Great debate: how clinicians make their views heard in health reform

Abstract

PUBLIC HEALTH SYSTEMS in Australia and internationally are faced with the need to implement significant reforms. These reforms are driven by the need to balance the delivery of best practice clinical care with rapidly spiralling cost pressures. With much of the agenda for reform driven by managerial, administrative and even political priorities, clinicians have often felt sidelined from the reform process. Indeed, there is some evidence that clinicians have had decreased enthusiasm for their work in recent years, coinciding with a greater role of nonmedical managers and more restrictions on resources.1 There is a wealth of experience and intelligence within the clinical workforce that can contribute to finding solutions to the many complex issues facing the health system.2 This experience and intelligence is expressed in advice on the clinician?s specific areas of expertise and often within their own environment. This may work against the clinician having an effective impact on the reform agenda at the macro level. In that context, the establishment of a Clinical Senate in Western Australia to inform the health reform process by debating major issues that impact across the system is innovative. The Clinical Senate requires that Senators adopt a broad view, set aside their particular clinical allegiances and debate the issues in the best interests of the community. The Clinical Senate is a forum that allows clinicians to influence statewide-level processes through formally recognised channels. This article examines the rationale, processes and operation of the Clinical Senate in WA as a mechanism for effective clinician input into health reform.