Introduction The National Health Reform Agreement - National Partnership Agreement on Improving Public Hospital Services is an agreement signed between the Commonwealth of Australia and its states and territories (The National Health Reform Agreement, 2011)…
1). The objective of this agreement is to help the patients have lesser waiting time for undergoing elective surgery, and in emergency department (ED) and also have access to better subacute care services (The National Health Reform Agreement, 2011, p. 2). The agreement has a basic ethos of “social inclusion” and has committed both the Commonwealth and the States to spend a reasonable amount of money towards developing better infrastructure, facilities and care in public hospitals (The National Health Reform Agreement, 2011, p. 3). Furthermore, socially disadvantaged people like indigenous groups have been incorporated as special beneficiaries of this agreement (The National Health Reform Agreement, 2011, p. 3). The investigations and reveiws that have been conducted on the effectiveness and implementation of the agreement have shown that some positive changes have been initiated. Keeping this in mind, and inquiring about the positive and negative aspects of the agreement, this paper envisages finding out whether this agreement is sufficient to achieve a patient-centered and all-inclusive scenario in the Australian health care system. It is hypothesised that though the target-oriented, porcess-centered and organisation-centered approach in the agreement has resulted in many positive outcomes, the health care system of Australia still lacks in sharing of leadership, two-way communication and a whole-of-hospital approach. Background The “overcrowding” in public hospital Emergency Departments and “access block to poorer patients” has been identified by this agreement as major issues affecting not only the quality and commitment to health care but also patient safety (Baggoley, 2012). The prevailing situation has been alarming in the sense that “ED overcrowding and access block” was causing about “20-30% excess mortality rate” among the patients (Baggoley,2012; Richardson, 2012, p.126). Another difficulty that arose from this situation was the “prolonged inpatient length of stay” (Baggoley, 2012). Highlights The highlights of the agreement are as follows. The agreement has set forth a national target for elective surgery to ensure that all the “Urgency Category patients” who are waiting for their turn for surgery, get the same done within the “clinically recommended time” (The National Health Reform Agreement, 2011, p. 14). For materialising this commitment, the agreement has the Commonwealth give an amount of $ 650 million (The National Health Reform Agreement, 2011, p. 14). The programme initiated for this, named National Elective Surgey Target (NEST), has its focus on giving within necessary time surgery access to all patients, and cutting short the “average waiting time” for patients whose surgeries are already lagging behind time (Western Australia Department of Health, n.d.). Once these targets are met with, the agreement has also a provision for “reward funding” of up to $ 200 million (The National Health Reform Agreement, 2011, pp. 16-17). There is also an elective surgery capital funding instituted by this agreement (The National Health Reform Agreement, 2011, p.27). Elective surgery is defined as “surgery that can be delayed for at least 24 hours” (The State of our Public Hospitals June 2010 Report, 2010). The procedure for deciding upon elective surgery is that the patients who approach public hospitals are enlisted in a waiting list by the doctors on the basis of the clinical judgment they make in view of the medical urgency of the matter ...
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