Leadership for the Sustainability of the Health System: Part 2 - Key ...

The case for change and the place of leadershipIn December 2005 the Productivity Commission identified the demand and supply issues in healththat Australia must confront in the next decade. These issues included:a changed mixture of disease burdens, including increasing numbers of people who will besuffering type 2 diabetes and dementiaincreased individual spending on health care, and increased expectations of timely accessto high-quality health servicesthe need for different models of care and new workforce practices to accommodate andutilise the wider range of treatment possibilities arising from new technologiesan ageing and longer-living population that will significantly increase health expenditure andthe incidence of chronic diseasethe increasing average age of health workers and the need to replace greater numbers ofretiring workers, in a context where health workforce supply already fails to keep up withdemand.In all OECD (Organisation for Economic Co-operation and Development) countries, total spendingon health care is rising faster than economic growth, and it has been predicted that the cost ofhealth care could reach 20% of gross domestic product by 2020 owing to the increasing affluenceand longevity of populations in developed countries. 6 Australia’s changing age profile willsignificantly increase health spending. Spending on the over 65s may be as much as four timesmore per person than on those under 65. 7In light of the global nature of health and health workforce challenges, and the results of researchand evidence both at home and overseas, the momentum towards health service redesign mustincrease, and the workforce reform and innovation necessary to support it must also increase. Thepace, level and nature of the needed change and innovation demand significantly increasedleadership at all levels of the system.The current focus is on:increasing numbers in the workforce—increasing numbers of clinical training places,encouraging re-entry, supporting retentionredesigning to support increased productivity—organisational and service redesign toincrease engagement in direct patient care by health professionalsrole redesign—efforts to ensure all professions work to full capacity and maximise return oninvestment in specialist training, and creation of assistant roles to free higher-skilled parts ofthe workforce arising from activities that only require a lower level of skill6Fogel RW (2004). The Escape from Hunger and Premature Death, 1700–2100: Europe, America, and the Third World.Cambridge Univ Press, Cambridge UK.7Productivity Commission (2005). Australia’s health workforce. Productivity Commission Research Report, Canberra,Australia.Leadership for the Sustainability of the Health System: Part 2 – Key Informant Interview Report Page 6