The global pandemic has focused the policy lens on what needs transforming, not just in healthcare but across most systems.

What we are seeing now in Australia’s health policy—not only because of the pandemic but also the culmination of a protracted period of reform discussion—is a key policy moment for physiotherapy and the wider health system.

In the context of health system failures laid bare by COVID-19, and a system undergoing transition and transformation, now is the time to prioritise the critical issues and structural changes that matter most.

Australia’s health system has evolved over time within a federation that doesn’t work seamlessly.

Although we know there is a long list of health system inadequacies, this crisis has shown us what reform at pace can really achieve.

We’ve seen that it’s possible to reconfigure major systems quickly, and we now must maintain this momentum in the slow crawl out of this international crisis.

In tackling the major system issues, the key pathway to reform lies is lifting the current barriers to enable service integration and collaborative models of care.

This will push towards our core objective of advancing physiotherapy so everyone has access to affordable and appropriate care.

In the context of the reform agenda, we have a significant opportunity to grow as a workforce and shape the future of healthcare.

We are well positioned through our leadership—we have powerful representatives on the government’s Primary Health Reform Steering Group and the Preventive Health Strategy.

We are at the decision-making table informing the current reform directions.

Our involvement is also key for the growth of physiotherapy as we move towards a longer term population-based health strategy.

It is through a greater emphasis on prevention and early intervention that we will start to set the required policy structures to address the underfunded parts of our system.

While these latest developments are positive, the protracted reform process nationally has shown mixed results for our sector.

The recent Medicare Benefits Schedule Taskforce Review response again demonstrates that financial considerations have been allowed to negate the evidence for change.

The rejection of the evidence-based recommendations, made by the specifically commissioned Allied Health Reference Group, shows policy contempt for reforms that involve physiotherapy (and other allied health providers).

Despite the setback, now is clearly not the time to drop the ball on payment reform.

Our recent 2021–22 Federal Pre-Budget Submission argued strongly for equity of access to primary healthcare for all Australians through affordable high-value physiotherapy.

Meanwhile, our strategic workforce planning and related advocacy will continue to follow the reforms in directing new models of care and ensuring we can influence how services evolve.

We need to be part of the solution in health system design and in improving efficiencies by advancing team-based care.

This requires a focus on skill supply issues, ensuring adequate supports and focused development for growing areas of need.

To achieve this, we need to see reform across the key areas of primary care, aged care and disability.

In making the case for physiotherapy, we also need to demonstrate our value in enabling a more efficient health system.

The landmark analysis of a range of physiotherapy interventions in the Nous Group-led report—Economic value of physiotherapy in Australia—provides a key advocacy tool.

It provides the evidence that physiotherapy treatment is a cost-effective option for patients and funders.

When departments and governments ask for the evidence for physiotherapy, we now have a ground-breaking economic report that clearly outlines the evidence. 

It’s also clear that our fragmented health system, and inability to integrate patient care pathways through more coordinated delivery of care, is limiting reform in both public and private healthcare.

Our role is to focus on new funding models that formalise physiotherapy in an integrated health system design.

These new models must be based on the value of physiotherapy, and how we ensure more patients in need of physiotherapy have access.

One area this may happen is in closer links between mental health and physical health and in addressing pain management.

Our workforce solutions should focus on facilitating wider scopes of practice and ensuring a greater emphasis on multidisciplinary care in the healthcare system.

It is also vital that policies encompass integration into service design.

This cannot be achieved through continued reliance on the current payment models or traditional structures that disincentivise integration.

We must also focus on workforce distribution beyond general practice workforce planning.

Failing to nurture rural retention will see continued health disparities across our most disadvantaged cohorts.

A stronger national policy focus is required to both recruitment and retention planning to build the physiotherapy workforce of the future.

There is a need for a targeted strategy, which financially incentivises physiotherapists into training and practices where they are most needed.

The strategic imperative is to build the workforce to address current need and future demand.

The APA has a key role in ensuring a skill acquisition pathway to support members in addressing service need.

Workforce capability means focusing on the future, preparing for disruption (as we’ve seen with COVID-19), and building a future-ready workforce that has both the skills required and the technologies needed to provide the best possible healthcare.

It is in this critical moment in reform that we need to position physiotherapy to ensure we influence health workforce policy decision-making.

Reform in healthcare is usually a slow and frustrating process; however, we see strong signs from the Commonwealth and state and territory governments that they share our goals of better equity in access, funding and workforce distribution.

Our solutions to support improvements in health system design will help to address poor integration, the significant cost barriers and inefficient use of resources.

Let’s make this our policy moment and give Australians access to the care they deserve.