Great Ideas to Improve Australian Healthcare?

September 22, 2011 6:08 AM

If you were having lunch with the Australian Minister for Health which new, innovative, targeted and cost effective measures would you suggest to improve health care in Australia? Ideas could focus on regional services, mental health, hospitals and nursing or GP services, preventative health and so forth. Links to fresh, successful strategies in other countries or well argued position papers would be appreciated. Simply suggesting spending more money isn't an option. This question has nothing to do with the oft rehearsed arguments over health insurance and provision in the USA.
posted by joannemullen to health & fitness (15 answers total)

Annual third party review of polypharmacy in aged care facilities.
Transparency in drug promotion/ education expenditures by pharmaceutical companies to doctors.
A Finland-style diabetes intervention.
posted by hawthorne at 7:03 AM on September 22, 2011

Stop the closed shop run by the colleges of surgery etc. who go to considerable lengths to prevent highly qualified, overseas trained specialists from working in Australia. The lack of competition for jobs creates a virtual monopoly and lack of commitment to public sector hospitals. The consequence is that hospital doctors are paid extremely inflated salaries, and yet don't actually work particularly hard , secure in the knowledge that they are safe in their (our!) jobs.

Protectionism is the enemy of high standards.
posted by bister at 7:28 AM on September 22, 2011

Thanks, keep them coming. This isn't a question asked out of idle curiosity or framed in a random way. From your lips to God's ear...
posted by joannemullen at 8:34 AM on September 22, 2011

Due to challenges of geography--similar to those in Australia--Canada's rural/remote areas have many "orphan" or "unattached" patients (people who can't find a GP in their community). One proposed solution is to allow more nurse practitioners to provide primary care to rural areas, with appropriate physician support.

Blog post about "orphan patients" by White Coat, Black Art host Dr. Brian Goldman
MP3 of his podcast episode featuring an interview with the staff at Canada's first nurse practitioner led clinic
posted by hurdy gurdy girl at 8:54 AM on September 22, 2011

Seconding the call for increased use of nurse practitioners. Physicians are required for diagnosis, prognosis, and treatment; however, many time-intensive tasks that currently fall to doctors, such as case management for comorbid chronic diseases, could be done more effectively and less expensively by increasing the scopes of practice for other health care providers.

Here is an article that may be of use (I haven't read it yet, so I can't vouch for the contents - but it could be useful!).
posted by meevo at 12:53 PM on September 22, 2011

- nthing nurse practitioners
- expanding telehealth especially for Mental Health & Substance Use services
- preventative and peer support services especially for youth
posted by Country Dick Montana at 4:51 PM on September 22, 2011

Checklists, as per Gawande's manifesto.
posted by anildash at 5:23 PM on September 22, 2011

convey Annual third party review of polypharmacy in aged care facilities to god, certainly, and while you're at it tell god to look - often - into iatrogenic psychoses within comfortably funded, yet dysfunctional, psych care units.

i swear to god psych health care workers are medicating the wrong people ... if only they had a collective clue, and a performance review process.

dedicated detox facilities for aged people and people trapped on long term anti-psychotics don't exist. they need to exist.
posted by de at 6:05 PM on September 22, 2011

Thanks again guys.
posted by joannemullen at 8:05 PM on September 22, 2011

Fix the antibiotic resistant infection issues prevalent in hospitals in Australia. I understand it is mostly to do with better hygiene.
posted by jannw at 3:37 AM on September 23, 2011

Reduce management to clinical staff ratio. Check out these statistics: http://www.health.qld.gov.au/performance/staffing/staff14yr_10.pdf
Over 15 years, nursing staff increased by only 1.6x. Medical staff increased by 2.5x. Management staff increased by 3.0x.
Hospitals should be run by people trained in health, not administration.
posted by superfish at 4:30 AM on September 23, 2011

New Zealand had a good program for tackling antibiotic overuse where patients with viral illnesses were given printed "prescriptions" explaining why antibiotics would not help and offering tips for basic self-care. If I remember correctly, it dramatically reduced inappropriate prescriptions - presumably it gave GPs something concrete to offer patients who pestered them for antibiotics.
posted by embrangled at 5:32 AM on September 23, 2011

I'd have to urge caution in suggesting acing management posts. It's a popular opinion, often voiced and particularly well received by clinicians.

It's absolutely true that excessive bureaucracy and committe style management seems to the bane of the current system. But as a clinician with a background in management in a previous career I'd argue that many of the ex nurses and doctors who occupy management posts simply don't have the necessary background to be effective managers. Their approach can also be somewhat parochial and may not be devoid of self interest.

I think well trained and experienced managers, with a background in healthcare management are a vital part of the system. If they are clinically trained they will need a significant amount of business training; if their background is in business they will significant training in healthcare. The NHS has attempted to provide this sort of training and the graduates from the programme can be quite impressive. (I'm talking about the calibre of the managers and not necessarily the quality of the NHS per se)

Good management and strategic planning are essential to ensure a coherent and effective healthcare system that delivers - otherwise resources and effort are wasted.
posted by bister at 9:41 PM on September 23, 2011

Er... Axing not acing..
posted by bister at 9:42 PM on September 23, 2011

Thanks again everyone who suggested some great ideas.
posted by joannemullen at 8:57 PM on September 24, 2011