Federal health boss Martin Bowles on his role as steward of a strained system

By The Mandarin

Friday May 5, 2017

With more than $160 billion a year being spent on healthcare in Australia across the public and private sectors, the role of the federal Department of Health is often not really understood, secretary Martin Bowles told an international rural health summit in Cairns.

Delivering a keynote address on the topic of “government responses to global change” to the recent World Rural Health Conference, Bowles explained the department’s crucial stewardship role, developing strategic and long-term policy directions for the Australian Government.

“It is our role to gather intelligence on what is working and what is not, what is happening, what are the interdependencies in our system and what are we doing about those,” he said.

“I believe another role of a steward is about building coalitions and maintaining partnerships like this coalition of rural health organisations at this conference.

“We need also to ensure accountability across the system to make sure that we can keep delivering the excellent care that is provided in this country. And I think we need to develop a culture that allows us to deliver on our policy objectives.”

”In the Department of Health I have put data analytics, evaluation and research right at the centre of our policy thinking.”

Bowles explained how the Department of Health played a significant role and had considerable influence in the national health arena, while speaking openly about the fact there is always room for improvement. In this regard he focused on consumer engagement.

“We haven’t always done it well, but we are getting much better. I think one of the real weaknesses up until recently has been that we haven’t really engaged well with stakeholders, we haven’t really brought them in and had proper conversations and we’re trying to do that a lot more.

“What we’re trying to do at the moment is really open up the conversation in quite a different way. Hopefully we’re getting there. I think we’re getting better. I know we’ve still got a little way to go though.”

Bowles said that while Australians have access to high quality healthcare, by international standards, the system was actually under pressure and facing quite a number of issues, notably the growth in chronic and complex diseases.

“I meet quite regularly with the states and territories and they talk quite openly about the issues within the hospital sector with chronic and complex patients.

“We also have an ageing population. It hits us in a couple of ways. One, as people age they need the healthcare system more and two, of course, workforce, which is quite a difficult issue for us.

“The third issue is technology change. And if you’ve looked at anything around genomics, precision medicine and some of the things that are coming down the line, the advance of technology in this space will fundamentally change the system we have today. And I don’t think we have very long before we’re actually there.

“I believe that one of the other major issues that is actually driving where we go a lot of the time is consumer expectation, and we need to better handle consumer expectation because they will leave us behind.”

Bowles told delegates the Australian health system was increasingly under strain and quite complex, especially due to the divide between the Commonwealth, states and territories.

“The costs across the MBS, and PBS and aged care are growing, along with the cost of technological change,” he said.

“If you think about pharmaceuticals into the future and precision medicine, where we’re really trying to focus down on people’s particular issues, it sounds as though we’ll get better and it will become a little bit more economical to do that, but that won’t happen in the first instance. We must be patient and methodical and innovative.”

Closing gaps with technology

Bowles said that the while Australia’s health system was delivering for most people, there were obvious gaps, in particular in the care of Aboriginal and Torres Strait Islander people, for people in some rural, regional and remote communities, and for people with mental illness.

“There is a lot of work going on to close these gaps, and one driver for change is the use of electronic health records, telehealth and data collection,” he said.

“Workforce shortages continue to be an obstacle to good health outcomes for people living in rural, regional and remote areas.”

“We must, start to understand data more broadly in our system. In this country, the datasets we have are phenomenal but complex.

“There are significant risks in some of these issues, but we cannot let those risks limit our thinking and if we start to look at the data. we will understand better a patient’s journey.

”In the Department of Health I have put data analytics, evaluation and research right at the centre of our policy thinking. And I do believe it has actually helped us to shift some of the long-held views and actually get a better policy outcome for the long term in Australia.”

A major challenge for the Australian health system is the health workforce, an issue that has now moved from the need for more health professionals, to distribution – the need to ensure that doctors and allied professions are available where they are needed.

“Workforce shortages continue to be an obstacle to good health outcomes for people living in rural, regional and remote areas,” said Bowles.

“The Australian Government is in the process of developing and implementing policies to address the major workforce issues facing Australia, now and into the future. These new initiatives aim to ensure people have access to the right health professional, at the right time, in the right setting.

“It is important to ensure Australia’s health workforce can respond to the particular needs of each community, which includes the Aboriginal and Torres Strait Islander population.

“It is also not just about numbers, but about ensuring that all health professionals, and service providers, are culturally appropriate.

“Working toward these aims is another stewardship role of the federal Department of Health which I am committed to see advance as quickly as possible for the benefit of all Australian consumers.”

This article was prepared by The Mandarin from a summary of the speech provided by the Department of Health.

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