18 September 2017 Submission

Options to reduce pressure on private health insurance premiums by addressing the growth of private patients in public hospitals discussion paper

Consumers Health Forum

First and foremost, we would like to remind the government and policy makers that consumers, the people who use the health system and for whom it was created, should be at the centre of all of decisions. As advocates for consumers, who do not have a financial stake in this, we offer suggestions which are based on the reality of consumers’ use of their PHI and how the health system can best serve them. Our key principles in this area are:

  • That consumers’ ability to choose to be private patients in public hospitals be maintained
  • That PHI policies that are public hospital only should still attract government incentives particularly given their importance for rural consumers
  • That patients should be treated according to clinical need, not ability to pay. This needs to be strengthened by improved monitoring and data collection on this issue.

As our submission highlights, most of the options presented in this paper and the broader discussion around PHI do not currently have consumers at the centre and may be seen to penalise consumers, instead of supporting them. While we acknowledge the importance of equitable sharing of funding between the commonwealth and states and territories, changes should not be made which would limit patient choice and potentially increase confusion or costs for individual consumers. We suggest that while this issue is not unimportant, that changes in this area are unlikely to have substantial or wide-ranging affects in the areas of value or affordability for consumers.

The discussion paper has many assumptions and conclusions that we suggest are not clearly substantiated with the evidence offered. For example, the paper argues that “(i)f the number of private patients in the public sector had grown at the same rate as private patients in private hospitals since 2010-11, premiums in 2015-16 would have been about 2.5% lower than they actually were” (page 4). It is unclear how these figures were derived.

14 September 2017 Presentations and Speeches

Webinar - Accreditation Systems Review: What’s in the draft report?

Professor Mike Woods and the Accreditation Systems Review

Watch it here: https://youtu.be/c3eliNq_jsc. Professor Woods provides a synopsis of the draft report and outlines the impact of proposed options for health consumers.  It was also be an opportunity for participants to provide feedback and comment on the anticipated reforms.

11 September 2017 Submission

Submission to the Independent Review of Health Providers' Access to Medicare Card Numbers

Consumers Health Forum

This is a response to the discussion paper released 18 August 2017.

CHF agrees with the Discussion Paper that there is a balance to be struck between security protections surrounding health professionals’ access to patients’ Medicare card numbers to avoid unauthorised, inappropriate or fraudulent use, and timely access to Medicare benefits for patients who are unable to present their Medicare card at the time of service.

Particular considerations for CHF are as follows:

  • The July 2017 media reports of illegal selling of Medicare card numbers on the Dark Web suggest that current controls for access to others’ Medicare card numbers need to be tightened, and possible weaknesses rectified, within the Health Professional Online Services (HPOS) system and the arrangements for the Medicare provider enquiries line.
  • Individuals who are unable to present their Medicare card at the time of service typically have understandable reasons for being in this situation, while possibly also being financially unable to meet the whole cost of the service provided out of their own pocket at the time of the service. For example, these individuals may be acutely or chronically unwell, homeless, escaping family violence, or under other significant stress for whatever reason. As the Discussion Paper notes, Medicare is Australia’s universal healthcare system, providing all Australians with access to timely and affordable healthcare. It is important that individuals who are unable to present their Medicare card at the time of service are not disadvantaged by changes to the HPOS system.
  • CHF supports the move to a national opt-out approach to the implementation of My Health Record, as well as measures which genuinely address consumers’ legitimate security concerns in relation to the My Health Record system. It would be unfortunate if inappropriate access to Medicare card numbers, as highlighted by the July 2017 media reports, reduced public confidence in the My Health Record system.
6 September 2017 Consumers Shaping Health

Consumers Shaping Health, vol 11, Issue 2, September 2017

Consumers Health Forum
CHF is proud be part of the push to build a consumer-centred health system in Australia.
23 August 2017 Report

Consumer Priorities for a National Health Plan - Summary

Consumers Health Forum

The Consumers Health Forum has presented Health Minister Greg Hunt with consumer priorities for a National Health Plan, setting out what’s needed to bring 21st Century consumer-centred care to our poorly-coordinated system.

