Support for better oral health and oral health services in rural and remote communities has long been and continues to be one of the top priorities for the Alliance.
Through the Standing Council on Health, Ministers have tasked the oral health sector to develop a new National Oral Health Plan for the period 2014-2023. That new Plan will need to be synchronised with Health Workforce Australia's project on the oral health workforce and with work to develop a National Oral Health Promotion Plan.
Having been invited to attend a two-day workshop in Canberra to begin the process of developing the new Oral Health Plan, the NRHA was interested in both the oral health endeavour itself and in the comparison with the current work on the National Strategic Framework for Rural and Remote Health. How is progress against the Oral Health Plan being measured and reported, and what implications might it have for reporting against the strategic framework for rural health?
The National Oral Health Plan for 2004-2013 is called Healthy Mouths, Healthy Lives and the reading materials for this week’s workshop included the latest report on process and outcome indicators against that plan. The report has been produced by the Australian Research Centre for Public Oral Health (ARCPOH) and it provides details of performance in the seven action areas. Six of the seven are population health groups (such as children and adolescents, older people), with the seventh being workforce issues.1
A number of the outcome indicators such as the percentage of children in specific age groups with dental caries are collected by ARCPOH from the States and Territories and there was an almost perceptible groan around the room when ARCPOH officers reminded people that Victoria consistently refuses to provide such data and that New South Wales had only done so once (in 2007). Oral health workforce data come from registration bodies and so are immune from this ‘Federal blot’.
As is the case in so many other domains, there was a general sense of dissatisfaction with the data situation in oral health but a shared view that it is much more important to progress action on the policy and program fronts and that enough evidence already exists for this to be a national priority.
Data shortages in relation to people with special needs, for example, mean that no process or outcome data are available in this action area. However, despite such gaps, the system in place for reporting on progress with the Oral Health Plan looks like a good standard to be aimed at by those working on performance indicators relating to the National Strategic Framework for Rural and Remote Health. There are a significant number of quantitative factors and the reporting process is led and managed by ARCPOH - an agency with independence, clout and credibility.
Who or what will provide the same characteristics when it comes to evaluating progress with the National Strategic Framework for Rural and Remote Health? Given the failure to date of Rural and Regional Health Australia to rise to the challenge, the NRHA's preference would be for the job to be done by a new centre of excellence for rural and remote health within AIHW.
A strategic framework is only as good as the detailed plan for actioning it. And a plan of action is only as good as the outcomes it achieves. It was strange to observe that some of those at the workshop seemed well pleased with the existing Oral Health Plan while also recognising that there is still a crisis in oral health status and services in Australia. Surely the two cannot coexist.
1 about 12 months ago ‘rural and remote’ was added as an eighth targeted action area and ARCPOH reports that the first analysis of KPIs in this area will soon be available.