Final Report on RREF 2001 - Department of Health

PART D: ACHIEVING EQUITY IN THE HACC
PROGRAM
The RREF makes a major contribution to achieving equity in HACC as the mechanism through
which growth funds are allocated to regions, but a number of other factors also affect equity of
outcomes in service delivery. The Terms of Reference of the Review pointed to these factors,
and they were raised in the consultations and in research conducted in the course of the Review.
This part of the <strong>Final</strong> <strong>Report</strong> summarises four issues and identifies options through which they
could be addressed in conjunction with the implementation of any revised RREF.
Regional and local planning for HACC
While the RREF is constructed with data at the LGA level, it is applied by DHS only at regional
level for state-wide resource allocation. Some DHS Regional Offices however apply the RREF
at a sub-regional or local level to develop notional resource allocations but the RREF is not
formally applied in this way.
The variability in regional and local planning processes was a subject of major discussion in the
consultations, and a clearer relationship between the allocation of resources to regions through
the RREF and the processes by which resources were subsequently allocated within regions was
seen to be desirable. It is not intended that any revised RREF be applied at the local level, but
access to the basic statistical data compiled in the Review was widely sought and a standard
data base that was regularly updated would make a major contribution to more systematic
planning in all regions. This data then needs to be considered in conjunction with a range of
quantitative and qualitative information on local service provision, including reports using the
HACC Minimum Data Set. As HACC services operate as part of local service systems, local
knowledge is also required and Primary Care Partnerships now provide forums for the exchange
of such information. By way of example, uneven access to region-wide services is a problem
that has to be addressed at the regional and sub-regional level, with resolution depending on the
particular configurations of local services and networks between providers.
The Memorandum of Understanding between the Municipal Association of Victoria and DHS
on local community services planning is another vehicle for advancing integrated regional and
local planning. The level of participation of Local Government in the Review Consultations
indicates the commitment to this goal on the part of Local Government as a major HACC
provider
While planning in conjunction with annual HACC funding rounds is focused on growth funds, it
needs to be emphasised that the amount of these new funds is small compared to pre-existing
levels of funding, and reviews of existing service arrangements are at least as important in
regional and local planning as the development of new services at the margin.
Four further issues relating to HACC planning processes that were canvassed in the Review and
that need to be taken into account in implementing any revised RREF are:
1. Having a statewide notional service mix for HACC was seen to be
useful in providing a benchmark to which regional variations could be
compared. Any notional service mix was not seen as a prescription, but
would rather provide a basis for assessing the reasons for variations that
did arise. Some specification of benchmarks for service provision
would also contribute to assessing the adequacy of service provision.
<strong>Final</strong> <strong>Report</strong> July 2001 82