The Royal Australian College of General Practitioners (RACGP) has once again urged the federal Government to give general practice care a shot in the arm so that no patients anywhere are left behind.
In the college's October 2022-23 Pre-Budget submission the RACGP is calling for reforms to:
- increase Medicare rebates for longer consultations, and create a new Medicare item for GP consultations longer than 60 minutes
- invest in rural and remote health by increasing incentives that recognise the unique role of rural-based GPs and encourage GPs to work in rural communities
- support longer telehealth phone consultations lasting more than 20 minutes
- introduce new service incentive payments to better care for older people, those with mental health conditions and people with disability
- additional support for patients to see their GP within seven days of an unplanned hospital admission or emergency department presentation.
RACGP President Adj. Professor Karen Price said that there had never been a more important time to invest in GP care.
"General practice is on life support and urgent action is needed," she said.
"GPs and general practice teams are up against it. The pandemic has exposed cracks in our health system, including primary care, that need repairing so that patient care is not compromised. Our number one priority is ensuring that GPs can take the time to talk to their patients and get to the bottom of what is going on. Unfortunately, the current Medicare rebate structure discourages us from doing just that. We have the absurd situation where rebates decrease as a person spends more time with their GP – the exact opposite of what we should be aiming for.
"Keep in mind too that longer consults are particularly important for people with multiple, chronic health conditions and those with mental health concerns and I can tell you that we are seeing patients with those sorts of health issues in spades. GPs are still managing the fallout of people delaying or avoiding consults and screenings during the pandemic and helping people with mental health challenges, including those who lived through multiple, prolonged lockdowns or had their livelihoods rocked by natural disasters such as bushfires and floods in recent years.
"So, there has never been a more important time to boost investment in GP care so that we can help these patients in need. The RACGP is calling for an increase of at least 10% to Medicare rebates for consults which last 20 minutes or more. In addition, we need a brand new rebate for consultations lasting more than 60 minutes, so we can take the time to really get the bottom of what is going on. This was a recommendation made by the MBS Review General Practice and Primary Care Clinical Committee in 2019 and endorsed by the previous Government's MBS Review Taskforce in 2020, yet it's still to be actioned or implemented. Time is of the essence, let's get this done."
The RACGP President said that the Government should not stop there.
"Telehealth has been a game-changer and there is no point walking it back," she said.
"It makes no sense that rebates for telehealth phone consultations lasting longer than 20 minutes have been removed. Many people are not confident or comfortable using video technology and this is borne out by the fact that between March 2020 and March the following year just 2.4% of telehealth services were conducted via video.
"Axing rebates for longer phone consults is particularly detrimental for patients in rural and remote areas where GP services can be few and far between and broadband strength and reliability are lacking. For goodness sake let's make longer telehealth phone consults a permanent part of our outstanding telehealth system.
"Other steps we are calling on the Government to take would make a real difference for many patients, particularly those who come into frequent contact with GP care. What we call 'service incentive payments' basically involves the grouping of services for certain patients so that they can have their complex health conditions carefully monitored and treated. This includes older people, patients with mental health issues and those living with disability. It will allow us to have more time to assess their health, figure out where improvements could made in their treatment and care and help establish a trusted, long-term relationship.
"Another problem we want to remedy is patients bouncing in and out of hospital with the same health conditions and worsening outcomes. We have a plan for that, in which GPs would receive support to see their patient within seven days of an unplanned hospital admission or emergency department presentation. The evidence tells us that patients who consult with a GP within a week of an unplanned visit to hospital are far less likely to be readmitted within a month, so this really is a no-brainer.
"Last but certainly not least, let's give GPs in the bush a helping hand. Those practising in rural and remote areas are incredibly multi-skilled and often provide care that would usually be provided by other specialists in metro areas. So, we are calling for additional payments for GPs who apply advanced skills in rural and remote areas. It makes perfect sense to provide access to specialist Medicare items when a GP possesses advanced skills in areas such as palliative care, paediatrics, or emergency care.
"GPs and general practice teams across Australia are doing a tremendous job and we should not be taken for granted. The Government must use this budget to show Australians that they are prioritising their healthcare and give general practice care a welcome boost so that patients everywhere can access the care they need when they need it. It's as simple as that."
The RACGP's Vision for general practice and a sustainable healthcare system (Vision) 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. It will also promote health equity for demographic groups who disproportionately rely on secondary care including treatment in hospitals.
Last year, PricewaterhouseCoopers Consulting found that implementing The Vision would create substantial economic benefits by reducing the need for more expensive secondary care and improving the nation's productivity through a healthier workforce.
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