Tangibly tackling the cost-of-living crunch in healthcare

Funding must be shifted back into primary care to create a truly affordable healthcare system, according to a panel of medical experts discussing practical ways to combat the cost-of-living crisis.
 
The Managing healthcare amid rising living costs webinar featured input from RACGP SA Chair Dr Sian Goodson, former Deputy Chief Medical Officer Dr Nick Coatsworth, and Australian Diabetes Educators Association Chief Executive Susan Davidson.
 
While the topic of access to healthcare has been discussed at length in several forums and in several different ways, the discussion aimed to provide practical and tangible advice for what needs fixing.
 
And it was general practice funding which came out on top for many.
 
It comes as a rapidly growing number of Australians are struggling to make ends meet, and for many, it is healthcare which is bearing the brunt.
 
For Dr Goodson, this is something she knows all too well.
 
‘I work in a low-socioeconomic area, so I’m seeing firsthand from my patients the stress and the pressure from the increased cost of living currently,’ she said at the webinar.
 
‘There is an access issue, as well as a cost issue when it comes to mental health services as well, and then, worryingly … other patients too are delaying or not getting their prescriptions.
 
‘I can do my best as a GP to prescribe the correct medication and give the correct advice, but if people can’t afford to get their prescription, we know they’re not taking it, and that’s really a ticking time bomb.’
 
The RACGP has long been calling for Australia’s primary healthcare spend to be upped to 10% of the total health budget, but this is yet to be rolled out.
 
And it is GPs who are seeing those consequences play out, with alarming rates of practices being forced to close their doors because they simply cannot afford to stay open in the current climate.
 
It has left some GPs previously to say they are ‘begging’ for urgent change.
 
Dr Goodson said the key to creating real, on-the-ground change is to shift money back into primary care, with that 10% target in mind, and to better allow GPs to work effectively within multidisciplinary care teams.
 
‘We don’t want fragmented care, we want a team that’s working together, communicating really well together, and has digital records that work so we can actually see what each other’s doing without having to replicate,’ she said.
 
‘We’re very clear that needs to be very much coordinated by GPs, and there’s great evidence that having a long-term GP [who] knows you well, having that continuity of care with a GP, means you live longer, and have better health outcomes.
 
‘Understanding how to get the best out of your GP appointments, I think, is really important, and that’s something we don’t always teach people.’
 
According to fresh data, the total number of non-referred GP attendances has taken a dive over the past year, dropping by 1.4% from 166.9 million to 164.5 million.
 
At the same time, the out-of-pocket costs of seeing a GP grew to $44.89 from $42.55, a rise of 5.5%.
 
Dr Coatsworth, who is also an Australian Patients Association ambassador, said he was on the panel to have a ‘frank discussion about what my colleagues and myself are charging Australians’.

‘A patient comes to see me at Canberra Hospital, true story, and has been to the emergency department 10 times in the past six months,’ he said.
 
‘When I ask them why they come to the emergency department or whether they’re able to see their GP, the patient tells me that $43 is too much for them.
 
‘There is a distinct pressure upon hospital emergency departments, which remain the last free solution for Australians in healthcare, the last bastion of universal healthcare.’
 
Currently, the bulk-billing rate among GPs over the past year has remained relatively steady.
 
The RACGP says it has already been proven that ‘funding gets results’, as shown in the wake of last year’s tripling of the bulk-billing incentive, but the college says there is still significant room for improvement.
 
For Dr Coatsworth, he said moving forward, transparency will be key, and general practice must be given greater value.
 
‘If we’re serious about moving towards a system that is primary care-based, preventive medicine-based, then we have to accept that the amount of money that some people are charging in the health system for advanced specialist care is very, very distortionary,’ he said at the webinar.
 
‘I’d really like to see us as a community … really pump the tyres and the value proposition of general practice.’
 
The full webinar is now available to watch online.
 
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