#CPHCEforum

Aug 17, 2015

Listening, trust and partnerships: learning from primary health care successes

Melissa Sweet — Health journalist and <a href=Croakey co-ordinator" class="author__portrait">

Melissa Sweet

Health journalist and Croakey co-ordinator

The Annual Forum of the UNSW Centre for Primary Health Care and Equity - held in Sydney last Friday - could not have been more timely. Forum participants heard about the importance of building genuine partnerships with communities in successful primary health care initiatives, as journalist Amy Coopes reports below for the Croakey Conference News Service. Beneath her report is an article by consumer health advocate Leanne Wells, based upon her keynote presentation to the Forum: Health literacy and consumer-centred care: at the brink of change? And thanks to all those tweeting #CPHCEforum (check the analytics at the bottom of the post). *** Amy Coopes writes: As hearings kick off into primary health care reforms aimed at reducing the cost burden of chronic disease and better meeting the needs of the chronically ill, some real-world success stories emerged at the annual Centre for Primary Health Care and Equity forum. A keynote from Consumers Health Forum of Australia CEO Leanne Wells sparked robust debate among delegates on health literacy, engaging communities and the patient-as-consumer. Wells is on the Federal Health Department’s Primary Health Care Advisory Group (PHCAG), and gave some interesting insights into the committee’s thinking as Australian health care finds itself at a crossroads. A McKinsey paper prepared for the group states that the rate of increase in healthcare costs is "unsustainable", with costs having risen from 7.3 per cent of GDP in 1993 to 9.1 per cent in 2011, with the growth largely driven by hospital expenditure. The paper also shows that Australia spends just 1.9% of its total health budget on prevention and public health, and is ranked 13 out of 19 OECD countries for preventable hospitalisations, which account for 6.2% of all admissions nationally (8.1% in the public system).

The McKinsey report found that Australia ranks fifth behind the UK, Switzerland, US and Canada on consumer engagement in health, and 14.3 per cent of people who see three or more health professionals for a condition report issues caused by a lack of communication. This rises to 18.6 per cent for people living in outer regional, remote and very remote areas, who also report waiting longer than is acceptable for a GP appointment – 1:3 versus 1:5 in the city. Startlingly, only 65 per cent of Australians say they know how to get advice on chronic conditions, according to McKinsey, and Wells said only 40 per cent of adults can follow health messages and make sensible decisions based on them. So how can the health and medical community better connect with and be more relevant to the people it aims to serve? Two success stories took centre stage at the forum, with valuable lessons to share from working with, within and for communities. The Gudaga project: partnership matters The Gudaga project, a longitudinal cohort study of 149 Aboriginal children from the Tharawal nation in Sydney’s Campbelltown region, will celebrate 18 years collaborating with the local community in October. Holly Mack told the forum Gudaga’s success lay in its partnership with the Tharawal community and their ownership of the project. Gudaga means “healthy baby” in Tharawal and was designed after yarning with local women about their concerns for children in the community. The research proposal was drawn up in consultation with the women and the project logo was locally designed. Retention in the program was so high (85 percent) because local women were trained as project officers able to liaise with the mothers and carry out the research. In a short tribute video played to the forum, Tharawal Aboriginal Corporation CEO Daryl Wright said the researchers’ partnership with the community in which they were treated and regarded as equals had been key to the project’s success. The original cohort of Gudaga children are about to start high school and the next phase of the project has begun – Bulundidi Gudaga – following a new cohort of children, born to at-risk mothers, from antenatal to two years of age. “We’ve now come full circle, feeding the results of our research back into projects in the community – a tree of which Gudaga is the trunk,” said Mack.

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