The AMA has welcomed the release of a draft reform blueprint by the Government's Primary Health Reform Steering Group while calling for extra funding and support for general practice as it delivers care to a community increasingly burdened by chronic disease.
With Australia's population growing, ageing and having more complex physical and mental health needs, the AMA says reform will be meaningless unless it is backed by substantial Commonwealth investment. Under successive Governments, funding for general practice has not kept up with demand or the increasing costs of providing care.
The AMA broadly agrees with the intention and direction of 20 draft recommendations that will inform the government's 10-year plan for primary health. In supporting these, the AMA has called on the Commonwealth to mandate expenditure on general practice at 16% of its total health expenditure. Currently less than 13% is spent on general practice.
This approach has been adopted in Oregon in the United States, with every additional dollar (USD) spent in primary care saving $13 in other parts of the health system.
The AMA submission highlights GP services are being systematically devalued through inadequate indexation of the Medical Benefits Scheme and a consultation item structure that "fails to keep up with the growing complexity of care and the need for GPs to spend more time with their patients."
The AMA is also calling for a for a GP-led governance structure to be put in place to implement the government's 10-year primary care plan once it is finalised.
"We welcome proposals to reform of funding arrangements for general practice as part of efforts to improve and strengthen primary care," AMA President Dr Omar Khorshid said.
"The Medicare fee-for-service model works well in most situations, but we need to look at supplementing this with other funding streams that recognise the growing complexity of care and the need to encourage a greater emphasis on prevention.
"We're pleased to see draft recommendations call for the doctor-patient relationship to be formalised through Voluntary Patient Enrolment, with current Government plans to implement this delayed due to COVID-19.
The Commonwealth set aside $448.5m to support VPE in general practice in the 2019/20 Budget, with this funding also being delayed. With growing pressure on general practice, the Government urgently needs to finalise plans to spend this much-needed funding so that it flows to support improved access to care as quickly as possible.
"VPE or voluntary GP nomination and funding reform are key parts of the General Practice pillar of the AMA's Vision for Australia's Health and when we launched our plan for a future-proofed health care system in June, we said that properly resourced, General Practice has the ability to transform and innovate and generate savings that can lower the burden on other more expensive parts of the health system.
"The good thing about the recommendations is that they recognise the central role that general practice plays in our health system and that strengthening this even further will support better health care outcomes and help keep our health system sustainable," Dr Khorshid said.
The Government's Primary Health Reform Steering Group's draft recommendations reflect much of the AMA's 10 Year Framework for Primary Care Reform released in July last year, in which it stated increases to funding are needed to ensure the economic sustainability of general practice in the face of an ageing population burdened by chronic and complex disease.
"General practice has been neglected for too long and the Government must ensure that these recommendations do not sit on a shelf gathering dust. These recommendations need to be urgently translated into a concrete plan that has real actions, timelines and funding attached," Dr Khorshid said.
The AMA's full response to the draft recommendations of the Primary Health reform Steering Committee can be read here:
