Australian Healthcare System – learning Journal

ENTRY 1: How Healthcare Is Organized In Australia

Q1: Understanding of the Australian Healthcare System

            I have been an Australian Defence Force (ADF) employee for the past 13 years, which limited my understanding of the Australian Healthcare System. I have not required any medical care through the public or private Australian healthcare system; as all ADF treatment, employers are done internally except for specialized and radiological services. The Australian healthcare system’s little practical exposure was during my clinical placements with paramedics, nurses, and doctors.

However, I have lately engaged in serious research and reading articles and publications about the Australian healthcare system, which has increased my knowledge inventory about the Australian healthcare system’s inner workings. The primary reason behind my growing interest in understanding the Australia healthcare system is that I intend on one day to leave the ADF and become a paramedic where I will be required to realize patient-issues with the healthcare system to improve on the quality of care. My husband’s fear of seeking medical care from doctors or specialists outside the ADF system due to cost and hassle of taking time to get the appointment is another factor that has drawn to learn more about the Australian healthcare system.

From my research, I have noted that the Australian healthcare system is perhaps one of the most affordable, comprehensive, and accessible healthcare systems globally. Australia’s state and territory, federal and local governments share the responsibility for health. The different government levels play roles such as funding, developing policies and regulations, and delivering healthcare services. There are also private sector healthcare providers, which include private hospitals, pharmacies, and medical practices. Private hospitals play a pivotal role in facilitating healthcare services access by bridging any gap left by the public sector, such a supply gap. The Australian state government mandates the universal public health insurance scheme, Medicare, which entails funding the primary health networks and subsidizing medical services (Australian Institute of Health and Welfare 2016). The aim is to make healthcare affordable and accessible.  

Q2: Primary healthcare and the health care workforce

My understanding of the Australian primary healthcare and the health workforce is also limited because of the consequences of being in this sheltered ADF medical system. However, despite limited practical exposure, I have been researching and reading about the Australian primary healthcare and the health care workforce whenever I get a little free time. Primary healthcare is the patient’s first contact with the healthcare provider. According to the information I read from the “Australian Government Department of Health” website, Australian primary health care involves a comprehensive range of suppliers and services that cut across the public and private organizations. At the clinic level, primary care encompasses the “first layer of services” that a patient comes across in the health care facility and demands teams of professionals working in collaboration to deliver comprehensive, consistent, and patient-centered care (Australian Government Department of Health 2013). Even though most Australians receives primary health care through general practitioners, nurses, midwives, health professionals, pharmacists, Aboriginal, and dentists, are also part of the primary health care workforce.

In an article I read lately by Halcomb, Williams, Ashley, McInnes, Stephen, Calma, & James (2020), the authors argue that primary health care forms Australia’s health care system’s frontline. It includes various activities, such as managing chronic conditions, health promotion, disease prevention mechanisms, and early interventions. The service can be provided in the community or home-based settings such as in general practices, or in private, community health, non-governmental and local government service settings (Halcomb et al. 2016). The services mentioned earlier are provided by GP, nurses, allied health professionals, nurse practitioners, midwives, pharmacists, and dentists. However, Australia faces shortages of the healthcare workforce, particularly in rural areas, as many practitioners prefer operating in the cities. I want to learn more about Australian primary health care, which means that much reading is still necessary to achieve this goal.

ENTRY 2: Equity and Access

Q3: Inequity of Access to the Australian Health Care (AHC) System

From the students’ discussion alongside the knowledge I have acquired concerning access to the AHC, it is practical to conclude that Australia experiences inequitable healthcare access. In one of the articles I came across from the internet, McGrail & Humphreys (2015) maintained that Australia is among the most highly urbanized countries globally with a larger share of the population, 63% living in capital cities. About 6.7 million Australian people, 37% live in rural areas, with about 2.8 million Australians living in sparse settlements with less than 1000 populations. Access to healthcare services in parts of the country with a highly dispersed community is a significant challenge due to the workforce undersupply (McGrail & Humphreys 2015). The authors further argued that Australians living in remote and extremely rural areas have poor access to healthcare services compared to those that live in the major cities and regional areas. They also have a high rate of potentially preventable hospitalization and lower cancer screenings (cervical, breast, or bowel cancer) (McGrail & Humphreys, 2015). People in rural parts of Australia relocate or travel to longer distances to receive specialized healthcare services.

