industry & policy
All those are important but we wanted to ensure that the people
who use the health system were the primary consideration in any
changes. In other words, we want to make sure any changes in the
system make it a better experience for them. That hasn’t always
been necessarily the first consideration in designing aspects of the
healthcare system and we think it needs to be.
What were some of the key concerns round table
attendees raised?
People talked about difficulty getting access to healthcare,
long waiting times for appointments, long waiting times when
they got to appointments. The [mentioned not getting] as
much information about the issues they had or ways to treat
them as they wanted. They didn’t feel empowered necessarily
to look after their own healthcare. They felt there were some
providers who were fantastic at engaging with patients and
users in an appropriate way that enabled better participation,
whereas others were less so. There wasn’t necessarily training
[for all workers in how to do it. Another concern was that] many
decisions about changes in healthcare delivery are being made
primarily for cost or efficiency. Often the perspective came from
those who were working in the health system, rather than those
who were using it, whereas the latter, in our view, should be
the priority.
the first of the eight recommendations in the report is to
develop a vision for australia’s health through 2025 via the
council of australian governments. What should this cover?
It’s time for us, as a country, to talk about what sort of health
system we want and what sort of outcomes we expect,
focusing on the fact that the key goal is to improve the lives of
all Australians. We should put that at the centre of the vision. It’s
not about creating a business or an enterprise or employment
primarily. It’s [primarily] about improving the health and wellbeing
of individuals and the people who use the health system. All
the other parts of the system should [build around] that. It was
important for all Australian governments to express the fact that
this is the core of our health system. This is what we want to be
the focus going forward.
You would also like to see consumer-centred practice
as a core professional competency in education. Where
does the onus for this lie and at who, specifically, is this
recommendation aimed?
It’s an important aspect. As I said earlier, there are many doctors,
nurses, healthcare professionals of all sorts, who are fantastic at
engaging with consumers. However, there are others who don’t
have necessarily the same levels of skill, and who were never
taught the sorts of skills that are required to implement consumercentred healthcare. We need to help up-skill those people [in]
all aspects of healthcare. It’s not just the doctors and nurses, it’s
the allied health professionals, it’s the receptionists. It’s everyone
involved in healthcare. It’s also broad in terms of the extent. For
example, it’s something that should be built into university courses
and training courses now and also made available to people who
are already practicing. As well as involving universities and colleges
and other training institutions, it’s important for the professional
bodies to take some responsibility for helping up-skill existing
practitioners and providing them resources and courses and
training, to give them the skills to engage with people using the
system in a 21st-century fashion.
another recommendation was around routinely measuring
patient experiences and outcomes and making the
information publicly available. Why is this an important
measure and what are some of the potential barriers to
putting something like this in place?
As someone who is a doctor working in the system at the
moment, I can say from personal experience it’s often easy to
focus on the blood test results or the x-rays or the number of
heart attacks. All of those things are important but sometimes
we forget and leave behind the other, if you like, softer aspects of
people’s healthcare experience that are at least as important to
them. The quality of information, the quality of communication,
the way they feel – these things are, we’ve learned, at least as
important to people using the system, but aren’t measured in a
routine way. Other countries are doing this now.
In the UK, for example, health services are routinely collecting
information from patients about whether they found the
engagement with the system enjoyable and useful, whether
it helped them in a broad range of ways beyond some of the
more concrete ways. That’s something we need to bring into our
system. We need to start measuring some of these outcomes,
and then making the [data] available. Because the nature of
the interaction with the healthcare provider is often at least as
important to the consumer as some of the other measures we
use. Therefore, people often would like to use [that data] in making
decisions. [This is about asking whether] previous users of the
system were happy with the way they were treated, and the whole
process as well as the outcomes. If consumers have all of that
information available to them, we think they can make properly
informed decisions and increase the likelihood that they get the
service they expect.
What other changes would you like to see take hold based on
this report?
Firstly, it’s time for a broader cultural change throughout the
healthcare system. This has already started to a degree but it’s
really important. [The system] is often focused on cost, it’s often
focused on the pressures on staff. It’s often focused on the need
for more resources. These things are important but we mustn’t
lose sight of the fact we’re there primarily to improve health and
outcomes for the consumers. Getting that message permeating
throughout all aspects of the healthcare system is important.
Up-skilling consumers is also important. [We need to] get
people more involved in decisions about how health services are
provided or more involved in running hospitals and healthcare
services – and providing that real consumer perspective. But to do
that we need to make sure people have the skills and the resources
they need to contribute in a meaningful way. So getting some
training for people involved in healthcare who aren’t professionals,
but are consumers, would also be important.
And finally, helping people get access to their own healthcare
records. [They should have] information about what’s happened
to them. [Get them] the results of various things they’ve had
done to them, so they can share that information with other
healthcare providers they see down the track. Also so they can
take greater ownership and responsibility for their own health
and make decisions based on all the information. These are a
few of the other characteristics that are important to look at
moving forward. n
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