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Steering without navigation equipment: the lamentable state of Australian health policy reform
BACKGROUND: Commentary on health policy reform in Australia often commences with an unstated logical error: Australians' health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generall...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2009
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791101/ https://www.ncbi.nlm.nih.gov/pubmed/19948044 http://dx.doi.org/10.1186/1743-8462-6-27 |
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author | Richardson, Jeff RJ |
author_facet | Richardson, Jeff RJ |
author_sort | Richardson, Jeff RJ |
collection | PubMed |
description | BACKGROUND: Commentary on health policy reform in Australia often commences with an unstated logical error: Australians' health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generally self-congratulatory tone of the discussion: a good system needs (relatively) minor improvement. RESULTS: This paper comments on some issues of particular concern to Australian health policy makers and some areas needing urgent reform. The two sets of issues do not overlap. It is suggested that there are two fundamental reasons for this. The first is the failure to develop governance structures which promote the identification and resolution of problems according to their importance. The second and related failure is the failure to equip the health services industry with satisfactory navigation equipment - independent research capacity, independent reporting and evaluation - on a scale commensurate with the needs of the country's largest industry. These two failures together deprive the health system - as a system - of the chief driver of progress in every successful industry in the 20th Century. CONCLUSION: Concluding comment is made on the National Health and Hospitals Reform Commission (NHHRC). This continued the tradition of largely evidence free argument and decision making. It failed to identify and properly analyse major system failures, the reasons for them and the form of governance which would maximise the likelihood of future error leaning. The NHHRC itself failed to error learn from past policy failures, a key lesson from which is that a major - and possibly the major - obstacle to reform, is government itself. The Commission virtually ignored the issue of governance. The endorsement of a monopolised system, driven by benevolent managers will miss the major lesson of history which is illustrated by Australia's own failures. |
format | Text |
id | pubmed-2791101 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-27911012009-12-10 Steering without navigation equipment: the lamentable state of Australian health policy reform Richardson, Jeff RJ Aust New Zealand Health Policy Commentary BACKGROUND: Commentary on health policy reform in Australia often commences with an unstated logical error: Australians' health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generally self-congratulatory tone of the discussion: a good system needs (relatively) minor improvement. RESULTS: This paper comments on some issues of particular concern to Australian health policy makers and some areas needing urgent reform. The two sets of issues do not overlap. It is suggested that there are two fundamental reasons for this. The first is the failure to develop governance structures which promote the identification and resolution of problems according to their importance. The second and related failure is the failure to equip the health services industry with satisfactory navigation equipment - independent research capacity, independent reporting and evaluation - on a scale commensurate with the needs of the country's largest industry. These two failures together deprive the health system - as a system - of the chief driver of progress in every successful industry in the 20th Century. CONCLUSION: Concluding comment is made on the National Health and Hospitals Reform Commission (NHHRC). This continued the tradition of largely evidence free argument and decision making. It failed to identify and properly analyse major system failures, the reasons for them and the form of governance which would maximise the likelihood of future error leaning. The NHHRC itself failed to error learn from past policy failures, a key lesson from which is that a major - and possibly the major - obstacle to reform, is government itself. The Commission virtually ignored the issue of governance. The endorsement of a monopolised system, driven by benevolent managers will miss the major lesson of history which is illustrated by Australia's own failures. BioMed Central 2009-11-30 /pmc/articles/PMC2791101/ /pubmed/19948044 http://dx.doi.org/10.1186/1743-8462-6-27 Text en Copyright ©2009 Richardson; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Commentary Richardson, Jeff RJ Steering without navigation equipment: the lamentable state of Australian health policy reform |
title | Steering without navigation equipment: the lamentable state of Australian health policy reform |
title_full | Steering without navigation equipment: the lamentable state of Australian health policy reform |
title_fullStr | Steering without navigation equipment: the lamentable state of Australian health policy reform |
title_full_unstemmed | Steering without navigation equipment: the lamentable state of Australian health policy reform |
title_short | Steering without navigation equipment: the lamentable state of Australian health policy reform |
title_sort | steering without navigation equipment: the lamentable state of australian health policy reform |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791101/ https://www.ncbi.nlm.nih.gov/pubmed/19948044 http://dx.doi.org/10.1186/1743-8462-6-27 |
work_keys_str_mv | AT richardsonjeffrj steeringwithoutnavigationequipmentthelamentablestateofaustralianhealthpolicyreform |