Study reveals that, on average, Australians who live in the remote and rural areas have a shorter lifespan, higher rates of diseases and injuries, and poor access to and use of good healthcare service compared with those living in urban settings. The poorer healthcare outcomes in remote areas are caused by several factors, including lifestyle differences, level of disadvantage linked to employment opportunities, education and access to quality healthcare (McGrail & Humphreys 2015), as many people migrate to urban settings. For instance, my family comes from a small rural town in Western Australia, and the population has reduced so dramatically, due to the workforce and its employment opportunities, that there was talk of closing the hospital down, making the next closest hospital a 50-minute drive.

Q4: Mental health and stigma

People with mental health complications may face stigma or be regarded differently as if they are different from others. Stigma may cause individuals with mental health conditions to be discriminated against, bullied, miss out on work, or become victims of violence. It may also mean they do not seek the needed treatment. Fortunately, I have had firsthand experience with mental health concerns from my history and friends and family. Unlike other forms of stigma such as racism, mental health issues are not so obvious and sometimes not treated with its seriousness. People are more likely to regard a depressed and anxious fellow as acting silly, as was the case with Georgia Appleton’s earlier post, where the girl’s father did not believe that his child’s depression and anxiety concerns are that serious instead, termed her as acting silly. Similarly, many people in the ADF where I work do not take mental health education seriously, and some even play mental health cards to avoid hard work. This has strengthened the stigmatization of individuals suffering from mental health challenges.

What a stigma does is that it reinforces and promotes social isolation, limits equitable employment opportunities, and recreation, and the worst part is that it discourages people who need mental health treatment from seeking help. Stigmatization of mental health is likely to create, reinforce, and sustain pseudo-psychiatric mythology, which is frequently adopted by individuals with mental conditions, translating in much suffering. While mental health professionals, carers, and patients can describe personal experiences of stigma, it is often challenging to prove that the experiences are because of discriminatory actions or negative attitudes. Stigma plays a significant role in hindering the quality of life for people with mental illness.

ENTRY 3: Future Healthcare Challenges and Opportunities

Q5: Self-Determination and Living with Disability

Self-determination is encouraging patients with chronic illness to accept, manage, and live with their conditions, believing they can control their destiny. The concept encompasses attitudes and abilities that lead individuals to set goals and take the initiative to accomplish these goals. Making your own choices, learning to efficiently solve problems, and assuming control and responsibility for your life are self-determination attributes. Individuals who are self-determined advocate/speak for themselves and others.  Self-advocacy is essential for people living with disabilities to ensure equal access to health, employment, and other opportunities and battle discrimination. As noted in my earlier posts, several programs are emerging within the Australian healthcare system to assist patients with chronic illness or disabilities to self-manage themselves and feel part of the community just like the rest of the population.

 Programs such as the Flinders Program, the Stanford Model, and “Get the Most Out of Life” significantly contribute to bringing people together, making those living with disabilities to feel that are not alone despite their conditions. I believe in the importance of educating the community from the young to older the people about the power of self-determination, which implies accepting and believing in themselves irrespective of their conditions. Self-determination relates to a host of a diverse positive quality of life outcome, including better employment and independent living outcomes for people with disabilities, therefore should be nurtured right from childhood. Promoting health across public spheres is absolutely essential to ensuring that individuals are educated and informed about chronic diseases and disabilities and preventive and management mechanisms.

Family and community support are vital for self-managing individuals, implying that education around disability and chronic illness is nurtured across the whole community. Fundamentally, promoting self-determination means promoting respect, dignity, valuing people, and raising disabled persons’ expectations. Self-determination is an essential facet of the transition from adolescence to adulthood; therefore, the focus should not only be on individuals with chronic conditions but even the young ones. Denying anybody the chance to learn the skills, have experienced, and support necessary to be self-determined is fundamentally equal to denying them the opportunity to live self-fulfilling life as adults.

