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Legislative Assembly for the ACT: 1998 Week 7 Hansard (24 September) . . Page.. 2195 ..

MR MOORE (continuing):

should have equitable access to public hospital services, regardless of their geographical location. All Australian citizens are eligible people. The category excludes the majority of foreign nationals. I must say as an aside, Mr Speaker, that the people of Canberra should know it does not exclude the diplomatic corps, for example.

The Commonwealth, States and Territories share the responsibility for meeting the costs of Territory-funded health services, facilitating national health reform and the sharing of information to gain a better understanding of the changing dynamics of the Australian health system. They will work together, and with other States and Territories as appropriate, to achieve the following: Implement the second national mental health plan; implement an agreed national palliative care strategy; participate in a forum to advise on overall directions for the casemix program; and explore options in the reciprocal health care agreements. The Commonwealth and the Australian Capital Territory will also implement this agreement consistent with the principles outlined in the Aboriginal and Torres Strait Islander health framework agreement.

The Commonwealth and the State/Territories have recognised the need for service delivery reform. In the next five years a range of initiatives will be explored which test the boundaries of Commonwealth-State responsibilities for health care financing and management in order to seek change. So it is in this context that activity will occur which looks further than merely questioning who is responsible for services by seeking to challenge what is delivered and why, in order to achieve greater improvements where possible.

Some of the reform initiatives will be around testing the current boundaries of service provision through ongoing exploration of initiatives which will occur under a "measure and share" model. Several States/Territories will work with the Commonwealth in evaluating the outcomes from the coordinated care trials to provide information to guide future directions for the reform of health service delivery. It is intended that these reforms will lead to improved patient outcomes and/or more cost-effective care.

The Commonwealth and States/Territories have agreed that there is a need for national commitment, in partnership with clinicians, to health care safety and quality improvement. There is recognition that there are some safety and quality issues which are best dealt with at a national level. In keeping with the need for reform, the Commonwealth and the States/Territories acknowledge that significant restructuring is necessary to improve the performance of the health system. Accordingly, the Commonwealth has established a National Health Development Fund to pursue projects and programs consistent with a strategic plan designed to improve patient outcomes in relation to such services; improve the efficiency and effectiveness, or reduce the demand for the delivery of public hospital services; and improve integration of care between the public hospital system and the broader health and community care services.

The agreement also foreshadows reform of pharmaceutical arrangements for patients on discharge and non-admitted patients. Further work needs to be undertaken before this occurs. The fundamental principles of the current interstate cross-border funding arrangements will be retained for the period covered by this agreement. This means that

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