The State of Health: Everyone’s business

"Health care is everyone's business and is big business," NSW Minister for Health, Jillian Skinner has told a CEDA function in Sydney.

Globally countries are facing the challenge of increased health spending, "leading to health care costs rising at a much greater rate than general economic growth," Ms Skinner said.

Currently the health budget in NSW accounts for 27 per cent of the state's budget, that's one in every four dollars, amounting to over $17 billion in 2011/2012 she said. Compared with the 1970s, health spending represented only 14 per cent of total state expenditure she said.

Ms Skinner noted the following key challenges facing the health system in Australia and the world:

• A growing and ageing population
• Increasingly complex and expensive medical technology
• Rising levels of preventable chronic disease; and
• Increasing utilisation of health services by individuals.
  
  "According to data published by the Australian Institute of Health and Welfare recently, total expenditure on health in Australia in 2009-10 was around $121.4 billion. Health expenditure now represents 9.4 per cent of the country's GDP."
  
  "Health care will continue to demand serious and sustained attention by policy makers," she said.
  
  "We will all, at times in our lives, need to access health care....it involves substantial investment of resources by governments, by private and not-for-profit sectors, and by individuals."
  
  On E-health, Ms Skinner said the government was living up to its commitment for NSW to lead the nation in e-health with nearly $400 million for ICT spending for the next four years.
  
  Project investments include:
• $170 million for a new electronic medications management system
• $43 million on new ICU clinical information systems
• $90 million to upgrade corporate systems and build new infrastructure.

"E-health is crucial to our health system and I am a passionate believer that it will complement the best medical workforce in the country," she said.

Ms Skinner also spoke of the National Health Reform Agreement, signed by COAG in August this year.

The COAG agreement primarily focuses on:

• • Organisational reforms
• • Funding reforms; and
• • Performance accountability reforms

"The NSW government has embarked on an organisational reform which includes a devolved government structure, where decisions are made as close to the patient as possible," she said.

"The new Agreement commits the Commonwealth Government to contribute 45 per cent of efficient growth funding for public hospital services from 2014-15, increasing to 50 per cent from 2017-18.

"Under this arrangement, NSW will gain an additional $3 billion over six years. This has been a great win for NSW.

"The Commonwealth is funding the establishment of primary healthcare organisations," said, with four already operational in NSW. These organisations will develop close working relationships within their districts, assess needs and service gaps and undertake joint palming.

"With respect to performance accountability reforms, the new National Health Performance Authority (NHPA) will monitor and report publicly on the performance of public hospitals, LHDs (Local Health Districts), private hospitals and Medicare Locals.

"NSW Health already has in place a well-developed Performance Framework and public reporting process."


Ms Skinner said her vision for the NSW health system was: seamless and integrated patient care, a proud and satisfied workforce and realistic and sound expectations of the health system from the public.

"I want a resilient, but flexible system, which is able to meet the challenges that I have identified... above all, I want a health care system that can deliver consistently high quality care to our patients and to our communities," she said.

During the question and answer session Ms Skinner answered many questions on a range of health topics including:

Research and investment - Ms Skinner said she was keen to ensure the best value for investment and hence, as part of her election promise, has set up The NSW Health and Medical Research Strategic Review, lead by research advocate and CEDA Governor, Peter Wills AC. She directed the audience to a discussion paper, released on (31 October, NSW Health and Medical Research.

Update on delivery of Northern Beaches Hospital (NBH) - Ms Skinner said that once the NBH is up and running, Manly Hospital will close, but Mona Vale will stay open. She said she is also interested in hearing from the public and private companies about innovative funding models.

Rural Health investment; Ms Skinner said the challenge is attracting and retaining a rural health workforce. Current key investments in clinical schools such as Dubbo have been so successful there is a waiting list. To assist, rural employers need to give certainty and confidence to staff and students by guaranteeing future employment, she said.

For event audio click here.