A Grattan Institute submission has highlighted where the Productivity Commission should look to improve preventive care.
The submissions keep coming for the Productivity Commission inquiry on delivering quality care more efficiently, with the Grattan Institute providing its two cents.
In alignment with the RACGP’s submission, the Grattan institute has commended the Productivity Commission’s emphasis on better integration of services and a stronger role for prevention.
The submission called for immediate systemic reform, focusing on needed improvements for collaborative commissioning and preventive care.
“The goals of collaborative commissioning, and measurement of success, shouldn’t start with the narrow and volatile measure of potentially preventable hospitalisations,” the submission read.
“Collaborative commissioning should also be part of a broader agenda that includes improving commissioning within systems.
“There is ample evidence of room for improvement in both federal and state government commissioning.”
The Grattan institute has compared this to coordinated commissioning seen between government faculties with the exception that Grattan predicts progress within healthcare will be easier to achieve with greater impact.
The Grattan Institute has also panned the Productivity Commission’s usage of potentially preventable hospitalisations (PPHs) as the metric to measure collaborative commissioning efficiency.
“While they are a useful measure, PPHs are not a good fit for this purpose,” the submission said.
“They were developed to measure primary care access, not system integration – the Commission’s policy goal.
“They capture only a sub-set of potentially avoidable admissions that can be measured using hospital coding, many cannot be avoided in practice, and they are strongly influenced by causes well beyond healthcare.”
The Grattan Institute instead recommended anchoring collaborative commissioning performance metrics to a national performance framework.
Test running these collaborative commissioning initiatives is being proposed for primary care ‘deserts’, to judge whether the schemes can have a tangible, immediate impact.
“We suggest the Commission recommend a systematic program to build commissioning capability in federal and state departments, and PHNs,” the submission said.
“This should be informed by assessment of optimum governance and funding settings, performance measurement approaches, current commissioning capabilities, and international best practices.”
The proposal from the Commission to develop a stronger prevention investment framework was supported by Grattan on the basis that it would establish sustainable funding and efficient, long-term management.
This has led to the Grattan Institute suggestion of embedding the functions of a prevention investment framework into the Australian Centre for Disease Control (CDC).
“The CDC doesn’t require a new government commitment to establish another agency,” the submission said.
“It will avoid duplication between the proposed cross-government agency and the CDC.
“It will be a better fit with government structures, with a lead Minister, rather than being an orphaned cross-portfolio body, or a low priority for the Prime Minister or Treasurer.”