Q6: Telehealth Technology and the Future of Medicine within Your Discipline

My role as an instructor in the ADF did not have any exposure to telehealth. Therefore I did not know anything about the technology before starting this unit. However, through the students’ posts and readings, I have learned that telehealth is applying technologies, such as mobile devices and computers, to access health services and manage your health care remotely. It enables remote patient-clinician contact, advice, education, care, intervention, remote monitoring, and admissions. Before the emergence of Covid-19, it was unsure whether telehealth could meet the standards of care in too specialized medical practices. The Covid-19 pandemic cast a new light for telehealth technology as it is accessed directly and remotely by people in their homes, thus reducing the chances of transmissions by limiting contacts. However, out of necessity, the world is forced to innovate rapidly, and telehealth is proving to be a perfect fit for the healthcare systems moving forward.

From the article I read authored by Fisk, Livingstone & Pit (2020), Australia already had moderately robust telehealth services even before the covid-19, with approximately about 150,000 visits, were made from remote and rural communities. However, the authors argue that most medical students have not been exposed much to training on telehealth technologies despite recognizing its future benefits. Nevertheless, on March 30^th, 2020, Australian declared funding of AUS $669 million to facilitate rolling out of universal telehealth models for all Australians to enhance remote access to health care (Fisk, Livingstone & Pit 2020). The move was to curb the spread of covid-19 by reducing person-to-person contact between patients and health care providers and is an indication that telehealth service will gain more popularity in the healthcare systems. However, there is still a potential threat to people’s data privacy because of e-health records. Low internet coverage in remote settings also raises a concern in the adoption of telehealth.

ENTRY 4: Conclusions and Reflections

Q7: Reflections throughout Semester

I have always had the interest to learn more about the inner workings of the Australian healthcare system. By openly contributing to the discussion forum and carrying out independent studies whenever I have free time, my knowledge of the Australian Healthcare System has significantly increased of late. I have learned several issues relating to AHC, including the role of government and private sector in the management of health care systems, accessibility and affordability of Australia the healthcare systems, and factors likely to shape the future of AHC. From independent studies, I learned that Australia’s state and territory, federal and local governments alongside the private sectors, play a pivotal role in taking up health responsibility. The different levels of government finance, develop policies and regulations and provide health care services, while the private sectors help bridge any gap left by the government, but are regulated by the state. However, Australia still experiences inequitable access to health care services, particularly in rural areas. Australia in a highly urbanized nation with the majority of the population living in the urban areas, leaving rural settings with a sparse population, making it a challenge to provide health care. People in rural areas travel for long distances to access healthcare services. I also learned that mental health stigma is a serious problem in Australia that hinders the development of healthcare systems and access to mental health services by people who need it most. Concerning the future of AHC, it is likely that telehealth services will dominate the healthcare systems post-covid-19 despites challenges associated with it, such as breach of personal information.

References

Australian Government Department of Health (2013). National Primary Health Care Strategic Framework. Primary Health Care in Australia. https://www1.health.gov.au/internet/publications/publishing.nsf/Content/NPHC-Strategic-Framework~phc-australia

Australian Institute of Health and Welfare (2016). Australia’s health in 2016. Australia’s health series no. 15. Cat. No. AUS 199. Canberra: AIHW. https://www.aihw.gov.au/getmedia/f2ae1191-bbf2-47b6-a9d4-1b2ca65553a1/ah16-2-1-how-does-australias-health-system-work.pdf.aspx

Fisk, M., Livingstone, A., & Pit, S. W. (2020). Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. Journal of Medical Internet Research, 22(6), e19264.

Halcomb, E., Williams, A., Ashley, C., McInnes, S., Stephen, C., Calma, K., & James, S. (2020). The support needs of Australian primary health care nurses during the COVID‐19 pandemic. Journal of nursing management.

McGrail, M. R., & Humphreys, J. S. (2015). Spatial access disparities to primary health care in rural and remote Australia. Geospatial Health.