Who we are
The Health Reform Group is an independent association of clinicians, researchers, economists, policy makers and civic leaders committed to improving the health of Australians and the fairness and efficiency of the healthcare system that serves them.
HRG has been meeting under the Chatham House Rule for more than twenty years. It began as an informal gathering of clinicians concerned about serious problems they were observing in NSW public hospitals, and the institutional barriers they encountered while trying to have these problems addressed. The group then evolved into a persuasive forum that helped spark the Garling Inquiry, which in turn recommended key reforms to the NSW hospital system. HRG has continued to meet, advancing a range of policy reforms across healthcare workforce, fairness, safety and quality.
In 2018, members agreed to adjust its name from the Hospital Reform Group to Health Reform Group, recognising that Australia’s most urgent policy challenges had moved upstream, from the safety on hospital wards to the preventability of the chronic diseases filling them.
HRG is an unincorporated association. It is not affiliated with any political party, college, agency, university, industry body or commercial interest. Members participate as individuals.
Our mission
HRG exists to grow Australia’s gross national healthspan, the years Australians live in good health. We do this by advocating for reforms that reduce the demand for care through effective prevention, and ensure the care we do receive is effective and fairly distributed.
We are not a think-tank. We are a lean, pragmatic, truth-seeking do-tank.
What we hold to be true
Health is a critical national strategic asset. The health of Australians is one of our most valuable strategic national assets, deserving of the same attention as our economic activity and military spending.
Health and healthcare are not the same thing. Australia has a world-class healthcare system. It does not have world-class health. Conflating the two lets a system built to treat disease crowd out the intention required to prevent it.
Our burden of preventable disease is unacceptable. Australia carries one of the highest burdens of preventable chronic disease in the developed world. This is not inevitable. It reflects decades of wilful inattention and under-investment in prevention, unchecked industry influence, and a political economy that misprices acute care over population health.
Incentives matter. Advances in strongly incentivised clinical treatments prolong lifespan. Prevention has few if any financial incentives. A fairer, safer, more efficient system will require reviewing these arrangements, including a strategic shift away from fee-for-service remuneration.
Institutional renewal. Australia’s healthcare institutions were built to diagnose and treat the acute illnesses that dominated disease burden in the 20th century. Newly designed institutions are needed for contemporary health burdens.
Institutional interests routinely override patient interests. Healthcare is among the world’s most profitable, fastest-growing sectors. The institutions within it are skilled at advancing their own interests while speaking the language of patient welfare. Genuine reform requires naming this honestly.
Pragmatic universalism. Australians should be able to equitably access the right care, where and when it is needed, based on need and irrespective of capacity to pay. Prioritisation should be decided on the national interest, not the concentrated interests of professions or industry.
The best change comes from the coalface. The most significant improvements in Australian healthcare have come from clinicians and patients who identified a problem and persisted against institutional resistance until the evidence compelled change.
Navigating technology-enabled reform. Healthcare’s institutions have blocked, delayed or misdirected multiple waves of technological innovation. The arrival of agentic artificial intelligence presents as equal parts threat and opportunity.
How we work
Chatham House Rule. HRG activities operate under the Chatham House Rule. Participants may use information developed or received, but may not identify any speaker or attribute remarks without their explicit consent. This has been in place since HRG started and has always been respected.
Independence. HRG is not affiliated with any political party, college, agency, university, industry body or commercial interest. Members declare conflicts and recuse themselves where a conflict is relevant.
Intergenerational transfer. Membership extends from students and early-career clinicians through to senior and retired clinicians, academics and civic leaders. Early career and senior members are encouraged to mix, collaborate and challenge.
Focus. HRG prioritises topics with recognised solutions inside the health and healthcare domains, and resists adjacent, overtly ideological or political activity.
Policy portfolio. Positions are nominated and led by members with relevant expertise, developed collaboratively, reviewed by the membership, and published under the HRG name.
Consensus. Full consensus is not required. Once a position is ratified, HRG speaks with one voice on it.
Being first matters. The first credible voice in a policy debate shapes the conversation that follows.
Lean operations. HRG runs on voluntary contribution. It does not accept funding from government or industry. Philanthropic funding or in-kind support, where accepted, is disclosed.
Membership. Membership is by invitation, extended through the Chair and Convenor.
Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.
Margaret Mead