Access to services is a critical prerequisite for quality care and support. Australia has well-developed care and support systems compared to many nations, however inequities in access exist. In rural and remote areas and for First Nations communities there may be no services accessible. Other times, lack of choice can mean the available options do not meet the needs of all users. Both issues contribute to low service usage across aged care and disability services in remote areas, and as well as for First Nations peoples and a number of other marginalised groups.
Increasing the accessibility of locally tailored and culturally safe care and support services for First Nations peoples requires supporting the growth of First Nations community-controlled organisations. These organisations are well-positioned to provide services grounded in First Nations perspectives and values.
Delivering choice and control in thin markets
The term thin markets is used to describe where there are low numbers of buyers or sellers for a particular product or service. Challenges to delivering services in thin markets include low and geographically-dispersed demand, increased costs, administrative and regulatory complexity, and workforce shortages.
The Market Capacity Framework (Table 1) provides a way to categorise whether markets are diverse and contain enough providers.
Figure 6: Market Capacity Framework28
| Market | Market Non-diverse | Market Diverse |
|---|---|---|
| Market Insufficient | Market Failure: “There are no providers offering services for me.” | One provider with strong tailoring to client needs: “There is just one provider, but they tailor their service to me.” |
| Market Sufficient | Multiple suppliers of standardised services: “There are lots of providers but they all offer the same thing. They won’t tailor to me.” | Diversified supply: “I can choose from a range of providers offering different approaches to the service I need.” |
Consumers need to have real choice and control over their providers for competition-driven market incentives and dynamics to work. More nuanced approaches to market stewardship are required in thin markets, and across the care and support economy, to ensure people have access to the care and support they need. This is addressed further below under Goal 3: Productive and sustainable.
Objectives
1.1 People have access to the care and support they need
1.4 Services are culturally and psychologically safe for all people
How will we get there?
The Australian Government is currently undertaking trials of integrated commissioning where providers are funded to deliver cross-sectoral services in thin markets. If one service delivers multiple services in a community (e.g. health, aged care and disability support), they may be better able to reach a sufficient number of clients to make service delivery cost effective. This requires government departments to pool funding and adjust regulatory requirements. The aim is to learn from these trials to iterate and develop good integrated commissioning models that can be more readily deployed to address thin markets.
- Reeders, D., Carey, G., Malbon, E., Dickinson, H, Gilchrist, D., Duff G., Chand., S., Kavanagh, A. & Alexander, D., Market Capacity Framework, Centre for Social Impact, 2019.Return to footnote 28 ↩