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Health Minister pushed for more detail on proposed general practice reforms


Anastasia Tsirtsakis


23/02/2023 5:00:02 PM

RACGP President Dr Nicole Higgins has written to Mark Butler calling for decisive government action and investment in patient care.

The Strengthening Medicare Taskforce report.
The Strengthening Medicare Taskforce report was released earlier this month.

Momentum is building around health system reform in Australia.
 
But since the release of the Strengthening Medicare Taskforce report earlier this month, which proposed a series of healthcare reforms and was cautiously welcomed by the RACGP, there has been little clarity about what the next steps to implementing the recommendations will look like.
 
With the May Budget fast approaching, RACGP President Dr Nicole Higgins this week wrote to the Federal Health and Aged Care Minister Mark Butler in a bid to get more detail on the work that is being done to fix Australia’s ailing healthcare system.
 
In a letter sighted by newsGP, Dr Higgins acknowledged that the report contains ‘many promising elements’, but also noted the ‘high level of ambiguity’ surrounding its recommendations, particularly the specific actions and investment required to address the immediate and long-term issues facing the sector.
 
‘As you are aware, general practice is the backbone of the health system, with nine in 10 Australians visiting their GP each year,’ she wrote.
 
‘Evidence shows that a well-supported general practice sector will result in efficiencies for primary and secondary care, and the broader healthcare system. However, for decades, growing healthcare costs in general practice have increased beyond investment.
 
‘Without decisive government action and investment in patient care, we will continue to see the deterioration of our health system, accompanied by worsening patient outcomes.’
 
Dr Higgins highlighted that immediate action is needed to increase patient access, and referred Minister Butler to the key measures identified in the RACGP’s pre-budget submission. The proposed actions include:

  • a 20% increase to Medicare patient rebates for Level C and Level D consultations
  • re-introduction of Medicare patient rebates for consultations lasting longer than 20 minutes, mental health and GP management plans conducted via telephone
  • new Service Incentive Payments that support care for older people, people with mental health conditions and people with disability
  • tripling of the Medicare patient rebate for the Bulk Billing Incentive items
  • support for GPs who see their patient within seven days of an unplanned hospital admission or emergency department presentation
The submission also proposes the introduction of a program for junior doctor placements in general practice to grow the workforce, as well as a feasibility study to assess the economic and health benefits of reforms to pharmacy ownership and location laws to improve access to medicines.
 
‘These measures will provide a critical boost for GPs and practice teams and will help attract new doctors into general practice,’ Dr Higgins wrote.
 
Meanwhile, looking to longer term solutions, the college president emphasised that the RACGP does not support measures that ‘add bureaucracy and further fragment funding’.
 
‘We encourage government to fund patient care directly through general practice, rather than through bureaucratic structures,’ she said.
 
‘As part of this long-term reform, we need to see action to simplify and streamline Medicare, reducing complexity and supporting GPs to deliver high-quality continuous services to all their patients.
 
‘While the fee-for-service model should remain the foundational platform for general practice funding, we see a key role for blended funding approaches to support quality general practice care, particularly for people with chronic and complex needs.’
 
One of the recommendations proposed by the taskforce, and welcomed by the RACGP, was increased investment to support multidisciplinary teams in general practice that are responsive to local needs.
 
However, while Dr Higgins backed this idea, she emphasised the need to have GPs at the helm.
 
‘Australia has an extremely high-quality health system that needs to be protected,’ the President wrote.
 
‘We need GPs working hand-in-glove with allied health professionals, pharmacists, practice nurses, nurse practitioners, and they should be supported within general practice, with GPs as the stewards of integrated patient care.’
 
There have been grave concerns emerging over expanding the scope of practice for private sector pharmacists, with both the RACGP and the National Aboriginal Community Controlled Health Organisation vocal that people’s care will be compromised as a result.
 
Dr Higgins drew Minister Butler’s attention to the UK House of Commons’ The Future of General Practice Report as a warning for Australia not repeat the mistakes of other countries by ‘over-prioritising access rather than continuity of care and optimal outcomes’.
 
‘This will result in a more fragmented and less efficient health system, and is likely to significantly impact on patient health and wellbeing,’ she wrote.
 
‘We know patients who have continuity of care with a regular GP report high levels of satisfaction with their experience of care, have lower rates of hospitalisation and emergency department attendances, have lower mortality rates, have lower healthcare expenditure and are more likely to receive appropriate and patient-centred care.’
 
Another recommendation proposed by the taskforce is introducing a streamlined and straightforward voluntary patient enrolment (VPE) scheme that enables patients to sign up to a practice that receives extra funding to coordinate care.
 
While Dr Higgins said that the evidence-based multidisciplinary approach to care should be underpinned by a fit-for-purpose VPE model, she said more detail is needed.
 
‘As we have previously advised, any VPE model must be supported by significant investment and align with the flexibility required in general practice,’ she wrote.
 
‘This will help to ensure the model brings benefits to patients, health practitioners and the broader health system.
 
‘We appreciate the Strengthening Medicare Taskforce Report features several measures to improve patient access to high-quality care and is a key step towards building a sustainable and effective health system.
 
‘We look forward to working with you to achieve this health system. To support a continued collaborative approach to reform, further advice regarding the timeline for next steps is welcomed.’
 
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Dr Abdul Ahad Khan   24/02/2023 11:13:50 AM

Dr. Higgins, you requested a 20% increase to Medicare patient rebates for Level C and Level D consultations
What about the Medicare Rebate increase for the bulk of GP Consultations - Level B ?