According to the Oxford English Dictionary, reform is the “amendment of some faulty state of things”. Many commentators including Medibank architect, Dr John Deeble, say that few, if any benefits in medical services will be delivered by Prime Minister Rudd’s new health funding model.

The medical profession is timid in its response to the plan even though it is very well placed to make a meaningful judgement about the efficacy and wisdom of the proposal.
If the doctors are quiet because of a lack of know-how about the intricacies of Federal funding, spare a thought for the ordinary citizen who must decipher Rudd’s rhetoric with only rudimentary knowledge of these matters.

Clearly, the costs of health are rising whilst the quality of services is declining.
And, why are health costs rising whilst quality is declining? The answer is complex but contributing factors include; the rising cost of new technology, increased layers of bureaucracy, poor management, increasing administrative paralysis, inefficient work practices, dubious quality assurance programmes as well as, flawed policies over the past quarter of a century.

So, will the new Federal/State funding arrangements alleviate the current problems of Healthcare delivery? In the long term I doubt it.

But, Prime Minister Rudd’s sweeteners may provide some short-term relief though.
Some of the manifestations of our ailing health system include stress in primary health, public hospitals, Mental Health and aged care.

For example, emergency department waiting times and “bed block” the inability to shift sick patients out of emergency because there are insufficient beds in the inpatient wards.
Prolonged waiting times on the outpatient booking queues so one sees a waiting list to get on the waiting list.
We all know about prolonged elective and emergency waiting times.

There are primary healthcare and GP workforce shortages. There are mental health issues in the community and public hospitals. Increased demand for aged care producing stresses on public hospitals and primary health.

To achieve genuine reform we need an over-arching conceptual plan that integrates all elements of health including service delivery, education and research. Problem solving will require expert assessment, accurate diagnosis, the correct treatment plan and political will. Patience may be needed as it may take a couple of decades to effect change and bring about improvement.

It will not be an easy task as there are many nettles to be grasped, only the brave and wise politician or government will take on issues such as the vested interests of the medical and nursing professions, a vast and at times, indolent bureaucracy and a rampant quality and standards industry.

Added to this is the daunting task of reining in the expectations of the public and its appetite for the highest quality health care at a bargain basement price.
Attempting to reverse entrenched profligacy of the consumer and the health industry is risky business for the major political party that is why Mr Rudd is only prepared to tinker with the behemoth at its edges.

The subtext of the debate is that we are getting to the point where we cannot afford cutting-edge health care unless we address productivity or we expend more than the current estimated nine percent of gross domestic product.
Another way forward is to consult the electorate and involve the community in formulating health policy – let the ordinary Joe Citizen have a say in how much GDP should be spent in this way.

What better way of achieving this than with a national health summit? If this were undertaken as a solemn, problem-solving crusade, genuine reform could be achieved in a more effective and timely manner than we are likely to witness with Mr Rudd’s fiscal gymnastics strategy.

Dr Katsaros is the Director of the Plastic and Reconstructive Surgery Department of the Royal Adelaide Hospital (RAH). He gained the Australasian Fellowship in Plastic and Reconstructive Surgery (F.R.A.C.S), and combined this with three years overseas experience in Glasgow (Scotland), Norfolk, Virginia (USA), and Louisville, Kentucky (USA).