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Work begins to address ‘terrifying’ general practice trend
RACGP Vice President Dr Bruce Willett outlines the discussions that took place at the first Strengthening Medicare Taskforce meeting.
The first meeting of the Strengthening Medicare Taskforce took place last Friday.
‘Primary care is in worse shape than it’s been in the entire Medicare era.’
These were the blunt words of the Minister for Health and Aged Care Mark Butler this weekend in a speech at the Australian Medical Association (AMA) annual conference in Adelaide.
The minister declared primary care as one of two priorities under his tenure, with the other being aged care.
‘It’s hard enough to get a GP right now and we know that the current generation of older GPs are pretty exhausted, particularly over the last two and a half years, and we just do not have the pipeline coming through,’ he said in a question-and-answer session following the speech.
‘It is probably the most terrifying trend that I see in primary care.’
The remarks, reported in Nine Newspapers, came shortly after the first meeting of the Strengthening Medicare Taskforce, which Minister Butler chairs. With representatives from the RACGP and a range of other peak bodies and advocacy groups, the group is due to present recommendations for fixing Medicare by the end of the year.
At that inaugural gathering, RACGP Vice President and Queensland Chair Dr Bruce Willett represented the college in the place of President Adjunct Professor Karen Price, who was unable to attend.
Dr Willett said he was encouraged by the tone of Minister Butler’s remarks.
‘It’s a wonderful thing to see a health minister acknowledge the parlous state of general practice,’ Dr Willett told newsGP.
‘This is a result of decades of literally decades of neglect of general practice, and it’s now time to fix it.’
Minister Butler also referenced discussions surrounding voluntary patient enrolment in the inaugural taskforce gathering.
‘I’ve posed the question to members… “how do you describe the value proposition for patients?”’ he said.
‘I really think that is a crucial challenge for us.’
Dr Willett said that when the issue was discussed, he expressed the college’s support for voluntary patient enrolment with clear caveats.
‘The RACGP accepted that there is a place for voluntary patient registration, particularly for those vulnerable patients with chronic complex diseases, where fee-for-service will struggle to provide adequate compensation and adequate care,’ he said.
‘It needs to be voluntary for both patients and practices and that’s essential,’ he said.
‘And it should not be tied to a requirement to bulk bill, nor [should it] replace fee-for-service. Fee-for-service needs to remain the mainstay of our healthcare system.’
He said he also reiterated the need for Medicare Benefits Schedule (MBS) to have ‘significant uplift’ to help address the challenges facing general practice.
Among other priority areas for the taskforce to consider, Minister Butler listed multidisciplinary care, the use technology in healthcare and business models for general practice.
In its report, Nine Newspapers referenced the low level of medical graduate interest for going into general practice.
In 2022, this has reportedly risen marginally to 16%, up from the 15.2% proportion of final-year students who listed general practice as their first preference specialty last year according to the college’s most recent Health of the Nation Report.
The AMA conference, in which Professor Steve Robson was confirmed as the new AMA President, while GP Dr Danielle McMullen was elected vice-president, also included a contribution from Department of Health secretary Professor Brendan Murphy.
Professor Murphy again alluded to an undersupply of early career GPs.
‘Far too many of our young doctors are not choosing to go into general practice, which is the area we have the greatest predictive need in the future,’ he said.
Dr Willett believes the work of the taskforce will be fundamental to reversing what he calls ‘an enormous amount of inertia’ about medicine workforce choices and says it will involve both financial investment and bolstering the status of general practice.
‘It’s going to take years,’ he said.
‘I would say that this taskforce is extremely important. The plans that have been discussed to restructure Medicare represent a potentially generational change.
‘It’s really important that we get them right and the governments listen.’
Noting that the taskforce is carrying out its work at a time of significant financial constraints, Dr Willett stresses that a well-resourced and highly functioning general practice sector underpins the world’s best performing health systems.
‘General practice is the most cost-effective part of the healthcare system,’ he said.
‘If the Government does not grasp the nettle here, the downstream costs are going to be enormous.’
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