England’s bold 10-year NHS blueprint has similarities to Australia’s reform ambitions. But the path on our shores looks very different.
The NHS recently released its 10-year plan for England, with the hope that it will reform its ailing health system.
Can we compare Australia’s healthcare system and are there any key learnings we should take?
Reading through the plan, CEO of Consumers Health Forum Dr Elizabeth Deveny said the NHS is dealing with some of the issues we have here in Australia. Similarities include making sure people get the healthcare they need in the setting they want and in a financially sustainable way.
She said England wasn’t always the best comparator country for us, however, “because our systems, populations and geography are quite different”.
“One thing that unites both of us is how the idea of a universal health system has for many decades been woven into the social fabric and identity of each country,” she said.
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Co-director of the Leeder Centre for Health Policy, Economics and Data at the University of Sydney, Professor Andrew Wilson, agreed that the NHS is very different to what we have in Australia.
“My first thought was, I wish it was so easy to do that in Australia,” he said.
“This is for England. You’ve got one health service, basically you’ve got one government. It’s much more like a state than it is a national health plan.
“You’ve got all the different elements essentially sitting under the same government department and within the same settings. They’ve got controls, general practice is funded by the same body,” he continued.
Despite the differences, however, he noted that many of the problems are similar to ours.
“It lists what the government says that its problems are. Many cannot get a GP or a dental appointment, waiting lists for hospital and community care balloon, staff are demoralised and demotivated. You’d have to say that applied to many [Australian] state systems at the moment,” he said.
England also highlighted that it lags behind other countries for major killers like cancer.
“We don’t,” said Professor Wilson.
“We lead in a range of these things. We’re number four in terms of life expectancy in the world. We’ve got pretty damn good cancer outcomes for many, and we’ve got falling cancer rates for some as well,” he said.
The NHS’s reimagined healthcare plan laid out three key areas for reinvention:
- hospital to community;
- analogue to digital;
- sickness to prevention.
The hospital to community plan includes the Neighbourhood Health Service. These community services will be tailored to local needs and will include multidisciplinary teams, including GP, nursing, dental, pharmacy, diagnostic and other services.
The goal is to create a healthcare model that is less hospital-centric and more connected to communities to provide continuous, accessible and integrated care.
“The thing I like about those is an attempt to structurally link together those different elements, so… there is an ownership of it. I think that’s a nice feature. Whether it works or not, it’s a different matter,” Professor Wilson said.
He believes Primary Health Networks could potentially fill this sort of role in Australia.
“One of the challenges here is that they’re quite large, the PHNs. So whether they can actually do it in the same way as envisaged here is less clear. But it’s certainly a structure within our system which could potentially bring these elements together in the same way as the Neighbourhood Health Services is anticipating,” he said.
Another element of the plan is to move from analogue to digital. Included in this plan is the Single Patient Record (SPR) and revolutionising the NHS app so patients have a “doctor in their pocket”. England also hopes to use AI more widely to give more time back to clinicians.
Professor Wilson said increasing the use of digital technologies and modern technologies has been a focus in the Australian system for a while now.
“Every state and territory is now moving to a single digit patient record… We’ve gone a long way in trying to connect that up. We’re going to have a real challenge with that system in connecting the public and private systems, but certainly in the public system, there’s a lot of good happening in that space,” he said.
There’s also been a focus on improving access to patients through digital technologies.
“I don’t think we’re there by any means, but they are changing. 1300 Medicare and Healthdirect and, depending on which state you are in, various other telehealth initiatives are moving to provide people with better access to care, anywhere, anytime,” he said.
Dr Deveny agreed.
“While our own digital health system isn’t perfect, I would say that it is probably an area we lead the UK in, if you look at the steps they are undertaking in this plan and that in large part if because of the priority the current and past governments have put into digital health, largely through the Australian Digital Health Agency,” she told HSD.
The final part of the NHS plan is to change the focus of healthcare to prevention. Included in this is a vapes bill, investing in expanding free school meals, expanding access for weight loss medications and public health campaigns for healthier choices.
Professor Wilson said while there are many strategies in Australia, no one has managed to link them together into the health system.
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“While we have a National Preventive Health Strategy, and we’ve got various strategies like the National Obesity Strategy, etc, they sit separate to the rest of the health system, and they lack a real ownership within the health system,” he said.
Dr Deveny said she would be interested to see how the NHS plan progresses, particularly if it gets the backing of the community.
“No government wants to be in the position of having its healthcare reforms rejected by the community. When this happens it usually turns into political kryptonite,” she said.
When the NHS plan was released, it also announced that Healthwatch UK was being defunded.
“Healthwatch UK work in their local areas to ensure the voice of consumers is heard by NHS decision makers and use consumer feedback to improve services. This is a step in the wrong direction,” said Dr Deveny.
In Australia, things work differently.
“In Australia we are dealing with our own federal government’s healthcare reform agenda, which in large part is funneled through the Strengthening Medicare program.
“I have to say on the whole, the government has shown its willingness to engage with community on these reforms and investments into Medicare and organisations like CHF and other consumer health organisations continue to advocate to government in a variety of ways as part of health reforms,” she said.
While it’s true that the NHS’s push toward more community-based, digital and preventive care mirrors Australia’s own healthcare aspirations, the comparisons can only go so far.
Australia may be ahead in digital health and some health outcomes, but challenges remain in uniting prevention strategies and delivering coordinated care at scale.
Ultimately, successful reform in either country will hinge not just on policy design, but on public trust, political will, and a meaningful consumer voice.
