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In Australia, the wide and strong commitment to healthcare system ensures provision of efficient healthcare services to patients while performing well by international standards. However, the current healthcare system struggles for providing equitable access to care for the Australians due to its complexity. The increase in incidence of chronic diseases in the population has raised the demand for healthcare services in Australia while complicating the healthcare system further (Armstrong, 2010). With changing lifestyles and ageing population, chronic diseases have become dominant contemporary health issue. Nonetheless, the continuous advancement in medical knowledge and the technologies have enabled the government at both state level and national level to improve communication with patients and increase efficiencies in healthcare system (Feo & Kitson, 2016). This has led to increase the expectations of patients and ensured delivery of maximum services at right time.
Accountability is a core element in improving the overall healthcare system performance in any country (Durey, et al., 2016). At first glance, accountability seems pretty straightforward but in reality it has a high degree of complexity. Put simply, accountability in healthcare is about taking responsibility for actions while ensuring the competence to perform and prioritizing patients’ need (Leape, 2009). There are generally three categories of accountability i.e. financial, performance and democratic accountability in healthcare system (Murray & Frenk, 2000). Overall, accountability in healthcare system is predicated on the relationships amongst the healthcare providers and the patients. In Australia, there are several efforts made at national and organizational level for linking the investments in healthcare system to measureable improvement in outcomes for patients (The Australian Health Policy Collaboration, 2019).
At state level, the Government of Western Australia (WA) initiated a WA Health Reform Program 2015-2020 that focused on establishment of holistic performance management system in hospitals in WA (Western Australian Mental Health, 2015). This initiative ensured that the WA health providers recognize their duty to implement and maintain the transparency in clinical and corporate governance. WA also entered in National Health Reform Agreement (NHRA) in 2011 for improving its governance framework and funding of health services. The reform program replaced the Hospitals and Health Services Act of 1927 so that the roles and duties of each involved party is clarified and accountabilities are recognized at all levels of healthcare system (Western Australian Mental Health, 2015). Such reforms also allocated healthcare provisions fairly across the WA health system and ensured that the health needs of community are met effectively. Similarly, the National health Reform includes the Performance and Accountability Framework that consists of the national performance indicators and national clinical safety standards. The framework also included public reporting standards, long-term goals for Australian government and need for patient-centered care system. The National Healthcare Agreement Report in 2010 focused on facilitating transparent monitoring system across services and jurisdictions in Australia (Productivity Commission, 2019).
Similarly, the Australian Charter of Healthcare Rights 2008 underpinned the provision of safe and high-quality care that supports the shared understanding of patients’ rights and practitioners’ responsibilities towards patients (Australian Commision on Safety and Quality in Healthcare , 2019). In 2008, the Australian health ministers also issued national charter with set of standards, rights and responsibilities of practitioners and rights of patients. In 2005, national eHealth Transition Authority also established an interoperable infrastructure for supporting communication across the healthcare system while ensuring accountability and transparency in all public hospitals. A budget of AUD0.4 billion was issued for supporting medical notes, referrals and diagnostic imaging reports (Glover, 2015). In 2010, the health ministers also agreed on establishing NSQHS standards and issued them in 2011. Under standard 1 of NSQHS, the governance for safety and quality in health service organization was formulated (Australian Commission on Safety and Quality in Health Care, 2019a). The framework advocated about patients’ rights and responsibility of care providers towards patients. Moreover, the Australian Safety and Quality Framework for Health Care was also established in 2010 that required all Australian states and territories for increasing their activity in measuring healthcare quality and patients experience.
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