Challenges and Reforms in Australian Health System: A Focus on Aged Care

This article discusses the challenges and reforms in the Australian health system, with a focus on aged care. It covers the different programs and services offered to elderly people, workforce distribution issues, and the need for reformation. The article also highlights the importance of a holistic approach and collaborative practice in providing quality healthcare services.

Introduction
Health systems can be defined as an organization or institution that provides health care services
to fulfill health need of targeted population. The primary purpose of health system is to restore,
promote and maintain good health. A good health system is one that is easily accessible,
provides quality services in time to people of any group or community without any
discrimination. Health care system of Australia is considered as one of the most accessible,
affordable and comprehensive in the world (Duckett, 2017). It promotes good health and makes
sure that Australian people have access to health and family services like aged and community
services, children and family services, public health initiative, pharmaceutical and Medicare
benefits, disability programs, proper health services for indigenous, emergency services, health
care and hospital funding etc.
In Australia health care is provided by both private and government organizations and has a
range of regulatory and funding mechanisms. Australian government’s main role is to develop
broad national policies, funding and regulation (Australian Institute of Health and Welfare 2016,
2016). Similarly, local and state government are responsible for management and delivery of
public health services. It also includes regulation of private hospitals and health professionals.
Australian health system is considered to be the one of the world’s best medical service provider
with positive outcomes, but it is not effective and efficient in some sectors. There are some
sectors that are major concern and needs change and reformation. Some of issues in Australian
health system are: improper workforce distribution, inaccessibility of health service to
indigenous people and people in remote and rural areas, low fertility rate, escalation in
profession skills, increasing number of elderly people in Australia and not able to provide need-
based health care etc. there is also increase rate of chronic disease, obesity, mental disorders etc.
in Australians (Jackson & Shiell, 2017). The health system requires better policy and strategy to
solve issues. They could apply holistic approach to develop Australian heath workforce and
outcomes. Holistic health care is a system that considers total care (Eriksson, Möller, & Gillsjö,
2017). It focuses on the emotional, physical, social, spiritual and economic needs of the person. it
takes care of entire human health needs rather than focusing on specific illness or body parts. It
considers whole person like how she or he interacts with environment.
It is important to provide health service that is accessible to people of every age, sex, group or
community, therefore competent and skilled workforce is needed in Australia. It has large work
force with sufficient number of medical professionals like doctors, nurses. But it still could not
provide proper healthcare to everyone. There are key issues in Australian health care system
which is major concern for health system like: improper distribution and supply health
workforce, quality of care, health care service in remote and rural areas, health services for
indigenous people (Bourke, Humphreys, & Taylor, 2012).

Aged care
People over 65 years are considered as aged people and are eligible for age pensions. In
Australia the health care system for elderly people offers many services to provide care needs for
each person. They provide range of services to old people in both residential and community
settings (Davis & Morgans, 2016). There are several programs in Australia that provides aged
care which are as follows:
Home care or Home Care Packages Programme:
It offers several packages of services at different levels of care which include clinical care and
care needs. It enables elderly people to stay in their home as long as possible. As man elderly
desires to stay in their home only.
Common Home Support Programme:
This Programme services is entry level support services like personal care, assistance with meals
and food preparation in order to help aged people stay independently and could stay in their
home for longer period.
Residential aged care
It provides variety of care option and accommodation on temporary or permanent basis for those
who are unable to live independently at their place.
Flexible care
It provides several flexible care programs for special circumstance and groups in mixed settings
including other mainstream programs. Transition care is one of the largest programs as it
provides support for people to go back to their home after getting admitted in hospital.
Percentage of elderly or aged people in Australia are increasing as Australian are living longer
than before. Increasing population of elderly has put pressure on government for public spending
on rising health costs and capacity of health system to provide proper service care for them.
Elderly people age group is divided into two groups: 85 and above who have issues like arthritis,
cancer, dementia and the other group is 65 and above who have lifestyle related disease like type
-2 diabetes which doubles the work load of heath service providers. They are higher user of
health services as with increasing age brings many health disorders and disability that brings
challenges to health care providers and systems (Aged Care: a quick guide, 2016). So, there is
increase in demand of health service which needs to be more effective and efficient. Ageing of
population brings direct challenges for health systems like changing health profile, rising health
costs and increase in demands for service use. There are many challenges that aged people faces
to access proper medical help and do not get need based care. Government is trying to sort issues
by reforming policies to provide them easy accessibility and high-quality services. There are
legislative and policy framework which is aimed at preventing any kind of discrimination against
elderly people. There are several problems like limited choice of services, variable quality of

service, insufficient skills of many health workforce, expensive, lack of need-based care, holistic
approach, culture-based care etc.
In 2010 AMHC which stands for the Australian health minister conference signed a work
program for Health Workforce Australia(NWA) which included the development of National
Health Workforce Innovation and Reform Strategic Framework for Action.it is a call for
redesigning workforce across education and health sector in an efficient and effective way this
framework is to help to redesign the future health workforce while enabling and supporting the
productivity of current workforce (Knight, 2017). The main purpose of this framework is to
support national effort and to guide and support work at local Nd jurisdictional levels. The
framework outline in following way that provides guidance to redesign or reform workforce at
different level:
 Reformation of health workforce for more efficient and accessible delivery of service
 Capacity and skills development of health workforce
 Leadership for sustainable health system
 Planning of health workforce
 Policy regulation funding of health workforce
Redesigning or reformation of workforce
The main objective of workforce redesign is that the health population workforce should respond
to changing demand for health services by maintaining the quality of service. This can be
achieved only when there is best use of resources, their skills required according to the situation
while delivering the service, it is vital to consider the manner in which team is formed their
specific roles, task delegation and substitution of task in order to maximize the use of available
resources to provide quality care (Healy & Sharman, 2006). The shifting of task in workforce
provides an option to expand the resources while reorientation of doctors or physicians towards
chronic disease and care coordination. The nurses and medical practitioners have enough training
to manage or care less critical patient provide counseling and other task of preventive care. This
provide the physician or surgeons extra time to treat the more critical patients with multiple
disorders.
Example of redesigning health workforce:
Role of emergency department nurse practitioners was redesign as below
 To observe and treat patients who have minor illness or injuries.
 To collaborate with groups of patients managed with services Emergency Department
medical professionals
 They should refer and consult to other health care providers within the hospital and
emergency department
 They have to determine and identify health issues and initiate interventions for crisis
appropriately

