GP reform push supported by emergency doctors

‘The result of decades of underfunding and under-resourcing primary care.’
 
Such is the characterisation of a key reason for the crisis affecting hospitals nationwide according to Dr Clare Skinner, the President of the Australasian College of Emergency Medicine (ACEM).
 
In an interview with Nine Newspapers published this week, Dr Skinner talked about an outdated model that is putting the tertiary care system under unprecedented strain.
 
‘We have squeezed every last drop we can out of this current model that was devised in the 1980s that is no longer fit for purpose as the population ages, and we’re needing to manage complex chronic disease,’ she said. 

‘We’re seeing people with chronic and complex illnesses who have deteriorated to the point where they need a hospital admission because they haven’t been able, or can’t afford, to access that care in the community.
 
‘Then there are no hospital beds available for them because there are other people occupying those beds who can’t be discharged for the same reasons.’
 
Dr Skinner said she believes most healthcare workers would welcome bold steps to address the situation.
 
‘I think healthcare workers of Australia would stand behind a government that had the courage to make the big decisions to reform this broken system,’ she said.
 
‘The workforce is totally broken.’
 
The pressures on hospitals workforces were also brought into focus earlier this week when the Victorian Government announced plans for five new GP-led bulk-billing priority care centres.
 
In its announcement, the Government described the state’s emergency departments as ‘the busiest they have ever been’, saying presentations recently hit the highest quarterly rate ever of 486,701.
 
The interview with Dr Skinner was published ahead of the next meeting of the Strengthening Medicare Taskforce this Friday.
 
The group was convened by the new Federal Government as part of a process to decide how to target $750 million of funding for Medicare over the next three years.
 
It includes 17 members from diverse parts of healthcare, such as the RACGP, AMA, Consumers Health Forum of Australia, the Australian Nursing and Midwifery Federation, and Aboriginal healthcare experts, as well as GP academics. The ACEM is not represented on the taskforce.
 
The RACGP recently published its advocacy priorities, which have already been raised at the taskforce meetings. The challenges of managing chronic health conditions are key, with enhanced primary care services for people over the age of 65 listed, as well as backing for longer consultations and improved telehealth access to ‘support patients with complex needs’.
 
Like Dr Skinner, RACGP President Adjunct Professor Karen Price highlights the connection between the way general practice functions and other parts of the health system.
 
‘We can’t go on or we risk really having a huge challenge in Australia – one which it’s never faced before – where the primary care sector falls over and the rest of the health system will seriously suffer,’ she previously told newsGP.
 
Professor Price, who is the college’s representative on the taskforce while it sits this year, has also said sweeping changes will be needed to address the issues – and flags the likely impact improvements in primary care could have on tertiary care.  
 
‘My focus will be to make sure that the big structural changes are implemented, and in particular, looking at one whole health system so states can recognise that contributing to general practice helps their hospital systems,’ she said.
 
Federal Minister for Health and Aged Care Mark Butler has frequently acknowledged the scale of the challenges facing primary care, describing it on one occasion as ‘in worse shape than it’s been in the entire Medicare era’.
 
He called the looming GP recruitment challenge ‘probably the most terrifying trend’ in primary care and has stated that improving Medicare is ‘the most important priority of our health portfolio’.
 
Log in below to join the conversation.

ACEM emergency medicine GPs primary care reform