**18. Discussion**

The Australian health system encompasses a mix of Australian Government and State Government responsibilities and is a combination of public and private services. This complexity makes a national health statistics system essential if the Australian health sector is to be understood, accountable, responsive, and improved. Since the 1980s, this system has been established, developed, and maintained. All jurisdictions and sectors have contributed to this effort. The 1992 National Health Information Agreement (NHIA) provided a critical framework for the development of national datasets, ensuring common data standards have been adopted in these datasets. The contrast with health sectors that have stayed outside the NHIA arrangements is stark.

Australia now has a comprehensive array of health statistics, published regularly without political or commercial interference. Privacy and confidentiality are guaranteed by legislation.

However, there are gaps, as some papers in this issue illustrate; most notable are data on primary care patients and encounters, with no current reliable information on the reason for encounter, consultation outcome, and other aspects of primary health care. Similar gaps exist for patients treated by medical specialists outside hospitals, and for patients of allied health practitioners. Additionally, some datasets (such as health workforce) exist in silos, separate from the national statistical agencies where users would expect to find information readily accessible.

The utility of national health statistical collections is dependent on the development and widespread use of national minimum datasets, which ensure the supply of comparable data from different sectors (such as public and private hospitals) and jurisdictions. The more recent emergence of 'big data' sets and analysis provides new opportunities, as long as good statistical practices are followed [50] and high ethical and privacy standards are adhered to.

The papers in this issue highlight that health statistics must respond to health policy needs and developments, and to emerging health issues. Casemix funding for hospitals energised the development and supply of hospital statistics and now relies on them. COVID-19 has led to more timely incidence and mortality statistics and focused attention on the calculation of excess mortality in a pandemic [35].

Work on the postponed National Health Information Strategy should be resumed so that clear priorities for health statistics developments are identified and committed to by all stakeholders. National consultation had occurred prior to the deferral of the development in 2020, which naturally gave rise to wide-ranging demands for improved data and analysis. It is important that the strategy focuses on a few key areas with clear short- and medium-term priorities. These include the following aspects:

