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Aged care missing in Coalition health picture


By Keryn Curtis

The Coalition’s health policy, launched yesterday by Opposition leader, Tony Abbott, had good news for a range of stakeholders including hospitals, GPs and the pharmaceutical industry but surprisingly no references at all to older people, health promotion or improved integration with the aged care system.

The Coalition’s Policy to Support Australia’s Health System, part of its Real Solutions election plan, places a heavy emphasis on reducing bureaucracy and redirecting resources to ‘frontline services.’

“With demand for health services expected to grow, we want to direct more resources to the frontline and remove unnecessary bureaucracy,” Mr Abbott said in his statement.

“By cutting waste, streamlining bureaucracy and providing strong and competent leadership, we can then provide much-needed resources to areas such as the provision of dental services to disadvantaged and vulnerable members of the community.”

Few advocates for older people or the aged services sector chose to comment on the health policy announcement, despite or perhaps because of the policy’s total silence on the connection of aged care with the healthcare system

The office of shadow minister for ageing, Senator Concetta Fierravanti-Wells, confirmed that there would be a separate dedicated ageing policy announcement as well as a separate mental health policy announcement before the election on 7 September.  A spokesperson for the Senator said the coalition felt that aged care and mental health were important enough to deserve their own separate policy announcements but was unable to say when during the next 15 days of campaigning that the ageing policy announcement would be made. However, sector insiders are expecting it in the final week of the campaign.

Valuing health promotion

Professor of Ageing and Public Policy at the Centre for Research on Ageing, Health and Wellbeing at the Australian National University, Hal Kendig, noted the absence of integrated health and ageing policy in the announcement, saying he had hoped there would be more recognition of the great potential for health promotion and better lifestyles to postpone or prevent chronic disease and all the consequences for health and care services.  

He told Australian Ageing Agenda that the most pressing questions about ageing have to do with the interrelationship between ageing, health services and health promotion at both the national and –just as importantly- the regional level.  

“We have to think of these things together in inter-relationship because there is too much cost shifting, gaps and duplication between the health and the care systems and between the commonwealth and the state governments. 

“To achieve this we need to recognise this potential to realistically apply more positive attitudes and to plan a coherent integrated health and care system,” Prof Kendig said.

Prof Kendig said research into older people and health systems demonstrates a strong evidence base for the value of integrated health and care approaches, not just at the national and state policy level but at the level of local regions.

“In the end we need to make sure that systems of community support and care are put together appropriately in a way that fits each local community and region and provides a full range of supports for people as they transition to later life in their local areas.

“It is imperative that the incoming government recognises these challenges early in its term and moves ahead constructively to address them. 

Training medical interns

Catholic Health Australia CEO, Martin Laverty,  welcomed the Coalition’s commitment to $40 million over the forward estimates to support up to 100 intern places each year for graduate medical students in ‘private and non-traditional settings’ as a solution to meeting the current shortfall of intern places within the traditional public hospital system.

“Some politicians and bureaucrats are entrenched in their understanding of how medical graduates should be trained, but we’ve been trying to show how valuable the Catholic hospital system, both public and private, can and should be in training tomorrow’s doctors,” Mr Laverty said. 

“We played an important role in averting the crisis that emerged late last year and pledged then to have an ongoing commitment to helping ensure medical students graduating in record numbers can become the quality doctors that Australia needs in the future.” 

In addition to offering Catholic Health’s network of 75 hospitals to play a training role, Mr Laverty strongly supports expanding medical training into aged care.

In an interview with AAA during the ‘crisis time’ last year, Mr Laverty said, “We need to expose doctors and nurses to the needs of elderly people early in their career.” 

“Expanding intern training places into aged care needed cautious program design – tested and piloted – before being rolled out nationally.  There will be many road blocks along the way, and the track record with state Governments in getting the training places organised is not great.  But we can’t let that stand in the road of needing to get doctors and nurses adequately prepared and skilled with dealing with older people,” he said.

Affordability ignored

Consumer advocacy group, COTA Australia, also welcomed several initiatives in the Coalition’s health policy released yesterday but said it does not go far enough in addressing several critical issues, including health affordability and the ‘critical areas’ of mental health and end of life care. 

COTA chief executive, Ian Yates said the Coalition’s health plan has the potential to deliver meaningful benefits for older people through more timely access to new medicines through the Pharmaceutical Benefits Scheme; improving diabetes management through a coordinated National Diabetes Strategy; and fast-tracking the full implementation of bowel cancer screening.

However, he said the policy falls short in not addressing better access to and affordability of quality health services.

“We’ve recently asked older Australians across the nation what matters to them this election and access to quality and affordable health services is their number one priority,” Mr Yates said.

“Many older people are struggling with excessive out of pocket expenses for their health care and COTA has been calling on all parties to look at ways to address this growing issue. 

“Out of pocket expenses are on the increase, with every Australian now paying more than $1000 a year to access health care. 

“For many older people this is a huge financial burden and Medicare needs to be looked at to see where it is falling down. 

“It is disappointing the Coalition policy falls short on addressing this issue.”

Mr Yates said older Australians are hoping there will be more to come from the Coalition on mental health, end of life care and palliative care and dementia research, all highlighted in COTA’s election platform.

“These areas are critical to the health of older Australians and we hope they have been left out of the health policy because they are being addressed in other policies which will be released separately within the next two weeks,” Mr Yates said.

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