HSMC in Australia: Setting health priorities

Last week was the biennial meeting of the International Society for Priorities in Health Care, and it took place in the glorious setting of the South Wharf of the Yarra river in sunny Melbourne Australia. Let’s not fool ourselves, academic conferences are as much about relaxing and socialising as they are about developing and sharing knowledge.  But this is a Society dedicated to addressing problems of scarcity, and the organisers got the balance between comfort and excess just about right (from this delegate’s perspective at least).  Huge thanks to Mary Lou Chatterton, Professor Rob Carter and their colleagues from Deakin Health Economics at Deakin University for putting everything together. The meeting was a great success and we look forward to hosting the next one in Birmingham in 2016.  As I contemplate the long journey back, there are three things in particular that I expect will stay with me from last week’s discussions:

We have now arrived at a point where priority setting is an inherently inter-disciplinary field of study and practice.  Whilst the inputs of health economics, ethics and philosophy, political science and organisational studies (and many more) are all valuable, none should be predominant and there are no reasonable grounds for excluding the full range of perspectives and insights.  This couldn’t have been more clearly demonstrated throughout the meeting.

The days when priority setters pontificated over the allocation of ever-increasing budgets appear, at least for the time being, to be over.  This has turned attention to the role played by priority setters in disinvestment.  An HSMC study into decommissioning in the English NHS has identified widespread attempts to grapple with this challenge, and a post-conference workshop organised by the Melbourne School of Government confirms that Australian health leaders have similar concerns.

I couldn’t finish this blog without registering how much I enjoyed listening to Stefan Crausaz talk about the approach of PHARMAC in New Zealand to keeping their drugs budget under control.  A national advisory body that says to Pharma ‘this is our budget, if your products are too expensive we will wait until they are not’ is a very rare thing indeed, and as a result New Zealand’s tax-payers are getting a strikingly good deal for their pharmaceuticals these days!

For more information on priority setting work at HSMC contact i.p.williams@bham.ac.uk