Pillar 5: A health system for the future

5.1: Prevention of illness, injury, and chronic disease becomes a foundation of Australia’s health system policy and funding response in the immediate future. 

• Increased funding and resources directed towards preventive health, as part of a preventive health strategy, including:
  • regular data collection, monitoring, reporting and publishing outcomes against the preventive health strategy to monitor progress and direct funding to effectively and holistically respond. 
  • GPs are supported to be at the centre of preventive health system design.
  • meaningful and goal-directed collaboration between healthcare professionals.
     

• Budget allocations for preventive health initiatives, with the goal of preventive health representing at least five per cent of the health budget.
• Increase in the number of preventive health programs implemented with increased funding.
• Frequent reports on preventive health outcomes.
• Budget allocations for data collection, analysis, and reporting.
• Increase in preventive screens and interventions provided by GPs.
• Reduction in preventable disease and conditions.
• Increase in early detection of communicable and non-communicable diseases. 
• Increase in public awareness and participation in preventive health activities.
• Increase in use of collaborative care plans. 
• Incorporation of the broader economic impact in cost-benefit analysis. 

• Promotion of the health benefits of addressing climate change, including:
  • recognition of the relationship between health and climate change
  • measurement and reporting of the health risks associated with climate change.
     

• Increased public awareness of the impact of climate change on health.
• Increase in the number of policies that recognise the relationship between health and climate change.
• Regular reporting on the health risks associated with climate change.
   

• Implementation of the actions in the National Health and Climate Strategy to protect health and wellbeing from the impacts of climate change.

• Progress in implementing actions outlined in the National Health and Climate Strategy, including appropriate budget allocations and resources for implementation.

• Implementation of the actions in the National Health and Climate Strategy to build a sustainable, high-quality, net-zero health system. 

• Progress towards implementation of the actions in the National Health and Climate Strategy.
• Achieve 80 per cent reduction by 2030, and net-zero emissions by 2040 (as outlined in the Australian Medical Association and Doctors for the Environment joint statement). 
• Reduction in climate-related illnesses.

5.4: Funding models that incentivise funders to prevention and early intervention to reduce acute and more costly care in the long term. 

• Explore innovative and longitudinal funding models, for example single-payer funding models, for patients at high risk of preventable hospitalisations.

• Reduction in the number of preventable hospitalisations, and the associated costs. 

• Funding for performance improvement to encourage prevention and early intervention. 

• Increase in the use of prevention and early intervention services. 

• Appropriate indexation of MBS patient rebates to accurately reflect the rising costs of delivering high-quality healthcare.

• Annual indexation that reflects the rising costs of delivering high-quality care.

• Reintroduce appropriate indexation for pathology and diagnostic imaging MBS patient rebates.

• Reintroduction of indexation for pathology and diagnostic imaging MBS patient rebates.

• MBS patient rebates are updated regularly to reflect advances in medicine.

• MBS patient rebates are contemporary and reflect advances in medicine.

• Funding models that support the delivery of multidisciplinary care, led by medical practitioners. 

• Increased collaboration and communication among healthcare professionals.
• Increase in access to multidisciplinary care led by medical practitioners.

• Mechanisms to ensure medical practitioners maintain independence with respect to clinical decision-making.

• Introduction of mechanisms to maintain clinical decision-making independence.

• Mechanisms to improve integration and simplify transitions between general practice, hospitals, aged care, disability care, and community care.

• Reduction in transition times between healthcare settings.
• Increase in collaboration and communication between healthcare settings.
   

• Establishment of systems and frameworks to measure patient outcomes. 

• Ongoing use of systems and frameworks to measure patient outcomes. 
• Improvement in patient outcomes over time. 
   

• Leverage technologies that support the delivery of patient-centred care, tailored to patient preferences and needs.

• Increase in adoption of technologies.
• Increase in patient uptake of technology-enabled services.
• Improvement in patient digital literacy. 
   

5.7: A One Health approach to protecting public health that recognises the link between human, animal, and environmental health to improve population health outcomes.

Refer to the AMA One Health position statement for more details.

• Leadership from Aboriginal and Torres Strait Islander communities in all aspects of One Health policy and implementation.

• Increase in Aboriginal and Torres Strait Islander representation in One Health decision-making bodies. .

• A well-funded and resourced Australian Centre for Disease Control (CDC) which is focused on current and emerging communicable disease threats, global health surveillance, antimicrobial resistance, health security, epidemiology, research, and evaluation, and a view to expanding scope to include prevention. 

• Ongoing budget allocation for the CDC.
• Increase in early detection of communicable disease threats.
• Improvements in timeliness and coordination of response to emerging disease outbreaks.
• Ongoing adoption of CDC research into health policies.

• The development of an overarching surveillance framework, led by the CDC, that includes disease monitoring and reporting across human, animal, and environmental health. This framework should feed into a global One Health surveillance network.

