Thursday, 5 May 2016
Standing Committee on Health; Report
On behalf of the Standing Committee on Health I present the committee's report on its inquiry into chronic disease prevention and management in primary health care together with the minutes of the proceedings.
Report made a parliamentary paper in accordance with standing order 39(e).
by leave—Recent societal and lifestyle changes have had profound effects on the illnesses that beset the Australian population. While medical advances have increased life expectancy and decreased mortality rates, the increase in sedentary workplaces and lifestyle factors such as diet, exercise and habitual behaviour such as smoking and excess alcohol consumption has seen the incidence of chronic disease skyrocket, both domestically and internationally.
According to the World Health Organization non-communicable chronic diseases are responsible for 70 per cent of mortality rates worldwide and, unfortunately, 90 per cent of mortality rates in Australia. The vast majority of these are lifestyle diseases, such as type 2 diabetes and most chronic respiratory conditions.
The primary health care system is ideally the mechanism for addressing the rise in chronic disease, however the fragmented nature of the current care model challenges the system's ability to deliver the best patient outcomes.
The fluid and open definition of chronic disease can also complicate prevention and management programs, as any condition with persistent symptoms and duration can be classified as a chronic disease.
Many specific health conditions were highlighted during this inquiry, however many illnesses and conditions not mentioned in the committee's report are just as relevant as those that are mentioned.
The federal, state and territory governments, as well as private health insurers and individual providers and peak bodies, all have a role in preventing chronic disease, although more could be done to coordinate the programs that exist, as well as widening the scope of screening activities that can identify the earliest signs of chronic disease.
The coordinated care and multidisciplinary approach to improved chronic disease management is evident in the examples that show best practice in Australia and internationally. The Wagner chronic care model, patient centred medical homes and supported self-management of chronic disease are evident in health care systems across the world.
These models can help inform the development of chronic disease care into the future, the first steps of which will be made with the Healthier Medicare introduction of Health Care Homes trials in 2017. The Health Care Homes trials announced by the Prime Minister and the Minister for Health on 31 March as part of the Healthier Medicare package will help to improve the prevention and management of chronic disease and with appropriate funding, privacy considerations, capture and consolidation of data, and a focus on research and improvement the cooperative care goals required to improve chronic disease primary care can become a reality.
The improvements that will come from these trials are welcomed by all Australians, though the positive impact they can have on care outcomes for low socioeconomic status, rural and regional and Aboriginal and Torres Strait Islander populations may be profound. About 65,000 Australians will participate in initial two-year trials in up to 200 medical practices from 1 July 2017.
The submissions and evidence received during this inquiry have indicated that the groundwork to improve the primary health care system to better prevent and manage chronic disease already exists across all providers and interested parties.
It is clear, however, that this cannot occur without cooperation, coordination, evaluation and adequate data and records to support Primary Health Networks in fulfilling their important role as coordinators of care.
Performance measurements, expansion of chronic disease items, improved referral and rebate claiming processes and encouraging private health insurers to manage their members in cooperation with the primary healthcare system is a clear goal.
The current regulatory and legislative framework that governs private health insurance in Australia is complex, but there are small areas of improvement that could be made to the Private Health Insurance (Health Insurance Business) Rules 2015 regarding expanding the providers that can be used by private health insurers in chronic disease management plans.
The committee appreciates the efforts and honesty of the large number of organisations and individuals that contributed to the inquiry. The breadth of chronic disease prevention, management and research in the Australian community is evident and the desire to improve the system was the overwhelming message communicated to the committee.
I thank all those who have contributed to this inquiry. I also thank the committee members for their participation and contribution to this important and wide-ranging inquiry and the secretariat—Jeff Norris and Stephanie Mikac—who did an enormous job. I also thank my colleague the member for Shortland, who I know is going to talk on this subject—it is one of her favourites. I would like to personally thank her for the time we have spent on the health committee since 2009 for the cooperative and helpful assistance that she has given while I have been the chair of the committee. On a personal note, I wish her all the best for the future. I want to thank all members of that particular committee. I commend the report to the House.
by leave—I rise to support the report that has just been tabled by the Standing Committee on Health, Inquiry into chronic disease prevention and management in primary health care,and to emphasise the importance of dealing with the issue of chronic disease. It is vital that government puts in place a proper strategy to deal with chronic disease, and it starts with prevention. I look at the inquiries that the committee has dealt with over the time that I have been involved with it. I was lucky to be on the first health committee in this parliament where we released The blame game: report on the inquiry into health funding. I would like to emphasise that practically every inquiry we have had has linked into chronic disease of some type. It shows that you can look at one disease, one illness and one category of diseases, but we need to look in a more holistic way and understand that all of these diseases contribute to and make up chronic disease—for example, things like dementia. One of the key inquiries we did that relates to chronic disease was on obesity. So many of the chronic diseases hang off obesity. You look at heart disease, cancer or asthma—everything that we do, every chronic disease, links into lifestyle. I think it is very important that we take note of this report and that we look at it. I would say that there is more work to be done in the next parliament.
I have to put on record my thanks to the committee and the committees over the years that I have worked with in health as well as a special thanks to Steve Irons, the member for Swan. It has been wonderful working with him. I know that he has a total commitment to health. Sometimes we look at things a bit differently but, overwhelmingly, we have the goal of improving health, improving the availability of health care for people in Australia and to giving people the opportunity to lead a healthy lifestyle. Thank you.