Implications of policy and management decisions on access, quality, and type of services for the elderly in Australia.

: There can be little argument that the need for a clearly articulated health care policy for the ageing is a legitimate concern. An optimum health system response will only evolve in a climate of clear definition of responsibilities, in concert with an effective policy-making mechanism. Within the health system there is likely to be a greater consensus concerning the elements of such a policy than would have been possible at any previous time. What is more likely to be debated is the question of what constitutes the legitimate boundaries of health as a concept to be applied to ageing populations and individuals. It is in our view essential that arguments about professional demarcation and alternative paradigms of ageing do not cloud the fundamental health and health care issues; these must be vigorously addressed if the otherwise inevitable burden of age-related illness and disability is to be effectively tackled.