Despite lots of well-laid plans and completed reviews and a likely runway of six years to get stuff done, this government still needs one unifying plan for healthcare.
The recent election results have set the stage for a government with a clear mandate and, potentially, two terms to deliver on its promises.
While the immediate focus is on fulfilling campaign commitments, the broader question looms: what transformative reforms could define the next term?
The answer lies in laying the groundwork now for a reimagined health system, one that prioritises integration, innovation, and sustainability.
Case for root-and-branch reform
We should be clear-eyed about the challenges ahead. This government is not a revolutionary one. It’s reformist, pragmatic and workmanlike. They’re not going to turn everything upside down in this term, but they have the time and the mandate to set the stage for significant change in the next.
The run up to the 2028 election should be the time when the government unveils a comprehensive reform package for the health system.
This will require meticulous planning, broad stakeholder engagement, and pilot testing over the next couple of years. We can’t afford to wait until 2027 to start thinking about it. The work needs to begin now.
At the heart of our vision should be the concept of “one health system”, a unified approach that breaks down the silos between primary care, hospitals, and other healthcare and other care (aged, disability) providers.
This would not only improve patient outcomes but also address inefficiencies and inequities in the current system.
Three pillars of reform
There are three key areas that must be addressed to achieve meaningful reform:
Transforming primary care
The current fee-for-service model, which incentivises short consultations and high patient turnover, is ill-suited to the needs of an ageing population and the growing prevalence of (multiple) chronic conditions.
While the current system disadvantages people with complex needs – those in aged care, in disability care, those with mental health issues and those with chronic diseases – it also provides little incentive for primary care to get heavily involved in prevention and addressing social determinants of health.
Reforming this model will require a shift in how GPs are compensated, as well as closer formalised collaboration between states and primary care providers.
The government is likely to face resistance from many quarters, particularly those who benefit most from the status quo. This highlights the importance of sensitive, adroit stakeholder engagement strategies.
Related
Reimagining hospitals
Hospitals often operate in splendid isolation, disconnected from the broader health system.
While new hospital buildings are politically attractive and highly visible, they represent a reactive approach to healthcare — what we might in fact call “sick care,” a model in which we wait until people get sick and then spend a lot of money on them.
But what if we focused on making hospitals part of a larger, integrated system? What if hospitals were supported to participate much more in prevention and early intervention?
Workforce, governance, and digital innovation
The third pillar of reform involves addressing systemic issues in workforce planning, governance, and digital health.
This is where the need for “one health system” really comes in, streamlining patient care, letting clinicians work at the top of their scope of practice and reducing administrative burdens. It is critical to foster innovation and collaboration at the local level, where many of the most promising solutions are already being tested.
Learning from local innovations
While this grand vision may be compelling, we are equally passionate about the need for immediate action.
In addition to working this vision up into a comprehensive package of reforms, we also need to start trying things locally: piloting new approaches, taking risks, and sharing what works among one another.
We might consider examples like Western Sydney, which successfully pooled resources to deliver the vision of “one Western Sydney Health System”.
Service gaps were collaboratively commissioned, and resources were realigned. Through integrated governance, delegations, shared culture, information sharing, community partnership and communications, Western Sydney LHD and Western Sydney PHN overcame barriers together to deliver a fully integrated, digitally enabled care pathways for consumers, families and carers.
Components of the cardiology in community pathway and value-based urgent care pathway continue today, offering valuable lessons for future reforms.
We might also look at innovative approaches to mental health care that blend digital tools, early intervention, and access to specialists.
Too often, people only get one piece of the puzzle, but the best solutions are those that provide a rounded package of care.
Balancing ambition with pragmatism
It is important to frame our discussions about reform in a way that is both ambitious and achievable. We shouldn’t spend all our time on pipedreams. We need feasible, practical solutions that the whole sector can get behind.
It is important that the government builds consensus around a unified vision for the future. It needs to enable people to think creatively, to take risks, and to collaborate.
The fact is that the path to a reimagined health system will not be an easy one to follow. It will require bold leadership, sustained effort, and a willingness to challenge entrenched interests.
But with a government poised for two terms and a growing appetite for change, the opportunity is there to create a system that truly serves the needs of all Australians. This is our chance to lay the foundation for something transformative. Let’s not waste it.
The Wild Health One Healthcare System Workshop and Summit in Canberra next week on 17 and 18 June will provide an opportunity for interactive sharing of ideas on moving faster to a unified system and will provide practical examples to take away and support healthcare leaders working at the local level. Last tickets are available HERE until 12pm on Friday 13 June.
Raj Verma is a Principal at the Nous Group and will be leading the One Healthcare System workshop on 17 June.