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Fit for the future - Planning for the Future: NSW Health 2025

Key comments made in this submission

• NSW Health is to be congratulated on initiating consultation to establish consumer views on the future of health services.
• Equitable access to health care is central to developing an affordable, high quality system, which is capable of sustaining a healthy community. That equity will not be achieved for people with disability until structural and attitudinal barriers are eliminated.
• Advisory bodies to NSW Health need to include people with disability who are more often aware of the existing structural barriers which work against equitable service delivery.
• Strengthening primary health and continuing care in the community must be fundamental to the future success of our health system.
• Targeted health promotion for people with disability, including funded preventative health care for designated groups with poorer health outcomes, is essential to the well-being of people with disability. Targeted health promotion has the incidental benefit of reducing costs elsewhere in the health system and/or later in the life-cycle of individuals with disability.
• The current silo mentality of Area Health Services (AHS) must be addressed further to reduce costs and improve the experience of people with disability accessing the health system.
• A person-centred approach is needed across the whole health service system. Service system responses to people with disability presenting for treatment (or support) should be no less individualised than responses to those without disability. This is not always true in today's service system.
• Redesign of the workforce is essential over the next 20 years. We should not maintain the traditional hierarchy of 19th and 20th Century health service models, often based on acute services. We need a 21st century workforce with modern skill sets and contemporary relationships.
• The development of alternative models of care will improve experience of the health system, reduce costs, and ensure people are better able to function effectively in the community.
• The practice of addressing smoking, excessive alcohol consumption, obesity and other health risks needs to be supported with a greater percentage of the health budget. Prevention is better than cure and early-intervention should be the default value of health promotion strategies.
• A seamless service system is required across Government. Its development cannot be limited to improvements in one department (e.g. NSW Health). Both primary health care and prevention should be everyone's business. A Whole of Government approach and interdepartmental co-operation is essential to its success

Conclusion

All people deserve to enjoy the best health possible. This is as true for people with disability as much as it is true for anyone. Equity of access to the health care systems of NSW must therefore be the cornerstone of all future decisions, funding and delivery of public health services in NSW. We believe the future directions identified by NSW Health are pivotal to achieving such equity.

People with disability will not be treated in an equitable manner, however, until the community as a whole accepts that to do so is an indicator of having attained the 'decent society' toward which our aspirations for social justice must lead us. Government services, health no less than any sector, must lead by example in a concerted, long term drive to reduce then eradicate systemic barriers that hinder equal access, participation and inclusion. NSW Health must pay particular attention to systemic barriers where they impact on the delivery of a high quality responsive health system.

Our comments and recommendations indicate an approach that has merit in considering how to further reduce barriers, including those of stereotyping and differential treatment of people with disability, currently commonly experienced by people with disability engage with the health systems of NSW.

We offer these observations as a supportive and encouraging contribution to the commendable strategic thinking evidenced by NSW Health in "Fit for the future". Council looks forward to continuing liaison, through partnerships and dialogue, with NSW Health as it strives to modernise the health system, equipping it with the culture, personnel, skills and performance levels that will be required to be responsive and appropriate to the needs of all in the community, now and in the decades ahead.

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