Consumer priorities for the Plan centre on two essential starting points:

  • Reforms to strengthen Australia’s primary health care system to make it more consumer-centred, prevention-oriented, and better integrated with hospital and social care and with more capacity to support transitions of care;
  • Boosts to investment in health systems research, shaped by consumer and community priorities to stimulate services that reflect advances in health sciences.

CHF outlines reforms in seven key areas:

  • PRIMARY HEALTH CARE: to expand the focus on new models of care to include children, families and others at risk of chronic illness, and to enhance the role of Primary Health Networks.
  • PREVENTION: pre-empt chronic diseases like obesity with effective public health measures
  • RETHINK FUNDING: to better link hospitals with coordinated community-based services
  • INTEGRATE MENTAL HEALTH SERVICES: with physical health, education and employment.
  • FLEXIBLE WORKFORCE: incentives, education and services to put consumers at the centre of care.
  • DIGITAL HEALTH FUTURE: support efficient care, more consumer choice and transparency.
  • CONSUMER ORIENTED RESEARCH: to ensure consumer say in setting research priorities and translating research into practical improvements to services.

Please read the PDF for the full summary.

23 August 2017 Report

Consumer Priorities for a National Health Plan

Consumers Health Forum

Health systems need to maximise the effectiveness and efficiency of health services and long-term care; deliver seamless care across services and providers; they also need, fundamentally, to deliver improvements that matter to patients and their changing care needs. We share with our people and clinical leaders the view that “people-centred care” should better guide the course taken by health care in the future.

Ministerial Statement, The Next Generation of Health Reforms, OECD Health Ministerial Meeting, January 2017.       

Despite Australia’s favourable performance ranking overall when compared to other OECD countries, all too often the Consumers Health Forum of Australia (CHF) frequently hears from our members and networks that that the consumer experience of the Australian health system is one of disconnected and poorly coordinated care.  

Too often we only rely on measures of what health systems do, and how much they cost, rather than their effects on patients[1]. It is time to ask patients: what matters to you and for the system to respond accordingly.    

In modern health systems in developed economies we must take experience of care to be an equal measure of the performance of our health system and whether or not it is meeting the expectations of the community. Experience of care measures must have prominence within the ‘quadruple aims’ that are commonly accepted as measures of health system performance: enhancing patient experience; improving population health, lowering costs; and improving work life of health care providers.

This issues paper outlines a consumer perspective on the key design principles and elements which should be incorporated in the four pillars envisaged as part of a national health plan for Australia. It has been developed with the input of over 20 CHF members, representing a cross-section of our members, who expressed interest in attending a Consumer and Community Ministerial Roundtable in August 2017, the Mental Health Consumers and Carers Forum and other key informants such as representatives from Primary Health Networks (PHNs).  

We believe there are two essential priorities that we must start with:

  • Reforms to strengthen Australia’s primary health care system to make it more consumer-centred, prevention oriented, better integrated with hospital and social care and with more capacity to support transitions of care; and  
  • Greater investment in health systems research and arrangements to ensure the national research agenda is shaped by consumer and community priorities, that the findings stimulate improvements in services and our national medical and health research funds are spent wisely.

New approaches to consumer and community involvement in decision making at all levels in the system should be part of the process for developing a long term national health plan. Whether it is at the point of care or in policy design, when consumers are activated and supported to be involved, better experiences of care, quality of care and health outcomes result.     

CHF outlines reforms in seven key areas:

PRIMARY HEALTH CARE: to expand the focus on new models of care to include children, families and others at risk of chronic illness, and to enhance the role of Primary Health Networks.

PREVENTION:  pre-empt chronic diseases like obesity with effective public health measures

RETHINK FUNDING: to better link hospitals with coordinated community-based services

INTEGRATE MENTAL HEALTH SERVICES: with physical health, education and employment.

FLEXIBLE WORKFORCE:  incentives, education and services to put patients at centre of care

DIGITAL HEALTH FUTURE:  support efficient care, more patient choice and transparency.

PATIENT-ORIENTED RESEARCH: to ensure consumer say in setting research priorities and translating research into practical improvements to services. 

