Discipline of General Practice, University of Queensland, Brisbane, QLD, Australia.
Med J Aust. 2010 Mar 1;192(5):284-7. doi: 10.5694/j.1326-5377.2010.tb03510.x.
Australia's health care system is at a crossroads. It is recognised that the fragmentation of health services, largely caused by the split between Commonwealth and state government funding responsibilities, is undermining patient care. The National Health and Hospitals Reform Commission (NHHRC) has advanced two models of health-system governance to redress this situation - neither incorporating the regional approach so prominent in submissions to the NHHRC and included in Option B of the NHHRC interim report. A regional governance framework such as that described in this paper could keep faith with the importance widely given to local engagement during the consultation process; sit neatly within the NHHRC's Healthy Australia Accord option; make regions responsible for funding allocation and service delivery; eliminate major weaknesses in our current system; and provide stability to the system at a time of significant reform.
澳大利亚的医疗保健系统正处于十字路口。人们认识到，卫生服务的碎片化在很大程度上是由于联邦政府和州政府的资金责任分割造成的，这正在破坏患者的护理。国家卫生和医院改革委员会（NHHRC）提出了两种卫生系统治理模式，以纠正这种情况——这两种模式都没有纳入提交给 NHHRC 的报告中以及 NHHRC 中期报告的备选方案 B 中如此突出的区域方法。本文所述的区域治理框架可以遵循在协商过程中广泛重视地方参与的重要性；整齐地纳入 NHHRC 的《健康澳大利亚协议》选项；使区域负责资金分配和服务提供；消除当前系统中的主要弱点；并在进行重大改革时为系统提供稳定性。
