Australian health review : a publication of the Australian Hospital Association
-
Laparoscopic surgery continues to evolve and to offer major potential for achieving benefits to patients and to health care providers because of decreased morbidity. Laparoscopic cholecystectomy has diffused rapidly and widely. However, the spread of other minimal access surgery methods has been more gradual, reflecting uncertainties as to the degree of benefit and rate of change of technology. Firm evidence of efficacy and costs of the new methods is still limited, and a number of organisational issues continue to demand attention.
-
Australian political leaders and policy analysts have increasingly sought to learn from Singapore, a nation which, despite its small size and lack of natural resources, has enjoyed rapid economic growth. Of particular interest to Australian policymakers has been Singapore's compulsory superannuation system, which has provided high levels of domestic savings and high levels of home ownership; it has also incorporated a scheme to enable Singaporeans to save for the costs of health care. ⋯ Saving for health care costs has been a largely neglected option in recent policy debate about reforming funding arrangements for hospital care in Australia. The potential for a formalised scheme for medical savings in Australia, subsidised by taxation concessions, is explored in terms of its socioeconomic policy implications, its congruence with Australian values, and the logistical ramifications of such a scheme.
-
Although constrained by Federal financial dominance, State governments can, nevertheless, significantly shape a number of aspects of health policy within their own jurisdiction. New governments often seek to implement both substantive and symbolic policy changes. This is often also accompanied by alterations to organisational structures and personnel with a view to making implementation more effective. ⋯ The decision-making style of the new government is also discussed. The authors regard the economic imperatives of Victoria's severe deficit as the dominant influence in all areas of public policy, including health services policy, although certain ideological predilections have also been evident. They further argue that the new government has primarily sought legitimacy by appealing to what it regards as its mandate to rectify Victoria's 'economic crisis' by reducing public expenditure and reforming managerial practices in the public sector.
-
Against a background of the appalling health problems experienced by indigenous Australians, the following discussion details the current status of health services for Aboriginal and Torres Strait Islander peoples and recent government and non-government initiatives to address these problems. In many localities, health services are overwhelmed by the tasks confronting them. State and Territory governments, having primary responsibility for the health of all citizens, must act in close cooperation with local communities, the Aboriginal and Torres Strait Islander Commission (ATSIC), regional councils and Aboriginal health services to ensure inequalities are addressed in health service provision to Australia's indigenous people. ⋯ A primary task remains to implement broader scale changes relevant to Aboriginal and Torres Strait Islander people within the mainstream health services. Mainstream services have the primary responsibility, and are funded on behalf of the whole population, to address health problems in a working partnership with the communities they serve. The Australian Hospital Association and its membership can help to improve the health of indigenous peoples by actively and sensitively working with them in the localities where they live, and through advocacy in the policies and plans that shape the whole of our health system.