The 2023-24 Federal Budget: A Patient Advocate's Perspective on Health Reform.

Many of the announcements for health in the 2023-24 Federal budget were met with applause in the Chamber on May 8th 2023, signalling popular support for bolstering bulk billing incentives, more convenient pharmacy trips, a move to multidisciplinary teams and a 15% pay increase for Australia's aged-care workers. 

But for those who use the health system regularly, were the announcements adequate? Or were the gaps and what has not been included in the budget another reminder of the challenges of living with complex health conditions in a system bursting at the seams? We asked two patient advocates with lived experiences of complex chronic disease and extensive wrangling of the health system for their thoughts on what the budget means through their eyes. 

Firstly, let's meet our patient advocates, Anja Christoffersen and Harry Illes-Mann:

Anja Christoffersen:  Anja (pictured above left) is a passionate disability advocate - empowering others facing adversity with the empathy and expertise she's built through her experience living with a rare 'invisible' disability from birth. As Founder of Champion Health Agency - a world-first 'talent agency for lived experience', Anja is providing representation for people with disability, chronic illness and carers to create transformative change by ‘professionalising’ their expertise. Champion Health Agency is a social enterprise grounded in a social impact model, determined to create cross-sectoral system change through a disability, chronic illness and carers lens, by facilitating implementation of "nothing about us, without us" at all levels, in all industries.  

Harry Iles-Mann: Harry (pictured above right) has been living with complex chronic physical and mental ill health since early childhood, which includes complex surgeries and significant hospital stays during COVID. Harry is passionate about ensuring that the insights of those with lived experience are elevated and empowered to affect design and decision-making more meaningfully in health. Professionally, Harry is a health consumer leader, consultant, speaker, and committee member harnessing over 2 decades of experience navigating the Australian public and private health system to provide insight on effective methods of meaningfully engaging with consumers and the community to realise impactful reform and innovation of design and decision making in health care provision, policy and strategy in health. 

What was your overall response to the health elements in the Budget?

Anja:  “One number that received little attention in the Budget speech and press announceables was $74B - this is the amount the growth of the NDIS will be curtailed by from July 2026, amassed by flattening the annual growth in the NDIS to 8%.  Some of the savings are indicated as coming from improving the consistency of the patient experience, but we aren't seeing the promises of co-design, choice and shared decision-making with the disability community materialising.”   

Harry: “It's great that some things are getting more money but the sustainability of change in our system will be made or broken by how effectively we reform the cultures and frameworks underpinning engagement and delivery, not just by the amount we spend. People with chronic diseases are eager for change and a reformed models of care that better reflect our values.”

On digital health...

Harry:  “Substantive investment in the digital [space] is a welcome inclusion in this budget. Successful system transformation requires creative agility and a secure funding base to sustain necessary technological and cultural changes. The commitment to modernise the product platform and ensure the sustainable operation of the ADHA (Australian Digital Health Agency) presents an important opportunity to successfully re-prosecute the case for more active engagement with and adoption of the MHR (My Health Record) as a key national infrastructure. [What's needed]...is the creation of key legislative and policy mechanisms (like establishing National Interoperability and Data Sharing Standards), public education, and consumer and community engagement initiatives. A mature combination of these will be critical to realising the impact of the funding commitments made to technology infrastructures and system transformation. We await the plan for what outcomes the funding will deliver.” 

On Strengthening Medicare & investing in bulk-billing incentives...

Anja: “The announcement of tripling the bulk billing incentives as being targeted to those least able to afford it sounds promising but it doesn't necessarily cover who needs it most. So many people fall through the system's cracks due to how social services are structured and so don't have concession cards and won't be able to access these extra concessions. Having NDIS doesn't necessarily qualify you for a concession card. Bulk billing isn't available to many non-resident migrant communities.”

Harry: “Funding to support practitioners to create and operate as multidisciplinary teams with patients as partners is an important good practice already happening elsewhere in the world - notably in the UK and Canada. This is also key to supporting the transition as a patient from in-hospital care through discharge and into primary and community based care at home, and in workplaces. We invite the review of the existing Medicare funding model that looks deeper into equity and sustainability beyond these initial stimuli as a stopgap. We welcome an ambitious reflection on and reform of national health funding frameworks that will chart a meaningful pathway to a mindset of health and wellbeing [not illness and burden].” 

Finally, on patient engagement and valuing lived-experience insights...

Anja: "We welcome the addition of $10.5m to the Consumer Health Forum and encourage consumer peak bodies to keep engaging with consumers and having them speak for themselves, not speak on their behalf. We would love to see some of these funds go into remunerating consumer advocates for their insights and time*, unlocking even more consumer voices to be at the table of important conversations that shape the health system's future that is ultimately for them.” 

Harry: “The legacy of important contributions made to health policy by the Consumer’s Health Forum of Australia is well known in the sector and across government - so the announcement of $10.5 million over the next four years is a welcome inclusion in the budget. The funding is a demonstration by the Hon. Mark Butler MP of an ongoing commitment to engaging with consumers and the community as active partners in reform and innovation. The relief felt by the advocacy community because of this announcement also serves as a pertinent reminder of our need as a sector to collaboratively strengthen and diversify channels of influence on policy reform to insulate against a loss of impact and opportunity should budget priorities change, or ministers’ assurances fall to the wayside." 

Where to from here?

While the recent budget announcements have shown promising investments towards healthcare reforms that deliver better experiences and outcomes for patients, it is important to remember that there is still much more work to be done in this space. The insightful comments from Anja and Harry above illustrate the crucial role patient advocates can play in shaping the future of health care in Australia. Engaging with your patients and incorporating their perspectives in the decision-making, design, implementation and ongoing improvement and evaluation of any health change is essential if we want to really achieve successful reform. 

At Patient Experience Agency, we are passionate about helping healthcare professionals to move beyond a patient-centred approach to truly partnering with their patients, consumers, carers, and community members to understand what truly matters to them. We respect their voices, knowledge, and contribution to designing modern care services that deliver better experiences and outcomes for everyone. Not just your patients and their care circle but your staff, your practice and you. 

We hope this blog inspires you to start engaging and collaborating with consumers. Here are three simple ways you could start bringing more patient collaboration and voice into your practice today: 

1. When focusing on a specific service improvement in your practice, engage consumers early to get their perspective. This will help uncover the root cause of problems, not just "symptoms". 
2. When attending a conference, consider enrolling a consumer to attend with you. That way, we are all "in" the conversation and will have greater representation of the patient voice at our industry events. 
3. Develop a "voice of the consumer" dashboard to share consumer feedback and metrics with staff, stakeholders, partners, and owners on a regular basis. This ensures the consumer's voice is included in all conversations and will help develop a patient partnership culture aligned to improving patient outcomes. 

 
*Patient Experience Agency offered both patient advocates renumeration for their input in this blog.

Further Learning:

For further details on why partnering with your patients will become more important to your practice in the near future, watch our free Kickstarter webinar - Australian Health Reform: What it means for you and your practice here.

Further Reading:

To learn more about why you need to move beyond being patient-centred, read our blog, here.