More reform to come

Nothing could be further from the truth. There is much more to come, including major decisions that will impact on general practice and primary care.

I have been fortunate to have two private meetings with the Prime Minister and the Health Minister recently. While I am not party to the timing or the detail of the policies still to come, I have been given a big picture overview of what the Government is hoping to achieve in health reform.

Like everybody else, the AMA is not yet in a position to pass judgement on the totality of the reform program, but I am heartened on a number of fronts.

First, the Prime Minister is openly declaring that he supports the need for clinician input to health decision-making at all levels, but especially at the local level – the coalface of service delivery.

This is a very important admission from the Prime Minister and evidence that he and his advisers have been listening closely to the people who have attended the 100 or so consultations that the Government has held around the country.

The Government knows the value of quality advice in crafting palatable health reform, and that is why many elements of AMA policy are acknowledged in the public hospitals plan.

We now hope to see the same effect in play with general practice and primary care policies.

The AMA welcomed the Government’s recent announcement of that there will be 1200 general practice training places by 2014 and 975 Pre-vocational General Practice Placements Program (PGPPP) places by 2013, but we still have to focus on the here and now for our current GP workforce.

The AMA has also provided the Government with strong advice about the present and the future of general practice.

Our message is to promote and support general practice because that is what people and communities want.

The National Health and Hospitals Reform Commission (NHHRC) reported that their consultations found that one of the strongest signals from people is that they want access to a GP.

The Government’s own round of consultations discovered essentially the same message. The Prime Minister has often regularly expressed his support for GPs

There is no doubt in anybody’s mind that for prevention advice, sickness, injury, or chronic disease management, people want to be able to see a GP.

So any future Government policy must be based around this fact.

The NHHRC had a focus on providing access to multidisciplinary primary care services. The AMA believes this approach has significant merit.

General practice can lead the way in the development of such services, but lacks the necessary infrastructure to do so.

The Government should be building on existing general practice infrastructure to build growth for the future in GP-led primary care services.

With over 7000 general practices across the country, the Commonwealth could significantly enhance patient access to general practice and allied health services through a broad infrastructure support program targeting existing general practices.

This would allow existing general practices around Australia to evolve and develop into GP Primary Care Centres, similar to the Comprehensive Primary Health Care Centres (CPHCC) envisaged by the NHHRC.

They could also provide specific additional services tailored to local needs and to train our future GP workforce. 

Better infrastructure could support more community-based training, support more on-site collaborative care, support more virtual consolidation and coordination with other services, support more practice nurse services and the integration of nurse practitioner services on site, and support more person-specific preventive health care through primary care services in the community.

Strengthening the role of general practice requires more than bricks and mortar.

This is sound advice – advice that could and should inform major health reform, especially reform around primary care.