Australian Health Review April 2007 Vol 31 Suppl 1 S13 System Observations Aust Health Rev ISSN: 0156-5788 1 April 2007 31 Suppl 1 S13-S15 ©Aust Health Rev 2007 www.aushealthre- view.com.au System Observations Abstract In advocating for significant reform of the health care system, the Australian Health Care Reform Alliance (AHCRA) supports a process of citizen engagement that will allow the wider community to have a say in the future direction of their health care system. Models that have engaged commu- nity opinions have been successful overseas, and Aust Health Rev 2007: 31 Suppl 1: S13–S15 this article calls for similar processes in Australia. COMMUNITY ENGAGEMENT TECHNIQUES have been carried out in Australia on a small scale. Government commitment is required to establish a rigorous and systematic national consultation process. This is especially important when crucial decisions about the future of our health care system need to be made. We believe this is the first step in the journey to health reform. The need for reform There is a chronic shortage of doctors, nurses and other health professionals, especially in rural and remote areas. Australia has the resources to train more health professionals, yet we are increasingly relying more on overseas-trained doctors and nurses. Twenty five per cent of all doctors working in Australia are trained overseas and, increasingly, nurses from overseas are relied on to address Australia’s skills shortages. 1,2 There is sound evi- dence that we have the resources to train more health professionals. According to the 2005 United Nations Human Development Report, Australia is ranked third of 177 countries in economic per- formance. 3 The Australian health system has insufficient focus on prevention and primary care, but, most critically, we have an increasingly fragmented sys- tem with inefficient allocation of government resources due to the state–federal funding struc- ture. The reform which the Australian Health Care Reform Alliance (AHCRA) advocates involves adopting a new approach which considers these failings and engages stakeholders which have pre- viously not been consulted. It involves undertak- ing a holistic approach instead of small sectoral changes. The nature of the reform needs to con- sider the views of consumers and the community to ensure reform meets communities’ needs. Why consult the community? AHCRA considers that reform of the health care system needs to consider the views of those who use health services and whose taxes are used to support the system. The community contributes to the government’s purse and should have a say as to how that money is spent. As articulated by the Health Canada Policy Toolkit, citizen engagement is described as the “public’s involvement in determining how a society steers itself, makes decisions on major public Tony McBride, CEO; and member of AHCRA Executive Viola Korczak, Health Policy Officer, CHOICE; and member of AHCRA Executive Health Issues Centre, Melbourne, VIC. Correspondence: Ms Viola Korczak, Health Issues Centre, Level 5, Health Sciences 2, Latrobe University, Victoria, Melbourne, VIC 3086. vkorczak@choice.com.au Community consultation and engagement in health care reform Tony McBride and Viola Korczak AHCRA The Australian Health Care Reform Alliance is a group of 46 consumer, clinical and academic organisations committed to health reform. This paper is based on “Paper IV: Community Consultation and Engagement”, one of five papers forming a submission to the Council of Australian Governments, November 2005.