Lessons from abroad? Elections in Australia & Norway move health policy

Elliot Bidgood, 10 September 2013

Over the weekend, Australia brought Tony Abbott and his conservative Liberal-National coalition to power after six years in the cold. Key issues in the election were the economy, the deficit, asylum and carbon taxation, but Medicare, Australia’s popular publicly-funded health system, was also debated. Further, following yesterday’s election in Norway, in which healthcare was a prominent issue, it appears that a coalition including Prime Minister-designate Erna Solberg’s Conservative Party, Liberal and Christian Democrat parties and the controversial right-wing Progress Party is likely to govern.

In a plea to both parties to protect Medicare, the Australian Nursing and Midwifery Federation warned Australians are “experiencing longer waits to see a GP” and that demand was rising due to “a rapidly-ageing population, an increase in preventable chronic disease and ever-changing technology”. These are familiar challenges, although despite similar GDP expenditure on health Australia does outperform the UK on key indicators including numbers of doctors and hospital beds, potential years of life lost, amenable mortality and life expectancy. One of Abbott’s pledges was to put “local communities and experts, not unaccountable bureaucrats, in charge of improving the performance of public hospitals” and to instil “a ‘patient care first’ culture amongst staff” – here, the Doctors’ Policy Research Group has proposed similar measures for our own NHS. Kevin Rudd’s Labor Party, which established Medicare in 1975, had however criticised Abbott’s pledge to cut Medicare Locals – introduced in 2011, the Nuffield Trust has compared Locals to our Clinical Commissioning Groups and they are intended to further strengthen localism in the already somewhat decentralised Australian system.

Meanwhile, in Norway, Erna Solberg “wants to see more use of private health care providers to reduce waiting lists at Norway’s state-run hospitals”, as a similar centre-right coalition has tried in neighbouring Sweden. Outgoing Labour PM Jens Stoltenberg – who went incognito as a taxi driver during the campaign to talk to voters, as Civitas EU researcher Jonathan Lindsell wrote about – warned against this policy, though this is in contrast to the “pragmatic” stance Stefan Löfven, leader of Labour’s social democratic sister party in neighbouring Sweden, has taken to privatisations (“It’s more important to deliver quality than it is who runs it”, he told The Guardian). Waiting times are indeed a problem in Norway, but the Norwegians can take comfort that they also lead us in the Euro Health Consumer Index 2012, are tied with Sweden for flawless performance on outcomes in that Index, have very high per-capita health spending and have far more nurses, doctors and hospital beds and lower amenable mortality than the UK.

Overall, it seems this pair of elections and the robust discussion of healthcare challenges and possible solutions they have fostered, along with the pre-existing relative high performance of the Australian and Norwegian systems, could well provide lessons for the UK, if we are willing to learn them.

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