Page 1551 - Week 06 - Tuesday, 18 May 1993
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into any context at all. This paper has absolutely nothing in it to suggest what might be in our health system in the year 2020. Mr Kaine made some interesting comments about looking back 27 years or 30 years.
Mr Kaine: What is in it for 1994? That is a good start.
MRS CARNELL: That is right. That is what I was talking about, Mr Kaine, on the basis that we cannot work out what is in it for next year, let alone what is in it for 27 years down the track. It is very hard to see the relevance of the paper. Again, the paper talks about a number of very interesting ideas and things that are not all that far down the track at all, things that are actually in place in many overseas countries. But it does not take the next step of looking at what our health system might be like in the year 2020 - the things we will need to be planning for. One of the more interesting comments in this paper is this statement:
"More of the same" will no longer be good enough.
I could not agree more. That really means that from this year on we must take that statement on board. More of the same will no longer be good enough. We will not be able to run our health system or, for that matter, anything else exactly the way we have in the past - just cut 2 per cent, or whatever we are planning to do - and expect this vision statement to be anything like correct down the track. Again in the health area, there are comments that seem to have been totally overlooked. For instance, it is said that we will desperately need to have a much closer working relationship between the private sector and the public sector. I suggest that, if that is the case, we might need a new Health Minister because that is not a likely scenario.
Mr Kaine made some interesting comments about what life was like 50 years ago in Australia. Even 27 years ago, in the health area the contraceptive pill was only in its very early stages of use. When you look at the quite dramatic change that has meant for women, not just in health terms but in the work force, in the family and so on, there are no projections of that nature in this paper. A number of very interesting medical breakthroughs are about to happen. (Extension of time granted) A lot of very interesting medical breakthroughs are currently being trialled around the world - not things that have not been invented, but things that have been. None of those issues has been brought up in this paper.
The area of information technology takes up all of one paragraph in this paper. Information technology is the one single issue that will have the most definite effect on health and health provision all over the world. Already we are seeing in America information technology - patient records, treatment by computer and so on - actually in use. This paper has one paragraph on that, and then does not take it through to its ultimate conclusion. There is also one paragraph about the need for proper resource management and the need to look at the use of QALYs, or quality adjusted life years, and how to appropriately ration health care. Again, this is not carried through to any ultimate conclusion.
I think it is important to have a long-term strategy, but it has to have a conclusion. This paper does not seem to have the end bit, the next step, which says what the health system might look like even next year, let alone in 27 years' time.
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