The authors of this paper propose the establishment of local Regional Health Organisations (RHOs) across Australia, with each responsible for the health care needs of a defined population within their region.

Australia's unique geography and federated system of governance has, over time, led to a health care system that is fragmented and duplicative, inequitable and less efficient than it might be. Shifting health care governance and funding to regional agencies that are more responsive to the needs of communities would improve both equity and effectiveness in Australian health care.

The RHO governance and funding model would improve the provision of health care by:

•    shifting responsibility for health care service planning and delivery closer to citizens;

•    improving the responsiveness and accountability of health care and helping to eliminate cost and blame shifting; and,

•    addressing the inequity of access and health outcomes and inequitable allocation of health resources.

This model proposes that all current health care funding from local, state and federal governments be pooled within a national agency and equitably distributed to RHOs on the basis of evidence about health care needs. Publicly available information on local health needs and health spending (regularly collected and updated in accordance with national standards) would inform decisions by RHOs about the appropriate allocation of services and resources in that region.

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