The Royal Australian College of General Practitioners (RACGP) is urging government to provide more support for GPs helping communities affected by the summer bushfires and COVID-19 pandemic.
The call comes via the RACGP’s General Practice: Health of the Nation report, an annual health check-up on general practice in Australia.
RACGP Acting President Associate Professor Ayman Shenouda said that this year’s report was informed by the health crises that have changed Australia.
“Each year the report has a particular area of focus and this year it is the impact of the COVID-19 pandemic and summer bushfires on general practice and patients,” Associate Professor Shenouda said.
“Many aspects of the Federal Government’s response to the COVID-19 pandemic, including new Medicare subsidies for telehealth consultations, were well received by GPs. On average, one million telehealth services were provided each week in April, May and June this year.
“However, there is definitely room for improvement. More could have been done – both in the early stages of the pandemic and as the pandemic escalated – to involve GPs in pandemic planning and to support GPs in their role as vital frontline healthcare workers.
“Another key challenge facing general practice has been adequate access to personal protective equipment or ‘PPE’ such as gloves, masks, eye protection and gowns.
“Some GPs have not always been able to obtain adequate supplies or have taken a hit to their hip pocket due to price surges in the private market. Even when PPE has been distributed from the National Medical Stockpile, the supplies have been sporadic and not included all required items such as gowns.
“GP clinics across Australia have done an incredible job maintaining access to care and keeping staff and patients safe throughout the pandemic. The infection control processes put in place have been successful and show just how expert general practice is at responding to a health crisis.
“However, shortages of PPE still need to be urgently rectified, particularly when you consider that in Victoria during the month of August there was an average number of more than 33 new cases among healthcare workers every day. Eight out of surveyed 10 GPs said that both the federal and state governments needed to do more to provide practices with PPE.”
Associate Professor Shenouda said the health crises have exposed flaws in how primary care is funded.
“The RACGP has argued for many years that reform is needed in the way government funds primary healthcare,” Associate Professor Shenouda said.
“Investing in primary care saves lives and saves money in the long term. Despite this, government spending on hospitals increases each year while spending on primary care declines and patients are the ones who are making up that shortfall.
“This is a recipe for disaster. We suspect the long-term health consequences of the pandemic are going to be severe. We will see an increase in mental health concerns, the effects of people delaying or avoiding seeking care as well as the impacts of the COVID-19 virus itself on the long-term physical and mental wellbeing of patients.
“The bushfires too have had a significant impact on the mental health of many patients, particularly people who had first-hand exposure to trauma and those who lost their homes or workplaces.
“To properly help these people we need additional Medicare subsidies for longer mental health consultations so that GPs can take the time to talk through what our patients are experiencing and how we can help them.
“Longer consultations would also greatly assist with patients presenting with chronic and complex conditions, some of which may not have been properly seen to during the pandemic or worsened by the COVID-19 virus itself. We are still learning about this pernicious virus but evidence continues to emerge that patients are being left with serious physical, cognitive and psychological impairments that will require long-term care.
“GPs will be crucial in helping these patients in the years ahead and we need the right support to do so.”
This year’s report also highlighted the need for a voluntary patient enrolment system, where GP clinics receive additional payments when patients choose to “enrol” with a practice and nominate a regular GP.
“The research shows patients who have a regular GP report better health outcomes,” Associate Professor Shenouda said.
“The Federal Government should not further delay funding for this system. The patients who will benefit most include those most susceptible to serious health impacts from COVID-19 virus, such as older people and those with chronic disease.”
Other key highlights of the report reveal:
· the health crises significantly affected the mental health of GPs. More than half of surveyed GPs reported at least one negative impact to their wellbeing during the COVID-19 pandemic, which includes 27% reporting a deterioration in their mental state
· seven in ten surveyed GPs think that continuing telehealth services after the pandemic would support patient access to high-quality care. Medicare subsidies for telehealth services have been extended to 31 March 2021; however, the long-term future of these subsidies has not been determined
· patient out-of-pocket contributions are increasing with the average patient co-payment to consult a GP in 2019-20 rising to $39.33, which is higher than the patient rebate for a standard consultation
GPs are seeking sector recognition and support and, as this report shows, are integral to the primary health care system across the entire country. This report outlines some of the issues the Federal Government’s 10 Year Primary Healthcare Plan needs to address to bolster general practice and ensure it can deliver on its preventive, early intervention potential.
The COVID-19 pandemic is an opportunity for innovation and long-overdue health funding reform. The RACGP’s Vision for general practice and a sustainable healthcare system outlines the urgent need to restructure the healthcare system into one that provides the right care for patients at the right time and in the right place, and that is sustainably funded into the future.