have seen everyday evidence of how strong public health systems protect people and the economy by reducing the spread of recession-inducing disease.

We have also seen the way the pandemic has hit hardest the aged, and those with the least, who have felt obliged to go to work despite COVID symptoms. 

The pandemic has highlighted - if it was ever in question - that services like social housing are closely associated with better health.  This budget of all budgets, is one which cries out for reinvigorated income and social supports like Job Seeker. 

The pandemic has revealed many cracks in our society and economy including: the extent of casualisation of the workforce; growing income inequality; an inadequate income support system; and a digital divide which is leaving many people behind.

It is those cracks that the 2020 Budget needs to start to address as they will widen and result in poorer health outcomes and even greater cost burden on health and human service systems if immediate action is not taken.

Nonetheless, we have seen an extraordinary effort across our health system and community to minimise the impact of the coronavirus, both on the health and wellbeing of the community but also the economy. Whilst for much of Australia the crisis has been dealt with, at least in the short-term, it is becoming clearer that we will be living with COVID-19 for some time to come.

With the disastrous exception of aged care, the health system has overall responded well to the crisis, with innovation across many areas of health service delivery moving to new models of care supported by changes to Government policy to facilitate this.

The expansion of telehealth services, introduction of new virtual care services, fast tracking of e-prescriptions and expanded mental health services are just some of the ways the health system has moved to ensure people still get the health care they need.

We have also seen glimmers of how a more collaborative approach between levels of Government to work together on solutions is possible when there is a clear and unambiguous common purpose.

We need a longer-term vision for the health system and our society. Both upcoming Federal Budgets for 2020 and 2021 should lay out an agenda for the future including Government’s full response to the Royal Commission into Aged Care, the Productivity Commission Inquiry into Mental Health and the long awaited 10 year Primary Health Care Plan and the National Preventive Strategy.

CHF has established a Consumer Commission to look at what should be made a priority in our health system beyond COVID-19. Thirty of the best consumer advocate minds in the country have been examining what reforms have been implemented through the pandemic that should be kept, where the fault lines are, and what the policy response should be.

The final report and recommendations from the Consumer Commission to be released in November will form the basis of key reform ideas CHF puts to Government in the future, particularly for the Federal Budget 2021.

For the Budget to be unveiled next week, CHF calls for a focus on five priorities:

• INCOME SUPPORT - A permanent adequate increase to Jobseeker and other income supports in line with the level of support paid through the addition of the COVID-19 supplement; and for the Federal Government to make pandemic leave entitlements available to all Australians.
• AGED CARE  -  A commitment to implement urgently and in full the recommendations from the Interim Report of the Royal Commission into Aged Care Quality and Safety prior to the final report.    The pandemic has shown profound deficiencies in the aged care system, in both residential aged care and the lack of provision of adequate homebased care to help avoid inappropriate admission to residential aged care.
• PRIMARY HEALTH CARE - Make the expansion of Medicare-funded telehealth arrangements permanent and an integral part of the 10 Year Primary Health Plan  The CHF Consumer Commissioners identified the expansion of telehealth as the most significant health service gain to come out of COVID-19 and urge it be maintained and strengthened. Telehealth and virtual care can be deployed across the entire health ecosystem if the right enablers are in place such as workforce readiness, funding models and consumer health literacy. The development of ten-year plans for both primary care and prevention are opportunities to transform health care and meet consumer expectations of 21st century care.
• MENTAL HEALTH - Increase investment in mental health services and work collaboratively with the States and Territories to implement the recommendations from the Productivity Commission’s Inquiry into Mental Health. Australia has a universal mental health system in principle but not in practice, and we need to begin a process of significant investment and reform to change this. The COVID-19 pandemic has led to a significant increase in the demand for mental health services, as people deal with isolation, anxiety and the impact on their lives.
• PANDEMIC PLANNING – Ensure pandemic planning is undertaken collaboratively with the States and Territories, and includes health, aged care and disability services and funding for consumer engagement in the planning process, drawing on the experience of COVID. Three key issues have emerged:  the need for closer collaboration with States and Territories; the need to include aged care and disability services in any planning; and the need for consumers to be involved in the planning and implementation of the pandemic plan. CHF has long advocated for a more integrated health system that not only links primary care with hospitals and other specialist services but links aged care and disability services.

We have slowly been moving to a more consumer-centred health care system in Australia with a growing acceptance that consumers need to be involved in the design and implementation of the health system Only consumers and their families and carers see and experience the whole health care system.

 Consumers’ observations and lived experience can shed a powerful light on how we can improve and reform health care. However, during the pandemic, the inclusion of consumers has been patchy as the need for urgent and decisive action reduced consultation and pushed consumers into being seen only as recipients of care rather than partners in the response.

There needs to be formal involvement of consumers in any national pandemic planning and this need to be adequately resourced to ensure the consumer s are available and able to eb responsive to rapidly changing demands.