The value of general practice
BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE
Last month, there was a lot of online discussion about GPs not bulk billing for an entire day. Unsurprisingly, the idea received a lot of support from the GP community. I fully understand the sentiment behind this idea and why it was so popular. For too long general practice has been undervalued.
We know that a robust primary healthcare system not only improves patient outcomes but lowers overall health costs. If you regularly visit your GP you will live longer and live better. Despite this, general practice has received minimal significant investment.
The AMA has advocated for increased funding to general practice through increased (or unfrozen) Medicare rebates and also through additional funding such as incentive payments and more recently coordinated care payments.
We were encouraged by the inclusion of over $1 billion of funding announced by the Morrison Government as part of the 2019-20 Federal Budget. We were pleased to see Labor endorse this spending. This was largely due to consistent AMA advocacy.
Of the $1 billion, over $200 million was allocated to the Quality Incentive Payments for general practices. The Budget also announced the retention of the Aged Care Access Incentive (ACAI). Both major funding issues I have outlined in earlier articles.
Another key funding announcement was $448.5 million to improve continuity of care for patients over 70 with chronic conditions. This would provide additional funding for GPs who coordinate the care of their patients. While it is a positive step, it is funding that can and should be available to all patients with chronic health conditions.
And this is the issue. This is all we have seen for years. Despite the Minister for Health stating at this year’s AMA National Conference that GPs are fundamental to the Australian health system, we have not seen new genuine investment to support this role. The failure of the healthcare homes is a perfect example of this – it was a good idea that was doomed to fail by a lack of investment.
At the National Conference I proposed on behalf of the Council of General Practice that the AMA lobby the Federal Government to increase funding for general practice so that it represents at least 16 per cent of the health budget, and that this figure should be mandated. This was overwhelmingly supported by delegates from all States and Territories and across the medical profession.
We proposed this because general practice has been undervalued for years. The only way we can guarantee the real and continued investment is by mandating it.
Sixteen per cent of the Federal health budget is in increase of around $2.5 billion and would allow not just real investment in the general practice, but deliver funding for the reforms that will allow GPs to continue providing the world leading care we currently do for our aging population.
It will also show us that the Government does value us and the role we play. Years ago, I chose to travel to Papua New Guinea and volunteer as a doctor. That was a fantastic experience, but it was my choice. Now, I feel like I am being asked to do the same in my own community despite having to support my family. As GPs, we regularly bulk bill our elderly patients or those who cannot afford out of pocket costs because we want to provide the best care to them that we can despite the fact it means we take a pay cut. These patients should not have to pay, but we should not be the ones who bear the cost.
It comes down to how the Government values general practice and what role it sees for general practice in the health system.
We have known for years that a robust primary healthcare system improves population health outcomes while lowering costs, and that general practice is the cornerstone of this system. It’s time for real funding and for the Government to show us that it really values general practice.
Published: 13 Jun 2019