South Australians must make some tough choices about the value of their public health spending to reduce the sector’s burden on the budget, SA Minister for Health and Ageing Jack Snelling told a CEDA Health review in Adelaide.
South Australians must make some tough choices about the
value of their public health spending to reduce the sector's burden
on the budget, SA Minister for Health and Ageing Jack Snelling told
a CEDA Health review in Adelaide.
Mr Snelling told the forum that while revenue and activity
over the past decade have grown about two per cent a year, health
spending had grown about eight per cent a year and now consumes
about 30 per cent of the State's budget.
The sector could not continue to grow unfettered at the
expense of spending in other sectors such as child protection,
disability services and roads maintenance, he said.
"It's time for a mature debate about what the public wants
and what they are willing to pay for in healthcare and other
areas," Mr Snelling said.
This included focusing on the quality of life impact of
clinical treatments such as those for aggressive brain tumours or
dialysis for elderly and frail people with multiple complications.
The value of health spending needed to be re-cast in terms of the
quality of survival rather than survival alone, he said.
"Patient-centred outcomes research looks at end points
other than mortality to assess the value of an intervention. It
asks, what is the quality of survival, what is the reduction in
distress - what interventions have made a difference from the
patient's perspective," Mr Snelling said.
Policy makers must consider reducing funding for
treatments proven to provide little or no benefits for patients, he
The forum, which also included Ernst and Young, Lead
Partner, Jim Birch, Southern Cross Care, CEO, Andrew Larpent and
RAA, general manager public affairs, Penny Gale, heard that
technological innovation in aged care, allowing people to look
after themselves at home and remain mobile, could significantly
reduce healthcare costs and improve the quality of life for older
The forum heard:
- South Australia is at the centre of a bid for a
Cooperative Research Centre on innovation in aged care;
- The aged care system and the health system must evolve
from a sickness based model to a wellness based model - for the
sake of patients and the public purse;
- South Australia is well placed to translate research into
clinical practice in the public health system with the new health
precinct around the South Australian Health and Medical Research
- The fee for service payment system is the largest
impediment to an integrated health system;
- Policy makers around the world are increasingly using
predictive analysis to target chronic disease prevention strategies
on the five-15 per cent of the population likely to cost the system
the most; and
- While the US health system was out of balance at the
national level, Australia should look to healthcare systems in
California and Colorado as producing the best results at least
Mr Birch said an integrated health system would be
critical to improving Australia's healthcare, which did not fare
well on a comparison of health systems in seven
"We always regard ourselves as having a good healthcare
system but we are not quite as good as we might think we are on
quality of care and safe care," he said.
"I'm not suggesting hospital systems are dangerous but
relative to the others we rate six out of seven."
Australia also fared poorly in terms of coordinated care
and the level of patient co-payments or cost of care with
Australians paying almost as much as Americans in co-contributions,
"We need to invert the funding model in Australia to be
able to reverse the utilisation in public hospital systems," Mr
This meant spending more on prevention than acute care
which currently accounts for most of the budget, he