The Ides of January
“For GPs, I want to be their Health Minister.”
- Health Minister Greg Hunt, January 2017
In recent years, January has been a turbulent month for the Health Minister of the day.
In January 2015, newly appointed Minister Ley had to interrupt her holidays to put an end to the co-payment Mark 2 proposal.
Almost exactly two years later, Minister Hunt is sworn in and, in his first public statement, emphatically proclaims he wants to be known as the Minister for GPs.
So what do GPs want from their new Health Minister?
No prizes for guessing top of the list.
GPs want Minister Hunt to end the MBS freeze immediately, restore indexation to patient rebates, and restore them to parity – that is, to the level they would have been if the freeze had not been effectively in place since 2013.
After being promised revolutionary new funding for a new care model, robust investment in the Health Care Home (HCH) trial would also tick a number of GP wish list entries. On the eve of the roll-out, a policy that promises so much may fail or falter because of inadequate penny-pinching support of the HCH.
GPs want a reliable and robust e-health solution to assist them in their care of their patients. A solution that will securely support electronic messaging and communication between all health providers and hospitals, and which will avoid duplication of services and unnecessary wastage of scarce resources and improve the efficiency of transfer of clinical care along the patient journey.
Rural and remote GPs would look to a robust e-health system to narrow the tyranny of distance. In addition, they in particular would cry for increased infrastructure funding to assist them in their practices.
GPs are crying out for assistance in access/options to manage their mental health patients. They want access to step down programs to manage acute crisis patients returning to the community, and also access to ‘outpatient’ type services to assist in management of difficult patients who are not quite crisis, but out of scope for routine practice care.
We need aged care services that reflect an ongoing commitment to reliable continuous primary care options for residents of aged care facilities – services that reflect the extra impost and time required to visit and manage these patients, many of whom are frail and lack mobility.
GPs would welcome increased funding for palliative care services uniformly across the country, and an assurance that conversations and interactions about palliative care and advanced care direction were appropriately funded.
The GPs who commit to educating the next crop of GPs would applaud due recognition for this vital but often underappreciated role. For far too long, there has been a significant financial disincentive against the noble art of mentoring and teaching our next generation of GPs.
We need funding for the AMA’s community residency proposal, which would provide all junior doctors with the opportunity to experience and understand General Practice, regardless of their final intended professional calling in medicine.
Of course, there are numerous other items that, in the general sense, would add to the quality of care and patient outcomes that GPs would achieve in their day to day treatment rounds.
Reducing hospital waiting lists for Out Patient Department services and elective surgeries, launching obesity and nutrition public health initiatives with related support and advisory services, and incorporating non-dispensing pharmacists in general practices would be good for starters.
Overall, I believe GPs want more than token acknowledgement of the integral role they play in the maintenance and efficacy of Australia’s primary care system, which underpins our world-class health system.
This acknowledgement must be backed by appropriate funding of general practice, recognising the specialist roles GPs play in the management of their patients.
GPs should not be subject to continual cuts and lack of investment, and constantly being asked to do more for less amid erroneous claims that health spending is out of control.
General practice provides efficient value for money care.
Genuine investment in general practice will allow practice principals to invest in their infrastructure and staff, and improve the quality and efficiency of outcomes and the take-up of innovation and technology in their practices.
This list is by no means comprehensive or complete, but it is a start. It is a catalyst for open dialogue with the new Minister, and an invitation to understand the centrality of general practice in the primary care team and the leadership role that GPs have in illness management and preventative care.
The important message is that the appropriate investment in general practice will return in spades later on for the Health budget. Minister Hunt is in a very good position to distance his new Ministry from the savage cuts of recent times.
GPs are waiting for a Health Minister who will recognise the value of GPs. Minister Hunt’s opening declaration to be the Minister for GPs is a promising start.
BY AMA VICE PRESIDENT DR TONY BARTONE
Published: 13 Feb 2017