The federal election is done and dusted but there are worrying signs about our health system that remain and demand reform, health leader Stephen Duckett told The Conversation.

Any fresh reform agenda will be starting from a position of relative strength, he says.

“Australia has a good health system that consistently ranks well compared with other wealthy nations – including on life expectancy, which is on the high side.

“Medicare remains the right infrastructure for funding primary care. But it is now more than  40 years old and needs to be updated and improved.”

Policy action, Duckett said, is necessary on five fronts:

• financial barriers to care
• managing chronic conditions
• mental health and dental care
• public hospitals
• the workforce

There has been inadequate funding of public hospitals by the federal government, Duckett says.

“The commonwealth share of public hospital funding has been trending down for the last few years, reversing the growth in its share over much of the last decade,” he says.

In 2014, the Abbott government abolished Health Workforce Australia, the national agency responsible for health workforce planning. Ten years later, Duckett says, it’s no surprise we are in the middle of a critical shortage of doctors and nurses.

“Ensuring we have the right workforce mix to address rural health needs requires a fresh approach. That includes revised funding models – as proposed in the GP incentives review – and allowing all health professionals to work to their full scope of practice,” he said.