AUSTRALIA’S  HEALTH SYSTEM STILL NOT UP TO SCRATCH

Canberra Report

DISSATISFACTION with the state of the health system is higher in Australia than in 10 other countries, with the sole exception of the US.

According to a landmark report we received last month, one-quarter of people in NSW, and nearly one in five Australians, think there is so much wrong with the system that it needs to be completely rebuilt -- compared with 27 per cent in the US, and just 11 per cent in New Zealand and France, 8 per cent in Sweden and Switzerland, and 3 per cent in Britain.

But the first annual report from the bureaucrats in NSW Health department ,which was set up following the highly critical Garling inquiry into the state's health system -- has found the Australian health system's true weak spots are not those given most attention as part of the federal government's health reform program, which has been criticised for being too hospital-centric.

Despite the public focus on emergency department and elective surgery waiting times, the report found both NSW and the rest of the country ranked roughly in the middle on these and on many others of the nearly 90 performance measures. In contrast to the portrayal by last year's National Health and Hospitals Reform Commission report that Australia's health system was "at tipping point", nearly half (46 per cent) of patients in NSW, and 56 per cent in the rest of Australia, had to wait less than a month for surgery.

This was much lower than the 78 per cent in Germany or 68 per cent in the US, but much better than Canada (35 per cent) and Sweden (34 per cent).

Instead, the report found the system's Achilles heel to be in the treatment of patients with chronic diseases, such as lung disease and diabetes, in rates of avoidable hospitalisations and in ensuring services remain affordable.

In NSW, rates of lower limb amputations was 17.7 per 100,000 people, a figure surpassed only by the US (35.7 per 100,000) and much worse than Britain (9), Norway (10.9) and Canada (11.3). The report uses data from the OECD and US-based Commonwealth Fund, and contains NSW-specific figures after the bureau paid both organisations more money to gather extra data.

Caesarean rates -- another source of avoidable hospitalisation -- have risen much faster in Australia over the past decade than in other countries.

Bureau of Health Information chief executive Diane Watson said the figures showed the management of chronic diseases "could be better".

"Better management of chronic conditions reduces the need for hospitalisation," Dr Watson said.

Jan Newland, chief executive of General Practice NSW, the umbrella body representing the state's 33 divisions of general practice, said the report showed that "chronic disease is going to overtake everything".