 Assessment, diagnosis and therapeutic intervention should be done in line with
emergency department nurse standing order.
Role of Emergency Department Physiotherapist:
 Provides treatment incase of bone fracture, soft tissue injuries and seeing them directly
from triage.
 Education role with medical staffs and nurses
 Ability to treat, investigate and discharge patients.
Role of Cardiac Liaison nurses
 Care and assessment of cardiac patients in the Emergency Department
 Provides educational resources for medical and nursing staffs
Health workforce capacity building and skill development
The enhancement of skills through training and practice implies an advancement in existing
clinical skills and knowledge, reasoning so that the practicing health worker becomes an expert
which will make the existing workforce more effective. The service of health care is evolving
with the demographic changes, technological advancement, development in evidence-based
health care process (Thompson, Quinsey, & Eckermann, 2012). To match with the evolving
health care demands and needs, the health care practice also needs to change. In order to address
the growing demand of health services especially in case of old aged people it is important to
ensure the most competent and cost-effective health professionals is delivering the services. This
means the changes in current role in scope of practice to other roles. For example: the addition in
the scope of practice in case of nurses and health practitioners and making them capable to focus
on tertiary care instead of preventive or subacute care. For example: Pharmaceuticals companies
have evolved now as they focus on patient-based practice rather than product-based practice
Collaborative practice
For any strategy to succeed it is important how it is implemented which further depends upon
professional respect, trust within the team members and understanding each other roles.
According to Who, collaborative practice is hen multiple health works coming from distinct
health professional backgrounds deliver the highest quality of services by working with patient,
their families, community and carers. This type of practice covers both clinical and non-clinical
and health counselling, health communication surveillance etc. this practice is gaining popularity
because of its positive benefits related to patient recovery rate and service when medical
professionals from different background together brings varied skills expertise and knowledge
which contributes to effective and efficient patient care. Health workforce in Australia is fairly
large but they still lag behind to provide proper care to everyone. It is important to provide health
care service that is accessible to people of all group or community, sex, age, social class (Health

Professionals Workforce Plan Taskforce, 2011). Therefore, competent and skilled workforce is
needed in Australia. There are many issues like improper workforce distribution, accessibility,
escalation in professional skills are main concerns. Due to many reasons and arrangement
workforce works under pressure. There is a need of reformation through government is trying to
initiate changes. To make older people live independently in their homes and communities for
longer the Australian government launched Common wealth health supports Programme. Under
this Programme entry level residential support to live independently.
Despite several reforms to better the quality of health services and quality of residential aged
care it has been found that current conditions are not satisfactory as per the community
expectations.
In the current scenario the elderly people living in care facilities suffering from disabilities and
mental disorder seek protection. The assurance of quality becomes vital here when families and
residents are not placed properly in contrast to quality facilities available at commercial aged
care centers. Thus, the primary role of the regulatory body should be the consumer protection.
Like many other countries Australia too have an ageing population. As it is natural that old age
people use health services and community care service more often and for longer period than
younger population. The people in old age have number of co m morbidities which require
complex care. The elderly people often need more from allied health and other services in order
to prevent further deterioration in function. This also implies that old people occupy hospital
beds for more days due to their slow recovery rate. Hence it is important to have adequate
number of beds to take care of this section of population.
There is some recommendation to improve the condition of health services in aged care that
health providers should consider. The people in community have different cultures, background
and past experiences. This implies that their requirement of accessing health care facilities will
vary. They must understand importance of diversity. So, it is very vital for health care
organization to understand the various aspects of culturally diverse aged population before
providing care or treatment. The government policy holds direct the health service organization t
be responsive to he needs of people from diverse backgrounds so that these people from diverse
background so that these people face no barrier while accessing the health services and are given
due respect and dignity and supported in every possible way so that their needs are met.
It is important to acknowledge the contribution of carers in maintaining the health of the aged
people. they often provide important information about the patient behavior, attitude, previous
illness and hence should be included in the discussion related to patient treatment with consent of
the patient.

Conclusion:
From the above discussion, it is evident that although there is adequate number of health
professionals in Australia there are still fraction of population who do not receive quality health
services. The number of old aged people seeking health facilities is large but still do not get
appropriate health service. The people of rural areas, indigenous people do not receive proper
health care facilities as compared o the people living in metropolitan cities.
So, for the effective management of heath professional’s nurses and medical practitioners should
be given the role of taking care of less critical patients with serious and chronic illness. The
health professionals should be given proper training for the enhancement of their skills to meet
the evolving need of patients. Lastly, the working of health professionals from different
background together brings vast amount of knowledge, experience and expertise which produce
better outcome and contributed to effective and efficient care of the patient.

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