Box 4.2 Two brothers a journey to better health — The Latrobe City Council and the Latrobe Community Health Service have been working together for several years to improve service coordination. In one case, two brothers were referred to the city council for meals on wheels. Assessment indicated the need for provision of other services by the Council and the Health Service that went well beyond meals on wheels, but included multiple coordinated interventions. and his brother were poor at meal preparation, and purchased many takeaways (creating ‘Fred’ financial pressures). A dietician assisted them in shifting away from this pattern of eating. Fred found it difficult to swallow and was referred to a speech pathologist. Fred found it hard to undertake personal care as a result of dizziness and fatigue and was — assisted by an occupational therapist. Fred was often in severe pain, was depressed and talked of suicide. A mental health caseworker provided assistance. The brothers had difficulty controlling spending on poker machines, increasing their financial burdens. A financial counsellor provided support and planning. The practitioners involved in care used a common electronic support plan and given access Fred’s to an ecare planning system so they could follow progress and know about interventions. others’ Outcomes for Fred and his brother improved significantly from this joint approach. Source: Victorian Government, Department of Health and Human Services (2016e). 4.5 Horses for courses not everything should be — devolved While devolution and links between primary care and hospitals are probably the most important directions for the Australian health system, some functions require coordination and cooperation across regional boundaries, or exhibit significant economies of scale — which means they are best left at the national level. There are myriad Australian State and Territory Government agencies and committees whose existence is justified on these grounds. Almost all research activities fall into this category, although that should not limit the capacity and desirability of strong links between researchers and regional decision makers.
Box 4.2 Two brothers — a journey to better health The Latrobe City Council and the Latrobe Community Health Service have been working together for several years to improve service coordination. In one case, two brothers were referred to the city council for meals on wheels. Assessment indicated the need for provision of other services by the Council and the Health Service that went well beyond meals on wheels, but included multiple coordinated interventions. ‘Fred’ and his brother were poor at meal preparation, and purchased many takeaways (creating financial pressures). A dietician assisted them in shifting away from this pattern of eating. Fred found it difficult to swallow and was referred to a speech pathologist. Fred found it hard to undertake personal care as a result of dizziness and fatigue — and was assisted by an occupational therapist. Fred was often in severe pain, was depressed and talked of suicide. A mental health caseworker provided assistance. The brothers had difficulty controlling spending on poker machines, increasing their financial burdens. A financial counsellor provided support and planning. The practitioners involved in Fred’s care used a common electronic support plan and given access to an ecare planning system so they could follow progress and know about others’ interventions. Outcomes for Fred and his brother improved significantly from this joint approach. Source: Victorian Government, Department of Health and Human Services (2016e). 4.5 Horses for courses — not everything should be devolved While devolution and links between primary care and hospitals are probably the most important directions for the Australian health system, some functions require coordination and cooperation across regional boundaries, or exhibit significant economies of scale — which means they are best left at the national level. There are myriad Australian State and Territory Government agencies and committees whose existence is justified on these grounds. Almost all research activities fall into this category, although that should not limit the capacity and desirability of strong links between researchers and regional decision makers.