Reflections on the Australia 2020 summit long-term national health strategy
Article Outline
The Australia 2020 summit was a landmark event, and an unprecedented opportunity for a number of representatives from nursing and midwifery to participate in deliberations and debates about the future of health care in Australia. A relatively small number of us took our places alongside prominent leaders in health care including health academics, medical practitioners, policy makers, health economists, health researchers, allied health professionals and consumers. As a group, we brainstormed, critically analysed and debated ideas and plans for a long-term national health strategy. It is significant that we were given places at the table at the Summit as Green (a Professor of International Health Planning at Leeds University in the UK) noted:
‘…nurses and midwives have been ignored by health systems that remain (male) medically dominated in their decision-making processes. Yet they have every right to a place at the policy table as key health providers… I have heard innumerable examples of how nurses and midwives have creatively found solutions to the service constraints within which they work. We must use this creativity’ (Green, 2006, p. 15).
Indications are that the current Federal Government recognises the importance of nurses and midwives to national health care. This is clearly a sensible position given the fact that we are major contributors in the national health workforce and ‘there is a growing body of evidence demonstrating that nursing and midwifery services are powerful resources for attaining national health goals. Specifically, innovative models of care that optimise nursing and midwifery practice have been effective in (a) containing costs, (b) facilitating equitable access to essential services, (c) responding to the needs of communities and changing health systems, (d) contributing to the building of sustainable health systems and (e) improving health outcomes for populations’ (Swan, Al-Gasseer, & Lang, 2003, p. 247).
The final report from the Australia (2020) summit can be accessed on-line at www.australia2020.gov.au. The chapter that deals with the long-term health strategy covers ideas for progressing work on ‘healthy lifestyles, health promotion and disease prevention; health workforce and health service provision; addressing health inequalities; future challenges and opportunities in health and health research, research translation and research training’ (Australian Government, 2008). If implemented, the ideas in the health area would see a focus on the needs of health consumers rather than health professionals, a strengthening of primary health care, an improved capacity to provide care nationally by utilising health workers, including nurses and midwives, more effectively and in new ways, a greater focus on prevention and health promotion, greater equity in distribution of health care, better workforce planning and efforts to create a sustainable health workforce and system wide improvements in quality of care.
These ideas will be considered by the Australian Health Ministers Advisory Council and related agencies including the National Health Workforce Taskforce (NHWT) (see: www.nhwt.gov.au), the National Health and Hospital Reform Commission, the National Review of Maternity Services and the National Primary Health Care Reference Group in planning reforms to our national health system. These reforms are likely to influence health care systems, models of care and approaches to the educational preparation of health professionals including nurses and midwives. A number of discussion papers have been foreshadowed by the NHWT and possible topics include: models of care, competency-based education for health professionals and clinical education in the health professions. We need to carefully consider and respond to all discussion papers, to influence future directions in health care and our respective professions. In addition, we need to anticipate change and work proactively to ensure that nursing and midwifery maximise their contributions to health care while always maintaining a focus on the consumer of our care.
Green, a Professor of International Health Planning at Leeds University in the U.K., argues that ‘… health systems need to examine the current portfolio of professionals and, using a competency-based approach, be prepared to revisit it. Resolution of the tension between the health system and programme approaches is key. There is a need to look in a multidisciplinary fashion at provider responses to needs and recognize the potential for more team working, drawing on the specific complimentary skills of different professions. This will inevitably have consequences for the existing make-up of professions, and professional leadership will be needed to tread the delicate line between genuine safeguarding of professional interests and wider social health needs’ (2006, p.14). We should anticipate similar debates here in Australia, and we will need to be actively engaged in these critical discussions about the shape, and composition of the health workforce in the future. We argue that the contributions of nursing and midwifery to health care need to be recognised, facilitated and advanced in order to achieve gains in quality of health care for all Australians.
We know that high quality health care depends, in part, on high quality nursing and midwifery education and an adequate professional nursing and midwifery workforce. This calls for attention to adequate investment and creation of work roles and environments which are conducive to recruitment and retention of nurses and midwives, and more prudent workforce planning and collaboration. It is clear that action needs to be taken to ensure that we have an effective, high quality, sustainable health care system and a healthy and robust health workforce.
The 2020 Summit health strategy work provided useful ideas which will inform a range of health service planning initiatives in the future. Nurses and midwives are well positioned to actively participate in influencing future health service development. In doing this let us show intelligent, informed leadership and a resolute commitment to advocacy. It is also important that nursing and midwifery continue their strong commitment to social justice and equity and give this expression in appropriate ways.
References
- Australian Government (2008).Australia 2020 Summit. www.australia2020.gov.au.
- . Nursing and midwifery: Millenium Development Goals and the global human resource crisis. International Nursing Review. 2006;53:13–15
- . Global partnerships to strengthen the evidence base for nursing. Nursing Economics. 2003;21(5):247–252
PII: S1322-7696(08)00049-8
doi:10.1016/j.colegn.2008.09.002
© 2008 Published by Elsevier Inc.
