AIRWG comprised representatives and observers from ADGP, AMA, RDAA, DoHA, an independent chair and two technical experts.

Under the current attendance item structure, financial incentives favour shorter consultations. Current broad time bands mean, for example, that the Medicare Benefit Schedule rebate is the same for a six minute general practitioner consultation as for a 19 minute consultation. The Attendance Item Restructure Working Group was formed in February 2002 to develop proposals for reform of the attendance item structure to address this issue and improve incentives for the provision of quality care.

This report of the Working Group considers in surgery unreferred attendance items, that is, Level A, B, C and D general practitioner consultations. It is provided for consideration to the Minister for Health and Ageing and general practitioner organisations.

The Working Group undertook an extensive review of available evidence on the relationship between quality and length of consultation and concluded that an increasing body of international evidence suggested that 'longer' consultation times are associated with better health outcomes. The Working Group concluded that the existing item structure, with financial incentives favouring shorter consultations, was not optimal for the purposes of supporting quality care.

In designing an alternative item structure that would better reward quality care, the Working Group identified structural issues, that is, issues relating to the composition of an alternative attendance item structure, and implementation issues, that is, its potential impact or implications.