• Development and implementation of a surveillance framework.
• Integration of the framework into health policies.
• Increase is cross-sector and global partnerships.
   

• All legislation considers and measures the current and future impact on the health of humans, animals, and the environment.

• Integration of One Health impact assessment process into legislative decisions.

5.8: A regulatory and compliance system that upholds the wellbeing of medical practitioners and all healthcare professionals.

• Medical practitioners are involved in all regulatory and compliance processes.

• Improvement in regulatory and compliance processes due to medical practitioner involvement. 

• Regular feedback on regulatory and compliance processes is sought to support continuous improvement.

• Implementation of mechanisms to gather regular feedback on regulatory and compliance processes. 

• Regulatory and compliance bodies (e.g. Australian health Practitioner Regulation Agency (Ahpra), Professional Services Review) operate and uphold their guiding principles.
• The National Scheme operates in a “transparent, accountable, efficient, effective and fair way” — the guiding principles outlined under the National Law.
• Mandatory reporting legislation is amended in all states to mirror the Western Australian model, which exempts treating doctors from reporting their patients who are registered with Ahpra.
• The Professional Services Review conducts its business according to its values and behaviours of “fair, transparent, and professional”.

• Investigations are completed within acceptable timeframes and according to guiding principles.
• Regular reporting on how regulatory and compliance bodies uphold their guiding principles. 
• Increase the initial screening of complaints to complaints bodies to reduce the burden on practitioners required to respond to inappropriate and low-level complaints. 
   

• Implementation of a more responsive process to clinical concerns regarding MBS complexity. 

• Reduction in complexity.
• Take a more educative and less punitive approach to compliance. 

• Improvements in supporting systems to facilitate quality care.

• Reduction in compliance activities.

• Transparency surrounding fee setting for compulsory fees. 

• Improved clarity regarding compulsory fees and what they are being spent on.

5.11: A more connected and interoperable health and human services sector that enables efficient data collection and exchange to support efficient and effective healthcare delivery and whole of person care.

• Implementation of the Fast Healthcare Interoperability Resource (FHIR) standard across the health and human services sector, accompanied by incentives and legislation to encourage implementation.  

• Implementation of FHIR standard.
• Implementation of a procurement guide at all levels of the health system to support adoption of FHIR standard.
• Increase in adoption of the FHIR standard across healthcare settings.
• Improvement in data sharing between healthcare settings.
• Reduction in duplicated tests and procedures.

• Ongoing investment in digital healthcare technologies to ensure equity of access. 

• Increase in adoption of digital healthcare technologies and use in healthcare delivery.
• Improvement in access to healthcare due to digital technologies.

• Automatic coding of input clinical data, and the development of clinical software and systems that can code patient data efficiently, validly and in a meaningful way within medical practitioners’ usual documentation processes and methods.

• Increase in clinical data that is automatically coded.
• Reduction in clinician time spent on coding.
• Increase in adoption of efficient clinical software.
   

• Education and training for medical practitioners and the broader health workforce to support interoperability. 

• Increase in uptake of education and training.
• Improvement in skills related to data exchange and interoperability.
• Increase in workforce supporting interoperability.
   

• Support for patients and consumers to build their digital health literacy, enabling them to access and control their own health data, and to know who is using their data and for what purposes.

• Increase in patient digital health literacy.
• Increase in patients accessing their own health data. 
   

• Evaluation of the application of interoperable healthcare systems to measure benefits for the health system.

• Implementation of mechanisms to support evaluation. 

• Continued investment in technology to support virtual care, including telehealth, telemedicine, electronic prescribing, remote monitoring etc.

• Increase in delivery of virtual care services.
• Increase in access to healthcare services. 

• Patients are supported with education for, and access to, virtual models of care.

• Increase in health literacy regarding virtual models of care.

• A national focus on improving the digital maturity of the health workforce through education and training.

• Increase in the digital health literacy of the health workforce.

• Investment in infrastructure to support adoption of new and innovative technologies.
• Equitable funding to ensure new and innovative technologies can be accessed by all patients.
   

• Budget allocations for infrastructure.
• Increase in delivery of virtual care services.
   

• Telehealth MBS patient rebates that fairly compensate medical practitioners for patient and non-patient contact time, while ensuring appropriate oversight and governance to ensure continuous improvement.

• Increase in patient access to healthcare through telehealth.

• Artificial intelligence is leveraged to assist in the delivery of healthcare services, with robust governance and regulation to ensure patients, consumers, and healthcare professionals are protected.

• Introduction of governance and regulation related to artificial intelligence that has been developed in consultation with medical practitioners and the broader health workforce. 
• Increase in healthcare facilities leveraging artificial intelligence.
   

5.13: Australia’s health workforce meets the current and future healthcare needs of the population.

