If the PM wants to get serious about health, he needs to prioritise prevention and primary care in the community over expensive end-of-the-road treatment.

While the PM’s Health Reform package is a start, it is not genuine health reform. Most of it is simply a change to the way hospitals are funded. The only reason Mr Rudd can boast about it being the biggest reform since Medicare is because there hasn’t been any reform since Medicare.

Hospital financing reform is welcome but the real challenge for government is to place prevention and primary care at the centre of health care policy. Currently, the majority of health funding goes to hospitals, acute care, and medicines, while less than 5% is spent on illness prevention.

Fee for service in general practice is an impediment to delivering good preventative care. It creates a perverse incentive to generate services and concentrates services in areas that are already over supplied. As a result we spend more on treating a Toorak resident than we do on an Aboriginal child in Tennant Creek. The government’s health package indicates little willingness to challenge this financing dilemma.

A blended payments model would be a positive move. Fee for service should be retained but we should also pool some Medicare and other public health funding to be reserved for local health networks, as the hospital reforms propose to do. Local boards, who are more connected to problems on the ground, could then distribute this funding to a range of primary care practitioners on the basis of health need, not just to those people who are lucky enough to be able to access services.

The proposed health reforms announced so far by the government seem to indicate that they don’t understand that a major function of any health system is to keep us healthy.

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