In March 2010, the Commonwealth Government released A National Health and Hospital Network for Australia’s Future, which set out the architecture and foundations of the Government’s National Health Reform Plan (Commonwealth of Australia 2010). Subsequent negotiations led to the National Health and Hospitals Network Agreement (NHHN) which was signed by all jurisdictions except Western Australia. The original NHHN Agreement foreshadowed the creation of LHNs and Medicare Locals.

On 13 February 2011, COAG agreed to various changes to the original NHHN Agreement. These have been articulated in the Heads of Agreement, with details to be determined over the next few months. The February Agreement will impact on the split of Commonwealth funding for public hospital services. The impact on other streams of activity is, as yet, unclear. However, COAG did acknowledge “the Commonwealth’s lead role in delivering primary health care reform to enable patients to receive the care they need when and where they need it – and in doing so, taking pressure off public hospitals”.

LHNs have been or are currently being established in each state and territory.

The Commonwealth Government is currently advancing the implementation of Medicare Locals across Australia. Approximately 15 Medicare Locals will commence in July 2011. A further 15 will commence in January 2012 with the remainder starting in July 2012.

Medicare Locals will be responsible for a range of issues in creating a better and more integrated set of primary health care arrangements. A key objective is to make it easier for patients and service providers to navigate the health care system. They will also facilitate more coordinated care. Key priorities for Medicare Locals will include:

  • Fast-tracking the afterhours GP care reform to allow patients to receive face-to-face GP services outside normal operational hours.
  • Establishing effective collaborations between Medicare Locals, LHNs and local Lead Clinician Groups once established to deliver more coordinated, integrated, locally responsive and flexible health services.
  • Driving telehealth services via Medicare Locals enabling Australians to receive health services at home. Medicare Locals will be required to support the development of e-health and health information, including shared electronic health records, data provision to drive health system performance, service planning, monitoring and evaluation.
  • Improving the planning of primary health care services to respond to local needs.
  • Implementing new program arrangements through a single funding agreement, giving Medicare Locals flexibility to address areas of need in their local communities.
  • Providing Medicare Locals with the potential over time to manage more flexible funding to target services to meet gaps in service provision in order to meet their local community’s specific needs.
The implications of national reforms are not yet clear for MSOAP and VOS. Neither the original NHHN agreement nor the 13 February 2011 Agreement, are explicit about which level of Government should be responsible for ‘specialist non-admitted patient care’.

The national reforms create two sets of new organisations (LHNs and Medicare Locals) that will have a key interest in access issues for their local communities and a responsibility to engage in planning and service development to meet local needs.