• Establish and fund an independent national health workforce planning agency to collate, analyse, and use health workforce data to inform evidence-based policies and strategies. 

• Establishment of a national health workforce planning agency.
• Implementation of a regular monitoring and evaluation process for health workforce planning.
• A medical workforce that meets community health needs. 

• Implement and fund the recommendations of the National Medical Workforce Strategy 2021–2031.

• Progress towards implementation of the National Medical Workforce Strategy 2021–2031. 

• Ensure the prevocational and vocational training pipeline can support the number of medical school graduates. 

• The number of prevocational and vocational training places are aligned with medical school graduates. 

• Ensure medical school intakes, including domestic and overseas full fee-paying places, are linked to workforce planning and community need.

• Medical school intakes are linked to workforce planning and community need.

• Review Commonwealth Government medical training programs (e.g. Specialist Training Program (STP), Bonded Medical Program, John Flynn Prevocational Doctor Program) to ensure they are fit-for-purpose and meeting policy objectives.

• Reviews are conducted and recommendations are implemented.  

• Full implementation of the priority actions outlined in the Commonwealth Aboriginal and Torres Strait Islander Workforce Strategy 2024–24. 

• Progress towards implementation of the Commonwealth Aboriginal and Torres Strait Islander Workforce Strategy 2024–24.
• Increase in the number of Aboriginal and Torres Strait Islander healthcare professionals. 
• Improvements in the delivery of culturally safe healthcare.

• A commitment across all education, training, and healthcare settings to grow the Aboriginal and Torres Strait Islander health workforce as a key enabler to the delivery of culturally safe healthcare and Closing the Gap, including:
  • medical practitioners across all specialities
  • nurses
  • allied health
  • Aboriginal and Torres Strait Islander Health Practitioners
• Aboriginal and Torres Strait Islander Health Workers.

• Increase in the number of Aboriginal and Torres Strait Islander healthcare professionals.
• Improvements in the delivery of culturally safe healthcare.
• Increase in Aboriginal and Torres Strait Islander peoples accessing healthcare.

• Regular and public reporting on progress to growing the Aboriginal and Torres Strait Islander workforce, and evaluation of programs to determine effectiveness.

• Implementation of regular reporting mechanisms.

• Provision of culturally safe environments for Aboriginal and Torres Strait Islander peoples, and implementation of mechanisms to reduce cultural load.

• Increase in healthcare settings that have implemented culturally safe practices.
• Increase in Aboriginal and Torres Strait Islander peoples accessing healthcare.
   

5.15: Medical practitioners are supported to provide culturally safe healthcare.

For more information see AMA Position Statement on Cultural Safety.

• A commitment across all healthcare settings for equity of access to healthcare services that are culturally appropriate and free of racism. 
• Promote cultural safety accountability across health systems, including state health departments, medical teaching hospitals, custodial settings, medical organisations, specialist medical colleges and medical specialty societies.
   

• Increase in the number of healthcare settings that have implemented cultural competence training and culturally safe practices.
• Increase in Aboriginal and Torres Strait Islander peoples accessing healthcare.
   

• All medical education and training providers are required to integrate cultural safety into education, training and continuing professional development programs at all stages of the medical education and training continuum.

• Cultural safety training is integrated into medical education.
• Improvements in medical practitioner understanding of delivering culturally safe care.

• Mandate all medical practitioners to undertake reflective practise about their role in integrating cultural safety into their clinical practice at all stages of their career, outside of and in addition to formal medical education and training.

• Cultural safety training is integrated into all stages of the medical practitioner career journey.
• Improvements in medical practitioner understanding of delivering culturally safe care.
   

• Migration and assessment pathways are streamlined while maintaining standards.

• Reduction in the time associated with migration and assessment.

• Implementation of mechanisms to support international medical graduates to achieve general or specialist registration, in line with a broader medical workforce strategy.
• Barriers to registration and employment are identified and addressed, including financial, social, and professional barries.
• International medical graduates are provided with tailored supports including relocation support, access to leave and subsidies for training, as well as programs to support training and employment within the Australian health system.
• Employment conditions for international medical graduates are fair and transparent, and comparable with domestically trained medical practitioners. 

• International medical graduates are supported to train and work in the Australian health system. 

• Increased financial support for supervising practice settings to enable them to support international medical graduates. 

• Increase in supervising capacity of practice settings who support international medical graduates. 

• Phase out the 10-year moratorium to implement more robust incentives and support mechanisms to attract and retain international medical graduates, as well as the broader medical workforce, in regional, rural and remote practice.

• A sustainable medical workforce in regional, rural, and remote areas.
• Improved access to healthcare services for those living in regional, rural, and remote areas.
   

• Implementation of the actions under the Every Doctor, Every Setting Framework.

