I just finished watching the Australian Prime Minister’s speech to the national press club announcing his plan to radically reform the Australian health sector (full report here). I feel that the plan overlooks two critical concerns that could potentially undermine the goals it sets out to achieve.

The plan fails to recognise that splitting administration into smaller local health networks may introduce more duplication of resources as local health boards take on functions that formerly were centralised in state health departments. One of the key areas I see running into this problem is ICT support. South Australia recently centralised its health IT in order to address inefficiencies introduced by fragmentation across hospitals and regions. Mr Rudd’s plan would reintroduce this fragmentation and then replicate it across the country.

The second issue I have is that of accountability. At least at the moment if we have an issue with the way that a state government is running the health system it is an area of focus and we can vote them out at an election, as is likely to happen in New South Wales. By spreading the accountability for health delivery across a number of local health networks the focus of the issue is diluted which decreases the accountability of the state government who appoints the boards and allows the state government to remain at arms length. The potential for mismanagement and local corruption has been increased.

These issues aside I think that the plan shows great vision and a promise of addressing the large hole in health funding coming through Australia’s aging population and the rise in health costs.

The award for the worst question after the speech goes to the Adelaide Advertiser who completely ignored the health agenda and asked some lame question about Tony Abbott getting lost in the desert. The Prime Minister gave some motherhood response and the discussion moved on with barely a ripple in the intellectual landscape. If this is the standard of newspaper journalism that the Advertiser promotes then it is no wonder they are under threat from online sources.

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