The message came through loud and clear from the PM’s speech to the National Press Club   – Mr Rudd has his sights firmly set on fixing hospitals rather than the population’s health.

And it seems that all those consultations held in hospitals have convinced him, funnily enough, of the benefits of giving local doctors and clinicians more say over service delivery. Not much mention at all of the need for greater community and patient engagement – it’s all about empowering doctors and nurses, apparently.

Not much mention at all either of the need to tackle the inequities in the system or to ensure that the new national health and hospitals network (which the PM kept calling the hospitals network) doesn’t simply mean more resources for those who already do quite well thank you very much.

I’m trying not to feel deflated. At least there’s a commitment to some action from the top dog. And he has promised that there will be further announcements on primary care and areas such as mental health and dental health.

But it still feels like everything is arse about. We’re talking elective surgery waiting lists and hip replacements, rather than reorientating the system towards better support for early childhood and families and for people with chronic illnesses or those who are otherwise under-served.

We’re talking about providing the services recommended by the service providers rather than what a clear-headed analysis of the population’s health needs might suggest. As the University of Sydney’s Alex Barratt noted in an earlier post today, clinicians may be good at patient care but that doesn’t make them experts in evaluating services.

I was struck by the PM’s thanks for the doctors, nurses, allied health professionals and health administrators who attended his NHHRC hospital road show. It seems somehow symbolic of a fundamental failure to grasp the need to reorient the system towards the broader community’s needs.

There is no doubt the PM is pitching significant structural reform. But is it visionary? Does it suggest this is a government that really gets health and is committed to improving not only the overall population’s health but also to reducing the gap between the health haves and have nots?

Perhaps it’s wisest to leave the answers to those questions hanging until the dust settles a little.

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