• Progress to implementing the actions in the Every Doctor, Every Setting Framework.

• Safe rostering of medical practitioners.

• Increase in compliance with safe rostering guidelines.
• Reduction in burnout among medical practitioners. 
   

• Greater availability and uptake of training programs on bullying, racism, discrimination, and harassment.

• Increase in the number of medical practitioners that participate in training programs on bullying, racism, discrimination, and harassment.

• Avenues for reporting racism, sexism, harassment, violence, and discrimination in the workplace, including the Australian Health Practitioner Regulation Agency reporting mechanism, are safe, evidence-based, and effective. 

• Safe workplaces that are free of discrimination, harassment and violence.  

5.18: Equity, inclusion, and diversity is advanced across the medical profession.

Refer to the AMA Equity, Inclusion and Diversity Plan 2023–25 for further information.
 

• Diverse representation of medical practitioners across hospital and health service governance and leadership to foster diversity in views and clinically-informed decision making as fundamental enablers of high-quality care.

• Increase in diverse representation across hospital and health service governance and leadership. 

• Policies and pathways that support work participation and career progression for international medical graduates, doctors with disability, doctors with caring responsibilities, and doctors returning to work after a prolonged absence.

• Increase in participation of international medical graduates, doctors with disability, doctors with caring responsibilities, and doctors returning to work after a prolonged absence.

• Collaboration to support Aboriginal and Torres Strait Islander doctors, doctors from culturally and linguistically diverse backgrounds, and LGBTQIASB+ doctors to work and train in culturally safe environments, free from racism and discrimination.

• Increase in culturally safe healthcare settings. 
• Reduction in reports related to racism and discrimination. 
   

5.19: High-quality education and training environments that support timely progression and trainee wellbeing across the medical career continuum.

• Accreditation of prevocational training prior to vocational training to provide a structured, safe, high-quality training experience. 

• Accreditation of prevocational training. 

• Development of a framework to support prevocational doctors to progress into vocational training in a timely manner. 

• Prevocational doctors progress to vocational training in a timely manner. 

• Prevocational doctors who do not wish to enter specialist medical training have access to structured training and support to allow them to progress into defined and valued hospitalist roles.

• Increase in retention of career hospitalists. 
• Reduction in doctors in training working in unaccredited positions.
   

• Trainees are supported to make informed career decisions and to undertake training in specialties in line with community need.
• Recognition of prior learning supports trainees to enter specialties in line with community need.
   

• Doctors are training in specialties in line with community need. 

5.20: A sustainable regional, rural, and remote health workforce capable of addressing the health needs of Australians in rural regions

• Develop a National Rural Health and Workforce Strategy, linked to the National Medical Workforce Strategy 2021–2031.

• Development of a National Rural Health and Workforce Strategy.
• Progress towards achieving objectives outlined in the strategy.

• Implement innovative and evidence-based regional, rural, and remote medical workforce policy and programs to incentivise and support medical practitioners to thrive and practice in regional, rural, and remote areas.

• Increase in access to medical workforce in regional, rural, and remote areas.

• Expand the John Flynn Prevocational Doctor Program (JFPDP) from 110 full-time equivalent (440 rotations) in 2022 to 200 full-time equivalent (800 rotations) by 2025 to provide doctors in training with prevocational general practice placements in regional, rural, and remote areas. 

• Increase in prevocational general practice placements in regional, rural, and remote areas.  

• Provide financial incentives to attract and retain both prevocational doctors and specialist trainees to live and work in regional, rural, and remote areas, and to choose general practice and/or rural generalism as a career. 
• Rural communities, local government, and health services work collaboratively to provide social connections and access to services e.g. childcare providers, accommodation, to support doctors to live, train, and work in rural areas, thereby contributing to the productivity, sustainability of a region.
   

• Increase in the number of general practitioners/rural generalists in regional, rural, and remote areas. 
• Access to medical practitioners contributes to the productivity, sustainability of a region.
   

• Complete the rollout of National Rural Generalist Program with a commitment to ongoing funding.

• National Rural General Program rollout is complete. 

• Build on efforts to date to build a training pipeline which takes students through to the completion of specialist fellowship training in regional, rural, and remote areas.

• Increase in the number of medical practitioners in regional, rural, and remote areas.

• Introduce accountability measures to ensure medical schools are training medical graduates that meet community and workforce needs. 

• Increase in exposure to regional, rural, and remote practice during medical training.
• Historically under-represented groups are supported to study medicine. 
   

• Invest in regional teaching, training, and research hubs.

• Increase in regional teaching, training, and research hubs.

• Set a target to expand academic positions for GPs and rural generalists in regional, rural, and remote to teach in medical schools. 

• Increase in exposure during medical school to GP and regional, rural, and remote healthcare delivery.
• Increase in the number of medical practitioners in regional, rural, and remote areas.