 

[1] OECD Health Ministers (2017) OECD Health Ministerial Statement – The next generation of health reforms: https://www.oecd.org/health/ministerial-statement-2017.pdf

26 July 2017 Submission

Submission to MBS Review Taskforce - Urgent after-hours Primary Care services

Consumers Health Forum

CHF welcomes the opportunity to provide this submission in response to the Medicare Benefits Schedule (MBS) Review Taskforce’s preliminary report on urgent after-hours primary care services funded through the MBS.  This submission elaborates on CHF’s responses provided via the online survey.

The Taskforce’s report acknowledges that after-hours GP services are essential services and highly valued by consumers.  While there has been an increase in the number of urgent after-hours services provided under the MBS, CHF notes that this increase on its own does not mean that these services were unjustified.  Other factors, such as better access to and availability of after-hours services, could explain the increase.  Moreover, an increase is not of itself surprising given the Government’s policy initiatives in recent decades to increase access to better organised after-hours services. Without these services many people, including parents and young families, the elderly including residents in aged care facilities, carers and people with terminal or chronic conditions, have faced great difficulty in getting the care they need.

24 July 2017 Submission

Submission to the Review of Pharmacy of Remuneration and Regulation - Interim Report

Consumers Health Forum

The Interim Report correctly identifies the challenges of the current approach and makes a strong case for the need to change. This is not to say that the current system fails consumers or that it is a system in disarray, Indeed we know from the many surveys done by the Pharmacy Guild and others including our own 2015 survey, people value community pharmacy and see it as a vital element of our national health infrastructure. Consumers also have a high regard for pharmacists.

Overall CHF believes most of the options in the Interim Report, if put into place, would lead to a more consumer centred community pharmacy sector that is sustainable in the long run. If most of the options were implemented the community pharmacy sector would be better placed to deal with population shifts, ever increasing rates of technological change and workforce changes in pharmacy as well as the changing health system landscape with its greater emphasis on collaboration and integrated care. It would also help clarify and more centrally position pharmacy’s place as an integral part of the primary health team. We have identified a couple of areas where we think the report could have said more, particularly in the use of technology and addressing after hours services.

In this submission we have concentrated on those areas where we know consumers have concerns and those which we think are critical to move to a modern health system. We do not address all the options in detail in the body of the submission but Appendix 1 shows our positions on all of the options with some comments.

13 July 2017 Presentations and Speeches

Webinar - Private Health Insurance and Pharmacy Remuneration & Regulation

Consumers Health Forum

Watch it here: https://youtu.be/wNeKJjIsvI0. This webinar covered current government policy and potential reforms in these two vital areas of the health system, and CHF's position in response.

15 June 2017 Submission

Submission to Senate Inquiry into the Number of Women in Australia who have had Transvaginal Mesh Implants and Related Matters

Consumers Health Forum

It is becoming increasingly clear that there has been a major failure of the health system with regard to the use of transvaginal mesh to treat women. Many women have been left with permanent injuries and disabilities as a result of this device being implanted. 

We welcome this Senate Inquiry as a very public means of shining a light on what has happened, looking at ways women who have been injured can be assisted and putting in place changes to the processes to ensure similar events can be avoided. Consumers have the right to be able to feel confident that the medical devices that are implanted in their bodies are safe and effective and will improve the quality of their life. In the case of transvaginal mesh this has clearly not been the case for all women.  

It is of concern that we do not know how many women are impacted by this as we don’t know how many women had the mesh implanted and how many have had adverse effects but have not reported them.  The Health Issues Centre(HIC) in Victoria along with the other State and Territory Health Care Consumers organisations (HCOs) have collected stories and HIC ran an anonymous survey to try to get a better understanding  of the magnitude in terms of numbers affected and in terms of the injuries, disabilities and negative impact on women’s lives.  The response to this was quite overwhelming and HIC documents this in its submission to the Inquiry as do the State and Territory health care consumers organisations (HCOs) in theirs.

 It is worth making the point that this informal collection of data would not have been necessary if the processes of adverse reporting were improved and if the use of registries for implantable devices were more widely used . This is one of the key recommendations from the HCOs submission that we endorse.

CHF is indebted to them for undertaking this work and sharing it with us to assist with our submission.

Pages