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Mid-Term Review of the National Health Reform Agreement Addendum 2020-2025

Dear Minister,
I am pleased to provide the Report of the Mid-Term Review of the National Health Reform Agreement Addendum 2020-2025. The Review was commissioned by the Health Ministers of the Commonwealth and all States and Territories and is a requirement of Clause 21 of the Addendum.

The Review makes forty-five recommendations that respond to the Review’s Terms of Reference. These recommendations seek  to build on the strengths of the National Health Reform Agreement, while proposing reforms and initiatives to enable the health system to address current and future challenges. The Review concludes that there are significant opportunities to broaden the scope of the Agreement to take a whole of health system view, to better manage the interface between care sectors, to embed innovation and reform into its operations, to incorporate the key system enablers of workforce and digital health and to establish priority actions in the areas of First Nations’ people, mental health, prevention and rural and remote health.

While progress has been made to improve transparency and efficiency of hospital funding, largely through activity-based funding, there is an opportunity to take this to the next level by developing  and enabling optimal models of care that seek to deliver care in the right place at the right time, often in the community or through virtual settings. The implementation of a  Health Funding and Payments Framework will embed financing models that are fit for purpose and that reward high value care to improve patient outcomes.

Establishing a robust performance framework that includes measurement of patient experience and outcomes across the health system will enable a more proactive approach to system  management. A thorough consultation process informed the Review and has been invaluable in developing its recommendations. I wish to acknowledge the open and collaborative way in which all stakeholders have participated and their willingness to test ideas and provide case studies and data.

I also wish to thank my initial co-Reviewer, Mr Michael Walsh PSM, who was a tireless contributor to the Review’s consultation phase, policy framing and direction, prior to his appointment as Acting Director General of Queensland Health in late July 2023. The Review was supported by Deloitte and I thank them for their contribution throughout, in supporting consultations,
reviewing submissions and collaborating on preparation of Review materials, report drafting and ideas.

Yours sincerely
Rosemary Huxtable AO PSM
24 October 2023

Copied to: Health Ministers’ Meeting – All Members
Health Chief Executives Forum – All Members


Download the Final Report (pdf)

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