|Implemented in this survey?|
In June 2005, the Australian Senate Community Affairs Committee released a report, titled "the cancer journey: informing choices". The committee was made up of 2 Senators from the governing coalition parties, 3 from the opposition party and 1 independent. The report examines the key areas of multi-disciplinary and integrated service delivery and the use of complementary and alternative treatments. It made 33 recommendations aimed at improving treatment choices and outcomes for cancer patients.
Australia's health care system is often accused of being fragmented and uncoordinated. This is said to create real quality and access problems for patients with illnesses such as cancer which require care over extended periods of time, by multiple providers in a variety of public and private care settings. The Senate report aims to highlight those issues and recommend ways in which they can be addressed. The overarching focus of the recommendations is to provide patients with more information about available treatment and support services, and to create greater financial incentives for providers to offer multidisciplinary care.
In cancer care there often appears to be a dichotomy between the doctors and patients attitudes towards treatment options; doctors tend to stick with scientifically proven treatments whereas patients are often looking for the most promising options in order to improve their odds. However, lack of data and the cost of less conventional or adjuvant therapies creates frustration and uncertainty for patients too. The Senate inquiry aimed to shed some light on these issues and look at these problems from the point of view of patients.
The report's recommendations create a number of incentives. In particular the recommendations call for:
Cancer-care patients, Cancer-care providers
|Degree of Innovation||traditional||innovative|
|Degree of Controversy||consensual||highly controversial|
|Structural or Systemic Impact||marginal||fundamental|
|Public Visibility||very low||very high|
Obviously it is too early to tell, but the recommendations have the potential to make a significant difference to the information that patients are given and are designed to give them more power over their treatment and care options.
In the 2004 federal election campaign, the Government offered a range of new policies related to cancer care. This included the establishment of new national agency called Cancer
Australia. Its role, in part, will be to bring together the plethora of cancer-related organisations, services and interest groups and make recommendations to the Federal
Government on cancer policy and priorities.
Following the government's re-election, the Australian Senate referred the following matters to the Community Affairs Committee, on the motion of Senator the Hon. Peter Cook, to inquire and report on:
The Senate report, brought down in June 2005, makes several recommendations on the future role of Cancer Australia.
Senator Cook was diagnosed with late stage melanoma in August 2004 and has now retired from the Australian Senate.
|Implemented in this survey?|
During its inquiry the Senate Community Affairs committee received 113 submissions from a range of organisations, individuals and Commonwealth and State health departments.
Previous reports by various organisations such as the Cancer Council of Australia, the Clinical Oncological Society of Australia and the National Cancer Control Initiative have identified the need for a more consumer driven approach to cancer care, including greater coordination of cancer services.
The reforms recommended in the report are not new but the Australian parliament has provided a means for these recommendations to be considered at a national level - across party lines.
The approach of the idea is described as:
renewed: The previous reports by cancer-related organisations identified above were first published between 2001 and 2003
A number of cancer organisations, including the Cancer Council of Australia, made public statements to endorse the Committee's report. The Senate report received very favourable and
relatively extensive media attention.
It is not clear what the Australian Medical Association's (Australia's main provider association) views on the recommendations are.
|Opposition and independent senators||very supportive||strongly opposed|
|Government Senators||very supportive||strongly opposed|
Given that the report was unanimously endorsed by the Committee, it is likely that the Government will formally respond to the recommendations.
If a formal response is made, the Government is likely clarify which recommendations it supports and provides details of how it plans to implement those recommendations. The influence, if any, of the legislative process will become clearer after this.
|Opposition and independent senators||very strong||none|
|Government Senators||very strong||none|
A formal response to the Senate report is likely to contain further information about the Government's intention to adopt and implement the recommendations.
The report was released in June 2005 and the Government is as yet to formally respond to the report's recommendations. It is therefore premature to make an overall assessment of the policy.
However, in the context of the Australian health care system it is difficult to instigate change without the support of the conventional medical fraternity. Yet, a large number of the recommendations contained in the report relate to complementary medicine as well as allied health and psychosocial support services.
There is therefore a risk that in developing more detailed policy statements arising from the report's recommendations, support amongst conventional providers will evaporate if they perceive a threat to their funding or status.
|Quality of Health Care Services||marginal||fundamental|
|Level of Equity||system less equitable||system more equitable|
The recommendations have the potential to empower consumers and create greater incentives for providers to respond to the patient needs and wishes. The recommendations also make specific provisions for more equitable access to services in rural and remote areas and the indigenous population.
Community Affairs References Committee. The cancer journey: informing choices, Report on the inquiry into services and treatment options for persons with cancer. June 2005. report available at http://www.aph.gov.au/senate/committee/clac_ctte/cancer/index.htm
Kees van Gool