Labor Fails to Join The Dots!

Today Kevin Rudd released an overview of a key element of the Rudd Labor Party Health Policy.

The essentials of the policy release can be understood from the following:

“Mr Rudd launched Federal Labor’s New Directions paper - Fresh Ideas, Future Economy: Preventative health care for our families and our future economy.

Mr Rudd said Federal Labor will:

• Develop a National Preventative Health Strategy to provide a blueprint for tackling the burden of chronic disease currently caused by obesity, tobacco, and excessive consumption of alcohol. The Strategy will be supported by an expert Taskforce.
• Shift the focus from so-called “six minute medicine” in general practice by beginning a reform process to provide incentives for GPs to practice quality preventative health care;

• Broaden the focus of the major health care agreement between the Commonwealth and the States and Territories beyond hospital funding by developing a National Preventative Health Care Partnership; and

• In its first term, commission the Treasury to produce a series of definitive reports on the impact of chronic disease on the Australian economy, and the economic benefits of a greater focus on prevention in health care.

The cost of providing health care and the cost of rising demand for health care is expected to spiral. Federal Government spending on health care will increase from 3.8 per cent of GDP in 2006-07 to 7.3 per cent in 2046-47.”

The full media release can be found at the following URL:

http://www.alp.org.au/media/0607/mshealoo280.php

The full document can be found here:

http://www.alp.org.au/download/fresh_ideas_future_economy___preventatve_health_care.pdf

All this I must say is totally rational, appropriate, needed, pragmatic, practical and sensible.

However, in the ALP Draft Policy Platform one finds the following:

ALP National Platform and Constitution 2007

Harnessing New Technology and Managing Patient Information

“67. Labor sees major opportunities for new technology to make health services more effective, more accessible and more consumer friendly. Technological change needs to be carefully managed with close attention to the social and ethical implications and the need for privacy for personal health records. Labor will ensure that commercial interests do not subvert intended health outcomes and that decisions are made on the basis of clinical and cost effectiveness determined by the best available research evidence.

68. Labor will, in collaboration with State and Territory governments, build information technology and communication infrastructure and systems that improve the decisions made by consumers, clinicians and health service managers about care, service delivery and policy. The purpose of this investment will be to:

• build accessible knowledge bases from quality data systems, libraries of research evidence and the experience of consumers and professionals;

• enhance online communication between consumers and professionals, and primary and acute care settings, regardless of location, to improve health outcomes and service quality; and

• create data management systems that monitor population health and the safety, quality and efficiency of health services.

69. Labor will ensure that appropriate training is undertaken by health professionals to develop and maintain the skills necessary to use these knowledge bases, health records and communication systems.

70. Labor believes the development and implementation of health knowledge management systems that include electronic health records and decision support systems for evidence based practice are central to improving the safety and quality of health services. However, these new tools cannot be widely used until satisfactory arrangements are in place to protect security and privacy.

71. Labor will ensure every Australian has a personal electronic health record that is privacy protected. Labor will develop a strong privacy regime built around a unique patient identifier based on the Medicare card. Legislation will prohibit this number being used for any other purpose and access will depend on authorisation from both the patient and the doctor. A range of other safeguards will be incorporated in legislation, which will be developed after a public inquiry into all the issues.

72. It is critical that health providers can communicate effectively with each other while maintaining patient confidentiality. Labor will provide leadership in the development of national, secure health data standards and will establish a common framework for health record systems. The delay in establishing this infrastructure is inhibiting the delivery of quality health services in Australia and contributing to unnecessary adverse events.

Specifically Labor will ensure:

• the use of tele-health to give rural clinicians direct access to city based specialists and the resources of major teaching hospitals;

• the use of secure electronic networks to give clinicians and pharmacists access to high quality drug information sources; and

• the use of electronic prescriptions to speed up and reduce errors in communications between clinicians and pharmacists.

73. Labor will give Medicare Australia greater powers to analyse data to examine variations in practices, to enable the promotion of professional practice based on the best available evidence from research. Clinicians will be supported in their evidence-based practice through the development of appropriate, accessible clinical guidelines and pathways of care.”

Again, this is music to those who see further development in e-health as fundamental to better health care safety, efficiency and quality.

What is missing from the announcement is a section that makes the link between effective computerisation of General Practice and delivery of consistent quality GP care – which is what is needed to actually have more preventive care undertaken. Intelligent advanced decision support for GPs is a major way to make sure all relevant interventions are scheduled, undertaken and followed up.

An extra sentence or two would have made me a much happy camper – knowing the link between e-health deployment and better preventive care was fully appreciated at the top!

In the interests of balance – interested reader who wish to understand Government Policy on the Topic can visit.

http://www.ama.com.au/web.nsf/doc/ween-6l76qj

This contains the proceedings of an e-Health Forum conducted by the AMA in 2006 where there were a number of senior government officials and Minister Abbott contributing.

Minister Abbott said at the forum (Jan, 2006) that:

“Just over two years ago, the first scripted speech I made as Health Minister was about the importance of creating an E-Health system. At that time, in my inexperience, I declared that it must be possible to bring about such a self-evidently worthy goal within five years. Despite the hard lessons since, I'm more convinced than ever of the importance of this project for the long-term good of the health system. It may never be the most pressing task for the people running our system but it may be the most important practical measure policy-makers can pursue to make it more efficient and more responsive to patients.”

This seems to be the most recent Ministerial statement available – other than the recent letter from the Department of Health and Ageing which was published here a few weeks ago. (Let me know if there is a later source!)

I leave it to readers to review and decide what approach they prefer and how credible each is.

David.