Budget: Promises kept but reform needed

Matt Woodley

25/10/2022 10:52:23 PM

The Federal Budget fulfils election commitments but does not address the major challenges facing general practice, the RACGP has said.

Federal Treasurer Jim Chalmers.
Federal Treasurer Jim Chalmers described the Budget as ‘solid and sensible’. (Image: AAP)

The Federal Government has committed $2.9 billion to ‘revamp’ Australia’s primary healthcare system, including a re-commitment to $250 million per year in general practice funding over three years – once the Strengthening Medicare Taskforce report is tabled in December.
The 2022–23 October Budget also includes a promised $143.3 million for rural and remote general practice care, and $229.7 million in grants so that general practices across Australia can build better infrastructure.
However, it did not include reforms called for by the RACGP in its pre-Budget submission, such as an increase to Medicare rebates for longer consultations or support for telehealth phone consultations longer than 20 minutes.
During his Budget speech, Federal Treasurer Jim Chalmers told Parliament the Government’s plan is ‘responsible’ and aims to ease cost of living pressures while strengthening the economy.
‘This is a solid and sensible Budget – suited to the conditions,’ he said.
‘One that puts a premium on what’s responsible, affordable, and sustainable.
‘It recognises that our best defence against uncertainty around the world is responsible economic management here at home.’
But RACGP President Adjunct Professor Karen Price said that although it delivers on many key promises, the Budget does not include major reforms needed to secure the future of high-quality general practice patient care.
‘The $750 million set aside for the Strengthening Medicare Fund can’t come soon enough,’ she said.
‘While this is a welcome confirmation, it is important to point out that this represents only 3% of Medicare funding for GP services … the Government must go much further so that no patients are left behind in the years to come.
‘By increasing Medicare patient rebates, boosting investment in rural and remote health, and making longer telephone consultations a permanent fixture of our telehealth system we can really transform general practice care and put it on a more sustainable footing.’
Professor Price also vowed that the college would continue to work hard to ensure further support is provided to general practice in next year’s Budget.
‘The pandemic has exposed cracks in our health system, including general practice care, that require urgent repairs,’ she said.
‘Unless strong action is taken the profession will continue to decline, and we will have more and more trouble attracting and retaining GPs.
‘So, we look ahead to the May Budget next year and urge the Government in the strongest possible terms to boost investment in general practice care and commit to meaningful reform.’
A release issued prior to the Budget by Federal Health and Aged Care Minister Mark Butler said the Government’s overall $2.9 billion package will drive an ‘innovative’ revamp of Australia’s primary healthcare system.
As part of the Budget’s support for rural and remote practice, incentive payments of up to $10,500 will be available to GPs and rural generalists with advanced clinical skills to practice in rural and remote communities, while more health workers will be eligible for salary support through the Workforce Incentive Program.
The Government will also provide $235 million to co-develop 50 Medicare urgent care clinics designed to help reduce the pressure on the hospital system, including $100 million in the first two years.
Professor Price responded positively to the re-commitment to general practice infrastructure grants and support for rural and remote areas, but added that the college is still waiting for more information related to their implementation.
‘These are measures the RACGP advocated for and these, and other initiatives encompassing remote, rural and regional health, like support for further trials of Single Employer Models, are welcomed levers to address the GP crisis in rural areas,’ she said.
However, Professor Price said the college is carefully considering other elements of the Budget before forming a position.
‘As anticipated, the Budget confirms funding for 50 Urgent Care Clinics, which will be developed and piloted in consultation with the profession,’ she said.
‘While the RACGP notes that these will be GP-led, we require further information, including the funding model, workforce requirements, where the workforce will come from, and the impact on existing health infrastructure
‘That is something that we will work through with the Government, because the devil really is in the detail.’
She also welcomed a commitment to the Uluru Statement from the Heart and initiatives aimed at boosting the Aboriginal and Torres Strait Islander workforce in the health sector, but was disappointed about a lack of additional support for general practice mental health services.
‘As our recent Health of the Nation report found, GPs provide the majority of mental health services in Australia, and mental health is the most common presentation in general practice. So, again that is something for us to work through with Government because GPs are the first port of call for many people with mental health issues,’ Professor Price said.
‘It’s been an exhausting few years for GPs and general practice teams and a trying time recently given sensationalist media coverage that has impacted the morale of practices across the nation.
‘My message to all GPs, practice managers, nurses, receptionists, and admin workers is that you are doing a tremendous job and you should not be taken for granted. We will continue working with Government and advocating strongly so that general practice care is properly valued and supported.
‘The fight continues, and we are up for it.’
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Dr Ian   26/10/2022 2:05:22 PM

General Practice will still be strong because there will always be a need for the competent and empathetic generalist who takes good histories and performs thorough and focussed examinations.
Particularly with all the new psychotherapies physical therapies and wisely chosen medications and investigations .

Dr Tatiana Cimpoesu   27/10/2022 10:07:34 AM

Take it from a rural GP, the incentive payments have been available for rural and remote practice GPs for quite a few years now, but was that enough to solve the rural GP shortage?
Other than this clever diversion, the real solution would be increasing Medicare rebates for longer consults so we can provide good care but avoid burnout, hence atract more doctors to general practice. And offer relocation and accomodation suport to rural areas.