Budget fallout: RACGP disappointment over 10-year plan

Matt Woodley

29/03/2022 10:08:17 PM

Despite previous Government assurances, vital components of the Primary Health Care 10 Year Plan remain unfunded, President Dr Karen Price has said.

Federal Budget papers.
The RACGP has said the Federal Budget does not address the future challenges of a fatigued health system. (Image: AAP)

The RACGP has issued a warning that measures announced in the Federal Budget do not address the realities of the COVID-19 pandemic and future challenges of a fatigued health system.
Of chief concern to the college is a failure to implement major components of the Primary Health Care 10 Year Plan, much of which remains unfunded.
Responding to the Budget, RACGP President Dr Karen Price pointed to the college’s recent 10-year plan submission, which emphasised the risks posed by maintaining the status quo – including the impact on high-quality general practice care – should appropriately funded reform not take place.
‘Reform without proper investment is not worth the paper it’s written on,’ she said.
‘General practice is under enormous pressure … we need to fix workforce gaps, particularly in rural and remote areas, and increase Medicare rebates to reflect the cost of providing high-quality general practice care for all patients, no matter their postcode.
‘Tonight’s Budget simply did not live up to expectations on the 10-year plan. This is very frustrating given the time, resources, and effort we and many other health groups have put in over several years.
‘The Federal Government has failed to provide much-needed funding to support vulnerable patient groups, including those with chronic and complex disease, and deliver on what is needed to ensure a strong future for primary healthcare in Australia.’
The college has also indicated that the lack of focus on funding and implementing the 10-year plan will result in continuing gaps in aged care, mental health, disability, and chronic and complex care.
‘There is also a disappointing lack of new investment in Aboriginal and Torres Strait Islander healthcare,’ Dr Price said.
‘If we are serious about Closing the Gap, then surely giving greater assistance to general practices, Aboriginal Community Controlled Health Services and other health services to improve health outcomes must be a priority.’
However, while the RACGP was critical of the lack of primary care investment, it did recognise funding for several important healthcare priorities, including:

  • $16.4 million to establish new endometriosis and pelvic pain clinics in general practice, ensuring that there is frontline primary care support available to improve early diagnosis, treatment, and support, as well as $5.1 million to develop an Endometriosis Management Plan to support patients in primary care
  • $81.2 million for a new Medicare rebate for genetic testing for cystic fibrosis, spinal muscular atrophy, and fragile X syndrome
  • $296.5 million towards the 10-Year Stronger Rural Health Strategy, including more rural medical Commonwealth Supported Places and deregulation of MRI Medicare Benefits Schedule services for Australians in regional, rural, and remote areas
  • $127.8 million for trauma-informed national counselling services to support victim-survivors and extending support for the Aboriginal and Torres Strait Islander Family Support Services for families who are experiencing, witnessing or at risk of family or domestic violence
  • $55 million for the purchase and continued provision of essential personal protective equipment for GPs and pharmacists.
A continued commitment to permanent universal telehealth was also welcomed, but overall Dr Price suggested that the Budget was underwhelming, given the level of investment required to support the long-term future of general practice patient care.
In particular, the lack of funding for reforms related to voluntary patient enrolment was described as a missed opportunity by Dr Price.
‘We know that continuity of care is linked to better patient relationships, better uptake of preventive care, increased access to care, and reduced healthcare use and costs,’ she said.
‘The Budget provides $0.5 million over four years to establish and maintain a governance and advisory group for the implementation of the 10-year plan. But we’ve already had three years of discussions and roundtables.
‘We don’t need more of the same; we need action.
‘This Budget will do nothing to attract medical students to the specialty of general practice and this means that the sustainability of the most cost-efficient and effective part of the health system remains at high risk.
‘A failure of investment in primary care puts every other part of the health system in jeopardy. 
‘We can’t afford to run out of GPs’ 
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Dr Zelle Hodge   30/03/2022 7:33:47 AM

Patient enrolment like all the other various funding mechanisms suggested in the past other than appropriate time based funding will not improve funding for GP nor patient care. It takes time to manage patients well. As I approach the end of my GP career I have the luxury of looking after patients because I want to and the financial incentives are not so important. So I can spend time assessing patients and it is amazing what a difference this can make to their health care. No country in the world can afford free first world health care to all. I have worked many many years ago in the UK. We do not wish to go down that path if we are committed to good quality health care without exploiting the health professionals who give it as is seen now in the NHS. Voluntary will become compulsory. There will never be enough funds to provide appropriate remuneration for skillful GPs if care is provided free to all which is what enrolment will lead to

Dr Marjorie Cross   30/03/2022 7:36:31 AM

Some other thoughts -
1. Around $650m over 5 years for mental health in tonight's budget, spread across > 35 individual programs/services(in marginal electorates).Do the maths - really not much either. These "investments" are likely to perpetuate fragmentation and delay systemic reform and coordination- generally, and hamper continuity of patient care.
2. The Medical Workforce Strategy ? 10 years in the making with wide consultation and evidence base - Resoundingly ignored
3. Perhaps a glimmer of hope for GP small businesses with tax deducibility extended for investment in digital health technology & education. Sure to be a catch though

Dr Suresh Gareth Khirwadkar   30/03/2022 7:09:06 PM

Nobody wants enrolment except Racgp. It serves no purpose at all other than a large jump towards capitation.

Instead incentivise GP to become to speciality it should be - experts in primary care. Not medical certificates and coughs and colds. We need protection from PSR for using level C and D consults so we can actually spend time properly with our patients. We all know that gives the best outcomes.

Dr LS   2/04/2022 1:24:20 PM

Enrolment , fee for service , chronic disease management funding , Mental health funding etc ,etc will not improve health care in this country. These programs are based on Government funding for care.
In General Practice time is key to good care . Time is money . Government funding for primary care is not sustainable . Patients will need to pay for care if they want quality.
I feel undervalued and disillusioned when a patient questions our fees for a service which are more than reasonable but has just attended their fortnightly hair dresser appointment.
I am a GP registrar supervisor. Have done it for a while. Was passionate about General Practice. No More. Can I recommend General Practice as a career. Not in this current climate.