GPs central to ‘best value for money’ healthcare

A Commonwealth deep dive into the nation’s health system has revealed it is becoming increasingly productive, but asking doctors to ‘do more with less’ will not help to continue this positive trend.
 
New research from the Productivity Commission found Australia’s healthcare workers deliver some of the best value for money of any in the world, with productivity growing by around 3% every year between 2011–12 and 2017–18.
 
However, it warned there is still significant room for improvement, and the positive performance ‘is not grounds for complacency’.
 
Commissioner Catherine de Fontenay said the research marks the first time the quality of healthcare has been considered in an assessment of productivity.
 
‘Australia’s healthcare spend is big and getting bigger, but we are seeing significant return on that investment through better health outcomes,’ she said.
 
‘A healthcare system that gets people in and out of hospital quickly and cheaply isn’t much good if those patients aren’t getting better.’
 
The Commission revealed that most productivity growth drivers came from advances in saving lives, but fewer, if any, gains have been made in improving quality of life.
 
RACGP Expert Committee – Funding and Health System Reform member Dr Tony Bayliss said the data shows the Australian healthcare system, and in particular GPs, are resilient, responsive, and dynamic.
 
‘GPs directly care for 90% of the population annually but receive less than 7% of funding, indicating that we are the driver for these improvements,’ he told newsGP.
 
And while Dr Bayliss welcomed the report, he said fragmentation of care resulting from ‘reactive, politically based health policy that appears to be entering the policy agenda’ is the biggest threat to delivering further efficiency gains.
 
‘From short-sighted changes regarding payroll tax that threaten the financial viability of general practice, to changes to prescribing regulations that encourage the development of antimicrobial resistance, the need for patient-centred collaboration and coordination between service providers and governments is clear,’ he said.
 
‘The greatest areas of waste in Australian healthcare relate to inefficiencies driven by the state-federal funding divide.
 
‘This results in poor communication and cost-shifting from state and territory health services to primary care, causing fragmentation of care that threatens the efficiency and effectiveness of our care for our patients.’
 
The research found the greatest improvements in productivity have been driven by reduced rates of smoking and improved management of skin cancers.
 
However, future ‘sizable risks’ include growing rates of obesity and alcohol consumption.
 
Moving forward, Commissioner de Fontenay said the nation’s challenge will be to provide services more cheaply and efficiently, without comprising on quality.
 
‘We have the fourth highest rate of obesity among the countries we studied and the sixth highest level of alcohol consumption,’ she said.
 
‘This worsens population health and creates more work for our healthcare sector.’

Dr Bayliss agrees that obesity and alcohol consumption represent opportunities to further improve the health of Australians, and said GPs are key to rolling out these improvements.
 
‘GPs routinely engage in preventive health activities with their patients, including in relation to alcohol consumption and obesity,’ he said.
 
‘Due to their integration in the lives of their patients, GPs are ideally placed to not only identify who can be helped but also to do this in a patient-centred manner.
 
‘Improved collaboration and coordination throughout healthcare will result in cost savings and improved delivery of care to patients.’
 
The Commission will next explore the transformative potential of technology adoption in healthcare in a follow-up paper, to be released later this year.
 
This will include an investigation into digital records, new models of remote care, and new technologies, such as AI, and their role in making healthcare more efficient and less costly.
 
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