What does the Federal Budget mean for general practice?

Doug Hendrie

4/04/2019 2:19:28 PM

GPs had high hopes for a major reinvestment in general practice, but RACGP analysis shows primary care still needs greater levels of funding.

Federal Budget 2019-20
RACGP President Dr Harry Nespolon wants a better deal for general practice.

But while there were positive steps, the Budget still does not adequately fund patient care and general practice, according to RACGP President Dr Harry Nespolon.
The RACGP’s Budget overview welcomes the big announcements, including:

  • $448.5 million over three years to allow chronic-disease patients aged over 70 to voluntarily enrol with their general practice
  • $201.5 million over five years to support practices administering the Practice Incentive Payment–Quality Improvement (PIP–QI), and for maintaining PIP Aged Care Access Incentive  (for which the RACGP strongly advocated)
  • $187.2 million to re-introduce indexation to all remaining GP services on the Medicare Benefits Schedule (MBS).
Dr Nespolon said that while the re-indexation is welcome, it would not repair the damage caused by years of de-valuing general practice services and the long-running Medicare rebate freeze.
‘The funding freezes, introduced by successive governments, have exacerbated the failure of proper investment in GP patient rebates to ensure they reflect the cost of providing quality care,’ he said
The RACGP will be advocating for the use of a more appropriate indexation method than the current Wage Cost Index 5, which is consistently lower than health inflation and the consumer price index.
‘Costs to provide care have continued to increase year on year, but the Government has failed to match these increases in the patient rebate. As a result, the Government’s contribution to patient care now only covers around 50% of total cost to the patient for privately billed care,’ the RACGP’s Budget overview states.
‘To ensure GPs can continue to provide high-quality care to their communities, the RACGP encourages GPs to set fees that reflect the cost and value of the care provided.
‘Until the Government commits to substantial investment in patient care and GP services, patients will continue to face rising out-of-pocket costs.’
While he welcomed the $448.5 million in funding, Dr Nespolon cautioned that the allocation for patient enrolment does not appear adequate to ensure the proper benefits can be fully realised.
Even though only a minority of eligible patients are expected to enrol in the first year, which the RACGP believes has been taken into consideration, the funding still does not appear adequate.
The RACGP supports a voluntary enrolment model that allows a patient to identify a preferred GP at their practice, while also being able to access care from other GPs within or outside of the practice as needed.
‘With the right funding, the RACGP would call for voluntary enrolment and access to more flexible services from a patient’s regular GP and practice extended to all patients,’ Dr Nespolon said.
Dr Nespolon commended the Federal Government on increasing funding to the PIP–QI, following significant RACGP advocacy. 
‘The RACGP is pleased to see that a number of concerns it raised regarding the proposed PIP–QI have been addressed, including the provision of additional funding,’ he said.
Other Budget announcements relevant to general practice:
  • The Aged Care Access Incentive will be retained, following repeated RACGP calls to keep the incentive for GPs to deliver care in residential aged care facilities  
  • A new training pathway for rural generalists was allocated just over $62 million in funding as a key Budget measure, which the RACGP sees as key in addressing the shortage of rural doctors
  • A boost to health and medical research, with $45 million for primary healthcare research
  • More than $26 million to extend the transition period for the changes under the Stronger Rural Health Strategy, including changes to geographic eligibility for rural bulk-billing incentives and a new Workforce Incentive Program
  • Unspecified funding for a new MBS item covering heart health assessments, on which the RACGP is seeking more information.
With the election looming, Dr Nespolon once again encouraged RACGP members to advocate for better funding for patient care and general practice during the election campaign. 
The RACGP will be calling for increased funding to support:
  • non-face-to-face care for a wider patient base
  • reduction of out-of-pocket costs, which could be alleviated by including automatic price increases for patient rebates that fully reflect the rising costs of providing primary healthcare
  • mental health services provided in general practice, such as the RACGP’s proposed GP mental health consultation lasting 40 minutes or more
  • longer consultations and better weighted Medicare rebates for professional attendances to recognise the time and skills required to undertake complex care.
‘In the coming Federal Election, the RACGP will be standing up for patients and practitioners, and will call on all sides of politics to properly invest in primary care,’ Dr Nespolon said.
‘We must see a change in healthcare priorities if we want to see Australians continue to be healthy and active participants in society.’

federal budget funding MBS Medicare

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Fiona Henneuse-Blunt   5/04/2019 11:18:47 AM

I realised yesterday when I took my son to the barber for a 10 minute buzz cut, that his price of $37 was almost the same as the bulk billing rebate I receive for up to 20 minutes of my time. I seriously doubt it took the lady cutting my son's hair none years training . If she even had formal training. It says it all really.