Australians with disability have poorer health than their peers without disability across a range of health outcomes, despite Australia’s obligation under the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (Article 25) that people with disability have the right to the highest attainable standard of health, without discrimination on the basis of disability. A significant proportion of the gap in health between people with disability and people without disability (disability-related health inequalities) are avoidable.

The poorer health of Australians with disability is related to social and economic disadvantage (social determinants) as well as lack of access and inclusion in health promotion, preventative health care and health services. To address these multiple drivers of health, cross-sectoral collaboration is required, particularly between the health and disability sectors.

The CRE-DH held a virtual policy forum in September 2022 with Commonwealth government policy makers and disability representative organisations. The forum was repeated the next day with different attendees. Participants in each forum were separated into groups and the groups discussed two questions:

• How can health care systems be designed so that people with disability receive the support they need to achieve health on an equal basis to others? 
• How can health, disability and related service systems work together to help achieve optimal health outcomes for people with disability?

The working groups identified 12 issues and discussed several solutions which form the basis for the 12 recommendations for reform that should be considered. These are summarised in Table 1 and grouped under three categories: whole-of-government, health system, and across the disability and health systems.

Recommendations

Whole-of-government reforms

1. Develop a National Disability and Health Strategy.

2. Include people with disability in the design and implementation of policy across all sectors.

3. Consider the establishment of a National Agency for Disability to coordinate disability-related policy and programs across government including health, possibly within the Department of the Prime Minister and Cabinet.

4. Improve the quality of national data through the development of disability identifiers and integration (linkage) of data across State and Territory service systems.

Health system reforms

5. Conduct Disability Impact Assessments to understand the potential impacts of policies on the health of people with disability.

6. Health services should be high quality, person-centred, accessible and address the needs of all people with disability.

7. Tailored health care services where necessary and building the capacity of mainstream services for all people with disability.

8. Health care systems should incentivise the promotion of health and equity outcomes, including for people disability, rather than simply fund activity (i.e., delivery of a service).

9. Commonwealth, State and Territory governments work together to achieve optimal health outcomes for people with disability through a National Disability and Health Strategy and a specific action plan through the Australian Disability Strategy.

Cross-sectoral disability and health system reforms

10. The health system should proactively collaborate with other organisations to guarantee accessible and timely availability of information and services catering to the broader health and wellbeing needs of people with disability.

11. Provide funding and opportunities for Commonwealth departments and agencies to work together.

12. Build on current cross-sectoral forums and committees that include people with disability and other stakeholders to identify opportunities for reforms across the sectors.