industry & reform
Dr Brett Scholz is a researcher and critical health psychologist . Picture : Supplied
The customer knows best
Is a consumer-led health system the way forward ?
Brett Scholz interviewed by Eleanor Campbell
The movement of consumer driven healthcare has become a growing phenomenon .
Engaging people accessing healthcare in the creation of policy , services , education and research is vital to address public needs , according to Dr Brett Scholz from ANU ’ s medical school .
Dr Scholz , who is a critical health psychologist and researcher , recently took home the 2021 ACT Young Tall Poppy science award for his studies in the area .
He joined Nursing Review to discuss the potential of consumer expertise during COVID-19 , the importance of listening , and breaking down the power hierarchies in healthcare .
NR : Can you paint us a picture about what consumer-driven health care is , and how prevalent is it in our health system ? BS : It ’ s not at all as prevalent as I would love it to be . The work that I try to do is about consumer leadership across the health system . So that includes in-health policy , in-health services , in-health education and health research .
The first example that comes to mind , and it ’ s really important now in the context of COVID , is that we have all of these standards that we work to , around
8 | nursingreview . com . au partnering with consumers . But around the time of COVID one of the disappointing but perhaps unsurprising things I saw was that including and engaging with consumers was forgotten .
There are pockets of where that is still done , but there was even more COVID policy that was developed without input from consumers . Here in the ACT , the triage process for COVID was actually developed with 26 different consumer care and community groups , and it means that the ACT ’ s triage policy is based on human rights , it ’ s based on consumers ’ needs , and it still takes into account clinical considerations like bed numbers , capacity and clinicians ’ day-to-day lives . The principles of that policy are grounded in consumers ’ needs . That ’ s an awesome example of policy that I wish we saw a lot more in COVID .
There are so many benefits . One of the first ones is that it means that we ’ re creating relevant policies for consumers , rather than just health professionals presuming what consumers need or want to know . It also allows us to be more innovative . In a number of projects that I ’ ve been involved in with consumers , non-consumer members of the team have said , ‘ Oh , how did I not see that solution the consumers had come up with or had co-developed ?’ They see the health system in a very different way to people who are working within that system as health professionals .
The other benefit is that it means we can actually be providing cost-effective services as well . There are so many things that happen in health that consumers might not want , or that are no longer relevant , or no longer fit for purpose . So if we can get rid of those things , or reform them to make sure that what we are offering does map with consumer ’ s needs , then we ’ re providing not only cost-effective but better value-for-money services .
Can a more consumer-led model help address health inequity ? In a lot of the work that I have done and some of my colleagues do in this area , we often acknowledge that . There ’ s so many intersections of vulnerabilities . Almost every paper I ’ ve read in this area has a paragraph towards the end saying it would be great to involve more diverse communities . It would be great to involve Aboriginal and Torres Strait Islander people , people from CALD backgrounds , people from socioeconomically disadvantaged backgrounds , and so on .
I don ’ t know that we ’ re necessarily doing a good enough job of it yet . I think people are acknowledging that we need to do better . I think if we are actually creating services , and policies , and education , and research together with the people that are impacted the most , including those who are vulnerable , stigmatised or marginalised , then I think we can work towards making more relevant care for them as well . I really want to see that being done a lot more .