Community management structures to promote health.

This article describes key requirements of effective health service management that emerge from a review of Australian developments in the respective roles of government and the market. From a public interest perspective, community and industry ownership and management of funds appear superior to market-driven health management approaches. The clear separation of public interest-based policy and administrative functions is vital for effective fund management. Greater transparency, more community input to broadly planned service delivery, casemix funding systems and better outcome data are required to tap the potential benefits of this policy-led model. A pooled funding approach to service provision may assist regional communities achieve their health aims, and the service breadth and flexibility which appear to be necessary to support health and related regional goals.