JANUARY

AUSTRALIA
In 2013, the federal government, in partnership with states, implemented the pilot phase of the National
Disability Insurance Scheme. The scheme provides more-flexible funding support (not means-tested), allowing
greater tailoring of services.
What are the key entities for health system governance?
Intergovernmental collaboration and decision-making at the federal level occur through the Council
of Australian Governments (COAG), with representation from the Prime Minister and first ministers of each state.
The COAG focuses on the highest-priority issues, such as major funding discussions and the interchange
of roles and responsibilities between governments. The COAG Health Council is responsible for more detailed
policy issues and is supported by the Australian Health Ministers Advisory Council (http://www.
coaghealthcouncil.gov.au/).
The federal Department of Health (DH) oversees national policies and programs such as the MBS and
PBS. Payments through these schemes are administered by the Department of Human Services. The PBAC
provides advice to the Minister for Health on the cost-effectiveness of new pharmaceuticals (but not routinely
on delisting).
Several national agencies and the state governments are responsible for quality and safety of care (see below).
The AIHW and the Australian Bureau of Statistics (ABS) are the major providers of health data.
Regulatory oversight is provided by a number of agencies, such as the Therapeutic Goods Administration,
which oversees supply, imports, exports, manufacturing, and advertisement; the Australian Health Practitioner
Regulation Agency, which ensures registration and accreditation of the workforce in partnership with National
Boards; and the Australian Prudential Regulation Authority, for private health insurance. The Australian
Competition and Consumer Commission promotes competition among private health insurers. Beginning
in July 2016, the Australian eHealth Commission will take over responsibility from the National eHealth
Transition Authority for matters relating to electronic health data.
State governments operate their own departments of health, and have devolved management of hospitals
to the LHNs. The LHNs are responsible for working collaboratively with PHNs. There are patient–consumer
organizations and groups operating at the national and state level.
What are the major strategies to ensure quality of care?
The overarching strategy to ensure quality of care is captured in the National Healthcare Agreement of the
COAG (2012). The agreement sets out the common objective of Australian governments in providing health
care—improving outcomes for all and the sustainability of the system—and the performance indicators and
benchmarks on which progress is assessed. It also sets out national-priority policy directions, programs, and
areas for reform, such as major chronic diseases and their risk factors. Indicators and benchmarks in the
agreement address issues of quality from primary to tertiary care and include disease-specific targets of high
priority, as well as general benchmarks.
The Australian Commission on Safety and Quality in Health Care (ACSQH) is the main body responsible for
safety and quality improvement in health care. The ACSQH has developed service standards that have been
endorsed by health ministers (DH, Portfolio Budget Statement 2015–16). These include standards for
conducting patient surveys, which must be met by hospitals and day surgery centers for accreditation. The ABS,
the national government statistical body, also undertakes an annual patient experience survey.
The Australian Council on Healthcare Standards is the (nongovernment) agency authorized to accredit provider
institutions. States license and register private hospitals and the health workforce, legislate on the operation of
public hospitals, and work collaboratively through a National Registration and Accreditation Scheme facilitating
workforce mobility across jurisdictions while maintaining patient protections.
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