There is much to appreciate about the level of support for health in the Federal Budget. The solid funding increases for Medicare, PBS and public hospitals; and the substantial financing of the COVID emergency response and the significant commitment of funding to ongoing development of telehealth have opened new and substantial fields of spending. We are benefiting from the sound basis that the Australian health system provides and by the force of circumstance that has prompted the Government to pour extraordinary amounts of money into health. The response from the health community has been largely positive although laced with a measure of concern about wider community needs that so often lead to poor health. Notable in the budget has been the absence of any significant attention to the social determinants of ill-health --- like shortages of affordable housing, and inadequate or non-existent income support for the many people like refugees and foreign students. Despite the widespread community shock at the plight of aged care residents, the increase in Home Care Packages while significant falls well short of what is needed to reduce the waiting times. There remain great areas of need, not just in aged care, but also in mental health where a doubling in Medicare-funded psychology services will still leave many people out of the loop. These zones of continuing misfortune demonstrate an overall shortfall in not just money but in coherent, joined up planning. We still await the full scope of the Productivity Commission report on mental health to be implemented and must hope that the Royal Commission into Aged Care will prompt watershed system changes to provide real care and dignity for elderly people. It may seem unreasonable, but attention is already moving to what the Government will do for health in next year’s Budget just seven months away. The Government has proved adept at short term bandaging, but longer term, more strategic goals in health --- like primary health care reform and preventive health --- pose challenges still to be met. For consumers there are various pathways opening fresh prospects for more individually focused, patient-centred health care like social prescribing, and self-care --- the latter the subject of the blueprint for reform released last week. The changing dynamics of health care provide we consumers with fresh ways of thinking about our health care that help persuade our political leaders to resolve longer term challenges. |