The AMA has a strong and direct interest in performance of the health system. It proposes that NHPA's Strategic Plan should more explicitly focus on how NHPA will work with its stakeholders. This should include implementing a process to provide comparative information to 'source' health care organsiations prior to public release, and minimising the cost of data collection and reporting. The Strategic Plan should include broad timeframes and bring forward work on teaching, training and research,and waiting lists for elective surgery. Performance monitoring should also focus on key on the ground issues related to capacity, access and sustainable delivery of services.
The AMA's submission on the IHPA Work Program 2012-13 notes the significant changes to hospital funding arrangements with introduction of the new hospital pricing framework and the National Efficient Price for hospital services. IHPA work program needs to address the potential for adverse impacts on the number and mix of services provided and to addressing quality of care and adequate provision for teaching, training and research as part of the pricing framework. It reiterates the AMA's calls for hospital services to fund on the basis of an "effective" rather than an "efficient" price.
The AMA submission to the Australian Institute of Health and Welfare and the Royal Australasian College of Surgeons highlights that: urgency categories should facilitate patients being prioritised for surgery fairly and equitably; category definitions should take account of all the factors relevant to a patient's requirement for surgery; the primary driver for surgeons to categorise elective surgery will always be clinical urgency; and elective surgery waiting time should be counted from the time the patient is referred by a general practitioner to a surgeon for assessment until the time surgery is performed.
The AMA Public Hospital Report Card 2011 has found that there has been
little improvement in public hospital capacity and performance across
Australia in 2009-10, despite extra Commonwealth funding.
It has been very much business as usual as public hospitals struggle to
The AMA's submission to the Senate Finance and Public Administration Committee on the National Health Reform Amendment (Independent Hospital Pricing Authority) Bill 2011 highlights the importance of the Pricing Authority, the Australian Commission on Safety and Quality in Health Care, and the National Health Performance Authority collaborating on their roles and responsibilities, for example, on data collection requirements.
It also points out that the Pricing Authority should consider the standards set by the Performance Authority when calculating the national 'efficient' price, that is, it must take into account the performance that must be achieved. In addition, the National Health Reform Agreement allows states to pay hospitals less than the determined efficient price, therefore, we recommend that the actual payments made to hospitals are reported to Parliament so that it is clear when poor performance is linked to insufficient funding.
Overall the Bill before Parliament responds to the AMA's lobbying last year to ensure the Pricing Authority considers the range of variables affecting the actual costs of providing health care services when calculating the national efficient price. However we recommend that the Authority is explicitly required to ensure hospitals can fulfil their teaching and research obligations.