Institute’s challenge is healthcare system reform


Professor Peter Brooks' team at the Australian Health Workforce Institute is tackling a big challenge – helping to transform Australia's healthcare system by researching better ways to support preventative health. Professor Brooks is the director of the Institute, which joined the Melbourne School of Population and Global Health (MSPH) in August 2012.
Come the much-needed revolution, Australia's healthcare system would no longer be structured around the current fee-for-service delivery, he predicts. This model financially benefits procedural specialists, among others, and reinforces professional silos, to the detriment of patients, taxpayers and the healthcare workforce, he says. Instead, healthcare workers would become adept at working interprofessionally in teams, and preventative healthcare would get a much larger proportion of healthcare funding. Importantly, patients would receive more primary healthcare in their homes rather than in hospitals. All of these reforms would demand a more flexible healthcare workforce.
Of course, Professor Brooks is realistic about the Institute's part in this revolution. "Our role is to be an independent group that can stand up and be counted and ask the difficult questions – that's what universities are about," he says. "Our research team is very effective and very interested in new models of care, how we get teams to work together, how we fund healthcare and how we use new technologies to make the health workforce more productive." The Institute's research is developing the evidence base to support these reforms, working across four key areas: education, training, policy and delivery.
One of the Institute's agendas is to start a conversation in the community about rapidly rising costs of healthcare and how much of it is borne by individuals, a topic he sees as the "elephant in the room". He cites a recent paper from the Australian Institute of Health and Welfare which found that, as a share of overall health spending, Australians' out of pocket expense is 18.2% – significantly higher than the median of 15% for developed countries.
The Australian Health Workforce Institute initially reported to the Dean of the University of Melbourne's Faculty of Medicine, Dentistry and Health Sciences. Professor Brooks anticipates that the move into the MSPH will bring more interaction with policy making and policy makers and strengthen the Institute's capacity to take on entrenched vested interests. He points to the specialist Colleges and the AMA as benefitting from the status quo under the current fee for service model.
Professor Brooks has a track record of leading reform within the healthcare workforce. As Executive Dean of the Faculty of Health Sciences at the University of Queensland, he oversaw the development of faculty-wide interprofessional learning, a new School of Nursing with nurse practitioner and midwifery streams, and a physician assistant program. The latter took 10 years to gain national recognition with the release in February 2012 of the Physician Assistants report by Health Workforce Australia (HWA), the Federal Government body that started in January 2010, charged with supporting the development of a sustainable healthcare workforce. He commends the HWA's early work but with reservations. "They've done some good things in terms of modelling but they haven't taken some tough decisions that need to be made about health funding," he says. "We look to them to provide leadership in this area."

Caption: Professor Peter Brooks