General practice is Australia's most accessed form of healthcare, with nearly 90% of all Australians visiting their GP each year. Despite this, funding for general practice represents only 7.4% of total government health expenditure including federal, state and local government expenditure.
Today's announcements are a step in the right direction towards providing improved services to patients over 70. However, much more must be done to provide real access to primary healthcare to all Australians.
As President of the RACGP, I have been firmly advocating for a sustainable future for general practice.
These calls are starting to cut through the political noise and while the announcements today are not enough to secure a healthy future for general practice, they are a positive move in the right direction.
Practice Incentive Program – Quality Improvement
The $201.5 million over five years of additional funding to support practices administering the Practice Incentive Payment–Quality Improvement (PIP–QI) and the PIP Aged Care Access Incentive is a welcome investment, aimed at supporting quality improvement in general practice and the delivery of aged care services.
The RACGP is committed to improving the quality of care Australian patients receive whenever they visit their GP.
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.
The seven recommendations made, which have all been addressed, are;
1. A profession-led Data Governance Committee to be established and funded by the Department of Health, to oversee the implementation of the PIP–QI
2. The general practice profession to lead the development of Terms of Reference for the Data Governance Committee
3. No general practice data collected in the first 12 months of QI–PIP is published
4. There is re-confirmation that only the 10 quality improvement measures agreed to by Practice Incentive Program Advisory Group (PIPAG) will be required in order to access the PIP–QI
5. The Primary Health Networks (PHNs) are provided with funding to upskill staff in data governance and practice support for quality improvement activities
6. A formal review of PHNs, as PIP–QI data extractors and quality improvement providers, to be conducted within two years of operation, with a view to broadening eligibility for organisations providing these functions (e.g. medical colleges and the Australian Institute of Health and Welfare (AIHW)
7. The RACGP and the profession to be provided with full access to any collected primary care data, including any additional improvement measures collected by the PHNs in addition to the 10 required for the purposes of PIP–QI
Addressing these concerns was central to RACGP supporting the program, as we believe the process had to address data privacy and quality. As the keepers of patient records, GPs want to make sure that any information is treated as our patients expect.
We believe these safeguards will ensure the integrity of patients' data.
This funding will also pay for the continuation of the Aged Care Access Incentive, which was previously earmarked for removal, to support GPs going out to residential aged care facilities.
Patient enrolment
The RACGP commends the Australian Government on looking at new ways to better support our patients with the most complex needs.
The new patient enrolment system will initially be available for patients over the age of 70, who will be able to choose to register with a practice, which will be responsible for the management of their healthcare.
For every patient that enrols, the practice will receive a payment to support flexible care models. This may include a phone call following up with a specialist, email communications with the patient, telephone consultations, checking in with a family member or carer, or other related items that are essential for quality care but are unsupported by current MBS funding. This is additional funding, separate from MBS funding.
The announcement begins to acknowledge the full extent of what a general practice does when caring for a patient. For GPs, healthcare does not simply start and finish when a patient is with you in the practice. A continuous patient–GP relationship fosters a properly tailored and holistic health experience and has been proven to provide better health outcomes for patients.
The RACGP was pleased to hear from the Health Minister that this is the first stage of a universal telehealth service and hopes to see this program rolled out to the broader community sooner rather than later in order to ensure that no patient misses out on the benefits of well-delivered holistic general practice care.
Rural generalism
The RACGP welcomes the funding provided for the fast-track of a Rural Generalist Pathway for trainee doctors. This pathway will play a key role in ensuring Australians living in rural and regional communities have access to a highly trained GP who understands their individual needs and circumstances.
The specific training for rural generalist GPs will ensure that GPs and registrars have the right skills to practice in rural settings and can address the shifting needs of rural and remote communities, including the ever-evolving needs of mental health and palliative care.
$45m for primary healthcare research
The Federal Government has committed $45 million for primary healthcare research. The RACGP welcomes this long overdue investment.
Funding for general practice
The Federal government will provide $187.2 million over four years from 2019-20 to re-introduce indexation to all remaining general practitioner services on the MBS. While this is welcome, it won't repair the damage caused by the Medicare rebate freeze over successive governments.
The RACGP will be advocating strongly for a significant investment in general practice in the coming Federal Election, because if something doesn't change soon, I am fearful of patients' ability to access care when they need, not when they can afford to.
