The Royal Australian College of General Practitioners (RACGP) is urging whoever forms government following the upcoming federal election to properly invest in general practice to ensure all people can access high-quality general practice care.
It comes following the release of the Australia's Primary Health Care 10 Year Plan 2022-2032 ("the Plan"), which features:
· the introduction of voluntary patient enrolment where those registered in the system will still have the choice of attending any practice for face-to-face consultations at any time. Patients, particularly older people, and those with complex needs, will receive more continuous and coordinated care, including earlier preventative interventions
· the potential for supporting longer consultations in general practice to provide appropriate care for people with disability, those with mental health issues, people from culturally and linguistically diverse backgrounds and other population groups with complex needs
· the establishment of the Primary Health Care 10 Year Plan Implementation Oversight Group
· support for more GP training places and enhanced GP, nursing and midwifery, nurse practitioner, allied health and Aboriginal and Torres Strait Islander GP and health practitioner training, particularly in rural Australia.
Last week, the college warned that this year's budget failed to adequately address the fall-out of the COVID-19 pandemic and the future challenges of a fatigued health system. Vital components of the Plan didn't receive funding, meaning that significant gaps identified by the RACGP and other health groups remain.
RACGP President Professor Karen Price said the time for action was now.
"The Primary Health Care 10 Year Plan has finally arrived, and the challenge is right in front of us," she said.
"Unfortunately, the timing of the release on budget night doesn't provide the opportunity for robust discussion. Nevertheless, here we are and it's vital that the Plan receives careful scrutiny.
"In our submission to the draft 10 Year Plan, we stressed that high-quality care offered by GPs is at risk if substantial reform does not take place. I urge whoever forms government to act decisively and secure the future of world-class general practice care for all communities by properly investing in the Plan so that patients don't miss out on the care they need from their local GP in the years to come.
"The Plan fails to include detail on the funding required for proper implementation. We really want to see more detail on the funding elements to know that the Plan will make a difference in supporting quality general practice services.
"To be effective, we need to have multi-source funding options in addition to the maintenance and enhancement of our current fee for service model. Investment is critical and will support the provision of essential team-based services, ensuring high-quality care for vulnerable patients. So, whoever forms government will have to devise the budget measures necessary to get the job done."
Professor Price said that time was of the essence with GPs and general practice teams working under extraordinary pressure.
"I'm not being overly alarmist when I say that the situation is critical," she said.
"As I said on Budget night, we have already had three years of roundtables and discussions and negotiations. The talkfest must now come to an end, we need action.
"Reform without proper investment is insufficient. The future viability of general practice care is at stake, so unless strong action is taken to invest in general practice we will not be able to attract medical students to the specialty of general practice and we will run out of GPs.
"We can't look at this in isolation; if the Plan is not implemented through real investment every single part of the health system will be compromised for years to come. This is at a time when we have an ageing population and the task of managing the fallout from the COVID-19 pandemic, including caring for those who have delayed or avoided screenings and consultations, people with mental health conditions, and patients with 'long COVID' just to name a few."
Chair of the RACGP Expert Committee – Funding and Health System Reform and practicing Sydney GP Dr Michael Wright said that the Plan contained many promising elements.
"The college generally supports the vision and intent of this overarching plan," he said.
"It was developed over three years in collaboration with many stakeholders and interest groups and a lot of hard work was put in by representatives from the RACGP.
"We are supportive of more GP training places and enhanced GP, nursing and midwifery, nurse practitioner, allied health and Aboriginal and Torres Strait Islander GP and health practitioner training, particularly in rural Australia. That is a logical step forward given workforce issues in many communities, especially outside of major cities. In addition, the RACGP supports the implementation of the National Roadmap for Improving the Health of People with Intellectual Disability.
"The RACGP also welcomes the fact that there is a specific action area focused on Aboriginal and Torres Strait Islander health. That includes implementing the new Aboriginal and Torres Strait Islander Health Plan in accordance with the principles of the National Agreement on Closing the Gap.
"The RACGP does have some reservations concerning some of the finer details of the Plan. There is no clear mention of additional funding for general practice and many of the commitments that the RACGP and other health bodies support are framed as things to potentially 'consider'.
"Voluntary patient enrolment should play a key role in general practice care in the years to come; however, fee for service must be central to any model of care. Further, the plan doesn't address our concerns that any voluntary patient enrolment model must be targeted towards supporting GPs to deliver high-quality care, rather than limiting expenditure.
"The Plan notes that as access to and useability of technology improves, the Government would expect increased use of video technology to deliver GP telehealth services. We need to remember that there are patients who do not have the skills nor access to the technology required for video consultations. This is especially the case for patients with increased health needs, such as patients in rural and remote communities, Aboriginal and Torres Strait Islander people, and older Australians. Telephone consultations remain the only way for these people to access remote care and for this reason it is crucial to permanently reinstitute Medicare rebates for longer telephone telehealth consultations."
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