Health reform an ‘urgent priority’: Premiers’ new year push

The issue of primary care funding has landed squarely at the top of the new year agenda, with state politicians pushing for urgent national action to support general practice.
 
Victorian Premier Daniel Andrews and NSW Premier Dominic Perrottet this week both called for urgent Medicare reform as their states’ tertiary care systems struggle to deal with intense pressure.
 
In public statements largely reflecting the advocacy position of the RACGP, the premiers both underlined the importance of increasing general practice investment.
 
‘We urgently need to pay GPs more, increase university places to get a pipeline of new doctors across the nation, attract GPs from overseas to Australia faster – and break down the barriers between primary care and our hospital system,’ Premier Andrews told Nine Newspapers.
 
‘Medicare should be fast, free and local. We’ve done enough talking about its issues – now it’s time for the Commonwealth to prioritise taking action and reform our primary care system.’

Premier Perrottet this week said healthcare is ‘the biggest challenge facing our country’ and said NSW needs more bulk-billing doctors to help relieve pressure on the state’s hospitals.
 
‘I completely agree with Dan. This is the number one priority hands down,’ he told reporters this week.
 
‘When you go through a pandemic, you see the pressure on the system.
 
‘We need to reform Medicare [and] we need to have our public state health system working in support of the GP network – at the moment, they are working against each other.
 
‘We have a moment in history for state governments to work with the Federal Government through National Cabinet to fix the national health system. And NSW will work very closely with the Victorian Government to do that.’
 
For RACGP President Dr Nicole Higgins, the public statements are a welcome acknowledgement of issues that have consistently been flagged by the college.
 
‘The fact the premiers have raised the red flag shows there’s now a recognition that the chronic underfunding has reached crisis point,’ she told Nine Newspapers.
 
‘What I want to see is that urgent funding goes into GPs and primary care.’
 
Dr Higgins said tripling incentive payments to encourage doctors to bulk bill patients as well as raising Medicare rebates for patients who need longer appointments are two areas where increased resources would make a difference.
 
The RACGP President also reiterated the cost-efficiency of general practice and primary care compared with tertiary care.
 
‘Investing in general practice keeps patients out of hospital waiting rooms, reduces ramping and reduces waiting lists,’ Dr Higgins told newsGP.
 
The high profile public intervention by two premiers from different sides of politics comes with the recommendations from the Strengthening Medicare Taskforce due imminently.
 
The RACGP is on the Taskforce, which consists of healthcare organisations, patient groups and policy experts. It began meeting in July last year.
 
Among its stated aims are improving access to general practice and GP-led multidisciplinary team care, making primary care more affordable, improving the management of chronic conditions and reducing the strain on hospitals.
 
At a press conference on Thursday, Federal Health and Aged Care Minister Mark Butler said he welcomed the premiers’ comments, noting that they had expressed similar views last year.


 
Minister Butler, who chaired the Taskforce, said the premiers’ words reflect the Government’s position, insofar as there is ‘no higher priority … than strengthening Medicare and rebuilding general practice’.
 
He also referenced the impact of the six-year Medicare freeze and cited significant increases in gap fees as well as a decline in bulk billing as particular concerns.
 
According to Minister Butler, the work of the Taskforce is ‘largely complete’ with a report due to be released publicly ‘in the coming weeks’.
 
‘I value the contributions from premiers and state health ministers,’ Minister Butler said. ‘State governments are very worried about the impact the parlous state of general practice is having on their own hospital systems.’
 
The Taskforce recommendations will help shape measures in the May Budget, he said.
 
The Government has committed $750 million for Medicare reform, the detail of which will ultimately be decided by Cabinet with the Taskforce’s recommendations designed to feed into their decisions.
 
Last year, Premiers Andrews and Perrottet also joined forces to announce state funding for 50 bulk-billed GP-led urgent care services to relieve pressure on the states’ hospitals.
 
According to the Victorian Government, more than 6000 patients have already gone through the 10 Priority Primary Care Centres (PPCCs) that have been established in that state so far. Many of them could otherwise have ended up in hospital emergency departments, the Government stated in a media release.
 
Nine Newspapers also reports that the premiers of Australia’s two most populous states are collaborating on a proposal to bring to the first National Cabinet meeting of 2023, which is scheduled for 1 February. 
 
According to articles published across the newspaper group, it is likely to include a change to MBS rebates.
 
The results of a poll run by newsGP last month looking at reforms proposed in the General Practice Crisis Summit White Paper showed the majority of respondents believe a 20% rise in MBS rebates would have the most impact on general practice.
 
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