General Practice Nurses good for health

The AMA is pushing the Government to pave the way for more general practice nurses to ease the impact of doctor shortages around the country, but strongly warns against the introduction of independent nurse practitioners. At its meeting last weekend (2-3 April), the AMA Council of General Practice (AMACGP) reaffirmed its position that quality care for patients and access to that care is best achieved in a setting that is coordinated by GPs. AMACGP Chair, Dr Rod Pearce said: "The best way to ease the pressure on the general practice workforce is to build primary care settings in which nurses are an integral part of the general practice team," Dr Pearce said. "The right way to go is to have nurses complement and assist the work of the GP, not have nurses become a substitute for GPs. General practice nurses help doctors see more patients and spend more time with patients who have chronic or complex illnesses - but they do so as part of the general practice team under the supervision of a GP. Accrediting nurses to go out and independently diagnose, prescribe and refer patients is the wrong way to go. Independent nurse practitioners cannot and should not replace the expertise and care provided by GPs. It would be consigning patients in areas of workforce need to inferior health care. The State Governments endorsing independent nurse practitioners are looking for an easy, and vastly inferior, solution - which is also an irresponsible and dangerous path to follow." The AMACGP has developed a draft general practice nurse policy to be presented to the AMA Federal Council in May for approval. The AMACGP is also calling for a single MBS item number for general practice nurse clinical tasks, and wants any practice nurse incentive programs extended to all general practices in Australia.

Health Assessment Item for refugees and new immigrants

The AMA Council of General Practice (AMACGP) has proposed introduction of a new MBS item for health assessments of refugees and new immigrants. AMACGP Chair, Dr Rod Pearce said: "This new item is particularly important for refugees. Most refugees entering Australia have had a basic health check in their country of origin, but this screening is not comprehensive and may be conducted months or years before they actually arrive here. Refugees usually have had limited health care in the past, are exceptionally unlikely to have their medical records and may not speak English. This means when a GP first sees these patients they must complete a thorough health examination, take a complete medical history and may require a translator to be present. A thorough assessment is important not only for the patient's well-being but for Australia's health care system. This is an opportunity to screen for infectious diseases and begin a preventative health care program that can save the medical system money in the long run. In addition, refugees may have experienced traumatic events that have affected their mental health and this can be identified and a care plan formulated. These patients may require dental or psychological care, immunisation catch-up, help with nutrition or care for a previously undiagnosed illness. Having time to discuss all these types of issues will ensure any problems are identified and addressed as early as possible." The item would be a one-off item for each humanitarian refugee and new immigrant that could be accessed within six months of arrival to Australia. The AMA has already begun discussions on this new item with the Government and will continue to pursue its introduction.

Health system review recommendations dated

AMA President, Dr Bill Glasson, said today that reports of Government changes to the health system seemed to have the priorities all wrong. The Australian newspaper reported this week that the Government's Podger review of health is recommending a three-tier model involving funding, purchasing and provision of services, effectively bypassing the States. Dr Glasson said the AMA backs a shake up of the health system but reported details of the Podger Report suggest the emergence of more red tape and less money for patient care. He said: "These changes are not new. They've been considered - and thrown out - in other countries like the UK. We want to see 90 cents in the dollar going to patient care and ten cents going to administration - not the other way around. We don't want powerful interests dictating the level of care or interfering with the doctor patient relationship. Reform proposals must improve access and affordability to quality health and hospital services for patients. Changes must give patients more choice about the services they use and how often they can use those services. The AMA supports changes that will encourage a move to national standards in our hospitals and improved integration between hospital, community and residential care. But we have to address the overcrowding in our emergency departments and work harder at getting doctors into areas of need."