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The consultancy will involve the participation of staff and unions. I wrote to the Trades and Labour Council seeking union participation in the process to select and oversight the consultancy. Regrettably, the unions decided not to become involved in the selection process. However, I am hopeful that they will still become involved in oversighting the consultants. It is imperative that management, staff and unions work together to produce the reforms that will benefit everyone in the ACT, so that taxpayers can be sure that each dollar is spent to the best advantage.

The third key direction of this Government will be the introduction of a casemix-based approach to the strategic management and funding of health services. By a casemix approach I mean a focus on the outputs from our health system. Casemix-based funding has been introduced in a number of other Australian States already. We are therefore in a good position to take advantage of, and learn from, their experiences and mistakes. Implementation in the ACT will therefore be far more strategic than has occurred in other States. I should also point out that casemix will be one of a number of tools that we will use to achieve our overall objectives. A comprehensive discussion document has been prepared by Professor Don Hindle. Professor Hindle is commonly acknowledged as one of the foremost experts on casemix in Australia and overseas. He has provided extensive consultancy services in this area for the Commonwealth and for most State governments. I will present Professor Hindle's discussion paper to the Assembly at the end of my statement today.

Mr Speaker, the funding of service units on a casemix base will provide a key incentive to clinicians and administrators to examine the efficiency and effectiveness of their practices and to make the necessary improvements. Service units will be funded on the basis of what they produce, not merely for existing. They will be accountable on that basis. Casemix-based information provides the most relevant foundation for benchmarking available today. Provided that service units are given the right support, they will be able to review their performance critically and to make changes. The improvements will be about not only reducing costs but, more importantly, improving Health outcomes.

To illustrate this, there is a wide range of surgical procedures which have established protocols for best practice; that is, each patient coming in for these procedures has the same techniques supplied and the same diagnostic tests run. Even in these areas there is often considerable variation in costs which do not relate to improved outcome or quality of care. The variations in costs are often due to manageable events, such as preparation prior to admission, errors in theatre planning or poor discharge planning. Casemix provides the information and the casemix-based funding provides the incentive to address these variations and implement best practice. The approach to casemix outlined in this paper will help us evaluate how efficient we are in the ACT, not just in in-patient services but throughout our health system. The strategic application of casemix information will also be used to examine the usefulness of all of our procedures. For example, is the health system producing services with only marginal benefit to patients? We will be trying to establish whether resources can be directed to more worthwhile activities in Health. It will also be a tool to enable us to enhance the continuity of care.

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