ICT the biggest infrastructure challenge for health: Leeder

As the senior members of the Coalition's leadership team meet in Canberra today, public health expert Stephen Leeder predicted that general practice would be the field where new initiatives will probably appear first under the new government.

Professor Leeder, director of the Menzies Centre for Health Policy at the University of Sydney, repeated his belief that IT and computerisation was “the biggest infrastructural challenge facing Australian health care”.

Professor Leeder told The Conversation website in response to the Coalition's win that “general practice is the field where new initiatives will probably appear first under the new Coalition government.”

“There is not likely to be enhanced funding for public hospitals,” he said. “No promises of substance have been made about aged care, palliative care and support for those with crippling chronic conditions.

“What will happen with subsidies for private health insurance, funding for prevention, support of medical and health research, or the biggest infrastructural challenge facing Australian health care, IT and computerisation?

“Indigenous health has received little airplay, as has rural and remote health. Watch this space. There is a lot of it to fill.”

Professor Leeder told an Australian Information Industry Association (AIIA) forum in Sydney recently that Australia was a long way behind – “I'd say two decades behind” – in terms of IT best practice in healthcare in comparison to health services such as Kaiser Permanente and Intermountain in the US.

“We've got a bit of this here and a bit there, but it was declared some sort of miracle about three weeks ago that we now have a relatively uniform email system,” he told the forum.

He laid the blame for the problem with poor quality management, both in the public and private sectors.

“How many billions of dollars has NSW Health invested?” he said. “Over the years that I've been working in it, my goodness the amount of money that has gone into bright ideas that have ended up going nowhere. It's just stupendous. That is not the problem of the ICT, it's the problem of management.”

The Coalition did not reveal much of its plans for health IT and eHealth before the election beyond reiterating statements that parliamentary secretary for primary health, Andrew Southcott, made to Pulse+IT in February, when he said the Coalition would do a “stocktake” of the PCEHR.

More recently, probable new health minister Peter Dutton criticised the implementation of the PCEHR, calling it a “$1 billion disappointment” and “flawed”.

Mr Dutton said that the Coalition would “assess the true status of the PCEHR implementation and again work with health professionals and the broader sector to provide real results on this important reform for patient care.”

Health economist Stephen Duckett, program director of health at the Grattan Institute, told The Conversation that going into the election the Coalition “had adopted a small target, steady-as-she-goes election strategy, giving no hints about what the new government’s intentions will be on the health front”.

Dr Duckett said one clear commitment was that “the bureaucracy will get a haircut” under the new regime.

“The Department of Health and Ageing has already started to downsize, but the Coalition’s savings initiatives will require further reductions in staffing,” he said.

“The alphabet-soup of portfolio agencies, each with its own staffing establishment is also to be reviewed, with agency mergers or abolitions on the cards.”

Rod Tucker, a laureate professor at the Institute for a Broadband-Enabled Society at the University of Melbourne, lamented the probable demise of Labor's plans for the National Broadband Network, but said he hoped that once the dust settles, the “Coalition will realise how foolish it would be to miss the opportunity for Australia to acquire a world-class” fibre-to-the-premises network.

“The Coalition is unlikely to do a total policy about-face,” Professor Tucker said. “But if good sense prevails, it will modify its plans so that the network is not too far removed from the original FTTP vision.

“In areas where Telstra’s copper network is unable to support fibre-to-the-node technology, for example, FTTP could be rolled out instead.

“Overall, the key challenge for the Coalition is to build a network that meets Australia’s ever-growing appetite for broadband and does not become obsolete by the time it is completed.”

The new government will have two medically trained MPs in its outer cabinet, including Dr Southcott and parliamentary secretary for rural health services and indigenous health Andrew Laming.

Dr Southcott is a former hospital physician who also worked briefly as a locum in general practice before entering Parliament in 1996.

Dr Laming has worked as a rural GP, has a diploma in obstetrics and gynaecology and has advanced training in ophthalmology. He also holds several masters degrees in public administration, public policy and public health.

Two of the Liberal Party's big hopes leading into the election were cardiologist Michael Feneley, a senior medical researcher at the Victor Chang Cardiac Research Institute and director of cardiology at St Vincent's Hospital in Sydney, and ophthalmologist and former AMA president Bill Glasson.

While some early polls were showing Professor Feneley in with a chance when he was facing former education minister Peter Garrett in the Sydney electorate of Kingsford Smith, he only managed a two per cent swing on a two-party preferred basis against Labor's Matt Thistlethwaite.

Dr Glasson achieved a much more substantial swing against Kevin Rudd but it was not enough to unseat the former prime minister. Dr Glasson told the Courier-Mail today that he would return to work as an ophthalmologist but may consider running again if Mr Rudd decides to retire from politics and a by-election is held.

Posted in Australian eHealth

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