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Vaccine rollout funding reform headlines RACGP advocacy agenda


Michael Wright


10/05/2021 4:55:14 PM

The college continues to call for additional MBS item numbers to support vaccine counselling in general practice.

Hand holding COVID vaccine.
The RACGP has argued that a patient’s choice to have a COVID vaccine is often made in the consulting room. (Image: AAP)

Highly-publicised reports of rare blood clots associated with the AstraZeneca COVID vaccine have contributed to increasing concerns about vaccine hesitancy in the community.
 
The RACGP has argued that a patient’s choice to have the vaccine is often made in the consulting room – with their usual GP. And while most patients do decide to have the vaccine, this discussion with our patients is taking an increasing amount of time, and this needs to be recognised through the Medicare Benefits Schedule (MBS).
 
The Department of Health (DoH) recognises that the vaccine counselling process is requiring more time than was initially anticipated for some patients.
 
The RACGP is advocating for additional funding to support GPs in providing extra counselling when needed. It is important our patients feel informed before deciding to have the vaccine, both about the benefits of the vaccine, as well as the rare severe adverse reactions.  
 
The RACGP is in ongoing discussions with the Federal Government on this topic and I hope to be able to provide you with more information soon.
 
Telehealth – Extension of MBS item numbers until December 2021
Late last month, we were pleased to see the Federal Health Minister Greg Hunt acted on calls from the RACGP to extend telehealth item numbers until 31 December 2021 in order to allow time for a permanent model to be developed.
 
The full details of the temporary extension will be announced as part of the 2021–22 Federal Budget, but we unfortunately already know that, with the exception of some mental health specific MBS items, funding for the majority of phone consultations longer than 20 minutes will not continue beyond 30 June.
 
While the Government is concerned about the growth in Medicare services, since early 2021, the RACGP argues that the small increase in growth is a result of the pandemic, due to a shifting of services from emergency departments (EDs) to general practice, and ongoing catch-up care related to people avoiding their usual appointments early in the pandemic. 
 
As such, we believe that available data on telehealth use may not predict future general practice service use. The RACGP maintains the current model should be extended, and has proposed that the development of permanent telehealth funding arrangements should be delayed until there is more accurate data available to determine what the need for and appropriate use of telehealth is, beyond the pandemic.
 
RACGP President Dr Karen Price has also urged the Government to reconsider the role of longer telephone consultations when developing a permanent telehealth model.
 
Continued Dispensing
The RACGP recently met with the Chair of the Pharmaceutical Benefits Advisory Committee (PBAC), Professor Andrew Wilson, to discuss our submission to the DOH’s proposal to allow a permanent model of pharmacist continued dispensing for a specific list of medicines, including those commonly used to treat chronic diseases like asthma, lung disease, diabetes and heart disease.
 
The RACGP does not support this proposal, as GPs are already highly accessible, and the introduction of telehealth and electronic prescribing has made it easier than ever for patients to get a new prescription from their GP.
 
Ultimately, telehealth and electronic prescribing means that there is not the same need for continued dispensing, and we hope that is reflected in any DoH decision on the proposal.
 
Senate Select Committee on COVID-19
Last month, Associate Professor Charlotte Hespe, Chair of RACGP NSW&ACT, represented the college at a public hearing for the Senate Inquiry into the Australian Government’s response to the COVID-19 pandemic.
 
The focus of the hearing was on the COVID-19 vaccination rollout, and Associate Professor Hespe spoke at length about the contribution GPs have made to Australia’s response to the pandemic overall, including:

  • the ways in which the general practice community has adapted to providing care during the pandemic
  • the role of general practice in vaccinating the community against COVID-19
  • the additional time required to inform and educate patients about the vaccine rollout
  • the need for GPs to be formally recognised as frontline health providers as part of pandemic preparation, response and recovery.
Submissions
Following feedback from the RACGP, several changes have been made to the draft Health Practitioner Regulation National Law Amendment Bill 2021 (the draft Bill).
 
The submissions resulted in several red flag issues being removed from the draft Bill, including allowing non-medical practitioners to Chair the Medical Board of Australia, and enforcing that practitioners disclose reasons for a chaperone condition imposed on their registrations.
 
The RACGP has also provided feedback on the draft Bill to strengthen protection of GPs around show cause notices, referral to other entities prior to finalisation of an investigation, and overreach of disciplinary action.
 
A separate college submission to the Senate Inquiry into the Administration of regulation and notifications by the Australian Health Practitioner Regulation Agency (Ahpra) welcomed the recent release of a framework for identifying vexatious complaints.
 
However, the RACGP argued that further work needs to be done to appropriately vet the huge volume of complaints that Ahpra receives. Our submission suggested that the resources required to manage the complaints Ahpra receives, which result in no further action 70.2% of the time, could be better used to appropriately support practitioners and notifiers through the notifications process for more serious complaints.
 
The college also provided a submission to the DoH’s Electrocardiogram (ECG) Review Committee.
 
The Committee was established by Minster Hunt following widespread sector concern with changes made to Medicare items for ECGs performed in general practice in August 2020.
 
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