Publication

Issue 05, Number 37 - 30 September 2005

Issue 05, Number 37 - 30 September 2005 covers the Productivity Commission Health Workforce Report and pandemic planning

Productivity Commission Health Workforce Report

The Productivity Commission released its position paper "Australia's Health Workforce" yesterday. The AMA will formally respond to the Productivity Commission in the next few weeks but has aired some immediate concerns.

"The report has squibbed the issue of Commonwealth/State health relations," AMA President, Dr Mukesh Haikerwal said. "There has been no attention given to the fact that the total number of doctors who can be trained is dependent upon the resources such as public hospital beds and theatre times provided by the State health systems.

"The report has also squibbed on measures to encourage doctors to stay in the workforce. Certain proposals in the report will actually discourage retention of doctors and will worsen the current medical workforce situation nationally.

"Another criticism is the lack of emphasis on the quality and safety of care, and the report does not acknowledge the level of excellence achieved so far.

"On a positive note, the report acknowledges that the medical practitioner, the highest trained health professional, must be in control of any task delegation sought by other groups within the MBS framework. The most significant change to health delivery in recent times has been the incorporation of practice nurses into General Practice under the supervision of the GP through the introduction of specific practice nurse item numbers, which are accessed by GPs. It has been a silent but significant change, which has enabled the GPs to refocus the way their practice works, while still maintaining high standards of care for their patients. More needs to be done to promote this type of model.

"The proposed new national accreditation body is another new committee with broad powers over the work done by Medical Colleges and others - and it is an area which needs careful consideration before it is endorsed. Taking control away from the profession would almost certainly diminish the quality and standards of medical training.

"More effective national registration of medical practitioners is to be supported, given our geography and demography, but previous attempts led to bureaucratic impediments that discouraged and disheartened doctors who just wanted to get on with the job of caring for their patients.

"The AMA welcomes the recognition that the provision of improved education and training opportunities in rural areas, along with the recruitment of students from rural backgrounds, is the key to building a sustainable rural workforce.

"Another positive from the report is the recommendation of the need for more rigorous examination of rural workforce programs to ensure that they are effective," Dr Haikerwal said.

GPs need to be more involved in pandemic planning

The AMA has written to the Department of Health and Ageing expressing concern that GPs are being neglected in urgent and critical pandemic planning. As the coalface provider of health care, GPs will play a pivotal role in limiting the spread of disease and caring for those infected in the event of an outbreak. To date there has been very little information or consideration of how the medical workforce, particularly general practice, will be assisted in dealing with a major and long-running outbreak.

The necessity for general practice to play a central role in bio-surveillance and identification of any disease coming into Australia has also been overlooked. Australia needs a strong national bio surveillance system. AMA believes that such a system must be centralised to allow critical response and implementation of planning measures. As an interim measure it has called on the Government to immediately revitalise the Australian Sentinel Practice Research Network, a network of doctors that report disease outbreak to the government. Unfortunately only around 50 GPs are involved in this project.

The Government must urgently focus on building a comprehensive national bio surveillance network that places general practice as central in the front line of surveillance. Bio-surveillance not only requires that those at the front line, including GPs, have access to appropriate information but importantly requires clear channels for notification. Communication channels also need to be established to assist clinicians when rapid decision making is required, particularly where the doctor, his/her other patients and staff may be at risk.

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