Health systems need to maximise the effectiveness and efficiency of health services and long-term care; deliver seamless care across services and providers; they also need, fundamentally, to deliver improvements that matter to patients and their changing care needs. We share with our people and clinical leaders the view that “people-centred care” should better guide the course taken by health care in the future.

Ministerial Statement, The Next Generation of Health Reforms, OECD Health Ministerial Meeting, January 2017.       

Despite Australia’s favourable performance ranking overall when compared to other OECD countries, all too often the Consumers Health Forum of Australia (CHF) frequently hears from our members and networks that that the consumer experience of the Australian health system is one of disconnected and poorly coordinated care.  

Too often we only rely on measures of what health systems do, and how much they cost, rather than their effects on patients[1]. It is time to ask patients: what matters to you and for the system to respond accordingly.    

In modern health systems in developed economies we must take experience of care to be an equal measure of the performance of our health system and whether or not it is meeting the expectations of the community. Experience of care measures must have prominence within the ‘quadruple aims’ that are commonly accepted as measures of health system performance: enhancing patient experience; improving population health, lowering costs; and improving work life of health care providers.

This issues paper outlines a consumer perspective on the key design principles and elements which should be incorporated in the four pillars envisaged as part of a national health plan for Australia. It has been developed with the input of over 20 CHF members, representing a cross-section of our members, who expressed interest in attending a Consumer and Community Ministerial Roundtable in August 2017, the Mental Health Consumers and Carers Forum and other key informants such as representatives from Primary Health Networks (PHNs).  

We believe there are two essential priorities that we must start with:

• Reforms to strengthen Australia’s primary health care system to make it more consumer-centred, prevention oriented, better integrated with hospital and social care and with more capacity to support transitions of care; and  
• Greater investment in health systems research and arrangements to ensure the national research agenda is shaped by consumer and community priorities, that the findings stimulate improvements in services and our national medical and health research funds are spent wisely.

New approaches to consumer and community involvement in decision making at all levels in the system should be part of the process for developing a long term national health plan. Whether it is at the point of care or in policy design, when consumers are activated and supported to be involved, better experiences of care, quality of care and health outcomes result.     

CHF outlines reforms in seven key areas:

PRIMARY HEALTH CARE: to expand the focus on new models of care to include children, families and others at risk of chronic illness, and to enhance the role of Primary Health Networks.

PREVENTION:  pre-empt chronic diseases like obesity with effective public health measures

RETHINK FUNDING: to better link hospitals with coordinated community-based services

INTEGRATE MENTAL HEALTH SERVICES: with physical health, education and employment.

FLEXIBLE WORKFORCE:  incentives, education and services to put patients at centre of care

DIGITAL HEALTH FUTURE:  support efficient care, more patient choice and transparency.

PATIENT-ORIENTED RESEARCH: to ensure consumer say in setting research priorities and translating research into practical improvements to services.