GP incentives review ‘nothing but disrespectful’

A new review has recommended general practice incentives undergo a major overhaul, but it is a plan GPs have labelled a ‘missed opportunity’.
 
Authored by an Expert Advisory Panel, the review follows on from the Primary Health Care 10 Year Plan 2022–23 and Strengthening Medicare Taskforce.
 
Its aim is to assess the efficiency of existing incentives, including the Practice Incentives Program (PIP) and Workforce Incentives Program (WIP), and to redesign the current incentive programs through the development of a new ‘shared vision for the future of general practice’ by 2032.
 
In the first look at the plan, its recommendations include a Baseline Practice Payment to embed multidisciplinary care into service delivery, and for this to be done through ‘core funding to practices weighted by patient need, complexity and rurality’.
 
It also recommends investment into creating a ‘cohesive vision for primary care’ through eligibility for accreditation being expanded to include non-traditional general practice models, including for services not currently eligible to be accredited.
 
RACGP President Dr Nicole Higgins said it is vital GPs understand the paper has only made recommendations, and that these still must be reviewed by Government before they are officially accepted or rejected.
 
Feedback from the consultation process will now be collated for the Expert Advisory Panel’s consideration as it finalises its report.
 
However, Dr Higgins said peak general practice bodies were denied input into the recommendations through a place on the panel, describing it as ‘nothing but disrespectful’.
 
‘This failure to co-design the recommendations alongside the relevant professional bodies is a concerning misstep by the Government if it wants GP support,’ she told newsGP.
 
‘What we actually need overall is to increase money into general practice – if we don’t fund general practice enough to meet future demand, then everything fails.’
 
The review’s authors said overall, its new payments will result in an increase in blended funding in primary care payments from 10% to 40% at the system-level by 2032.
 
The review also recommends an After-Hours Care Support Payment to provide deputising after-hours services for patients, a Quality and Innovation Program, and a Teaching Payment.
 
As part of the proposed approach, over time, the existing PIP and WIP Payments will be replaced ‘while ensuring viability of general practices to meet patient needs’, the review states.
 
In a previous RACGP submission to the ‘Effectiveness Review of General Practice Incentives’, the college said the incentives are critical to the viability of general practices and should be better aligned to quality of care.
 
‘GPs must be equal partners in the design of any new payment models and are engaged to achieve the desired outcomes of the various incentive programs,’ it said.
 
‘It is critical that the redesign of general practice incentives and associated funding programs does not result in a net loss in funding for general practice.’
 
The review also recommended the Government to direct all current WIP provider payments to general practices, rather than individual health professionals, to enable flexibility and agility in attracting, recruiting and retaining health workforce professionals into rural and remote practices.
 
But Dr Higgins said one of her biggest concerns is around the impact of the WIP changes and how they will affect rural practices and the impact this will have on GPs doing rural locum work.
 
‘It could rip out general practice incentives in rural areas – this will be a further disincentive for workforce attraction,’ she said.
 
‘Australia has got one of the best health systems in the world, but the problem is that general practice is underfunded, and the system is not currently meeting patient needs.
 
‘The importance of this report is we’ve got Scope of Practice about to land, and other reports, other reviews that are all dovetailing into each other, and we now can see the direction the Government is heading.’
 
It also recommends for the Federal Government to commission an independent primary care pricing authority to advise government on Commonwealth payments to general practices and primary care.
 
GPs have previously been overwhelmingly supportive of the introduction of an independent body responsible for setting MBS rebates, with a newsGP survey finding 81% of respondents backing the idea.
 
Finally, it called for the facilitation of an ‘effective transition’ to the new payment model through funding, research, and modelling.
 
Dr Higgins said she fears the onslaught of changes will only devalue general practice as a profession and a career choice.
 
‘There is significant change coming and the RACGP has done a lot of behind the scenes to change the direction, but now I can see that GPs are beginning to understand the impact and these implications,’ she said.
 
‘GPs need to come along that journey with us, because GPs understand the need for reform, they are angry that many of the reforms and recommendations further devalue the role of GPs in the health system.
 
‘It’s been a missed opportunity … it’s just more red tape and confusion for GPs who just want to get on and see our patients.’
 
For GPs wanting to know more or to get involved, further information will be available at a Review of General Practice Incentives consultation webinar, beginning at 2.30 pm (AEST) 12 August.
 
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