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27 Jun 2018

BY AMA PRESIDENT DR TONY BARTONE

On the day I was elected AMA President, I told journalists at my first media conference that general practice will be one of the central themes of my Presidency.

Primary care, led by GPs, is the thread that holds all the elements of the health system together.

Properly-funded and strategically-positioned and resourced general practice is the key to high quality, affordable continuity of care through all stages of life.

GPs are the entry point to health care for most Australians. GPs assist patients to navigate their way to the right care at the right time for their individual care needs.

I am a suburban GP in a very busy practice. I have extensive GP practice management and business experience. I am well placed to advise governments on GP policy.

For more than 30 years, I have seen and helped patients of all ages with their health. Over that time, there have been many changes, both in health policy and health care delivery.

People are living longer. There are more people living with complex and chronic conditions.

There have been amazing advances in technology and medicines. Lifestyle factors are having a greater impact on the health of individuals – just look at the rates of obesity, stress, depression, mental health.

Like all parts of the health system, general practice and GPs are under constant pressure. The demand for quality primary care and advice is huge and growing.

On the final morning of this year’s National Conference, I emphatically told delegates that general practice has been systematically starved of funding, tearing at its heart; wearing it down, putting at risk its world-class outcomes in primary care …. threatening its very survival.

These comments have been quoted repeatedly over the last few weeks by many journalists in media.

General practice must be understood, supported, and respected by our politicians. This is the clear message I took to Health Minister Greg Hunt and Shadow Minister Catherine King in my first meetings. They listened and they agreed. They get the message.

The task ahead – and I mean in the short term, the here and now – is to work with the Government to produce a comprehensive plan for structural reform of primary care, built around the leadership of GPs, as part of a vision for our health system.

The time is right. There will be a Federal election sometime in the next 12 months. Some say as early as September, depending on the results of by-elections. Others remain confident the Government will go full term.

Whenever the election is, health will be at the top of the policy list – probably number one. Health policy won and lost votes last time around. It will be the same again.

It is the AMA’s job to ensure that both the Government and the Opposition go to the voters with visionary health policies. It is our job to ensure that general practice is at the core of those policies.

Over the next few months, the AMA will be working to shape and inform these policies.

Building general practice is about more than funding, although there is no doubt significant additional investment is needed. We need more than a 55-cent increase in the Medicare patient rebate. The AMA advocates on this every day.

But we need to do more, much more.

We need to resource GPs and general practice to allow better access to quality GP care for patients in aged care facilities.

GPs must be central to the mental health care teams in our community, not sidelined.

GPs must be rewarded for all the work they do for patients that is not face-to-face time.

We need models of care that allow GPs to embrace the benefits of the My Health Record and telehealth.

We must cut the red tape burden on general practice, and free up time to allow doctors to be doctors.

We need a comprehensive vision for positioning general practice as the solution to managing the growing burden of disease and assisting the strategic allocation of health care resources.

This vision will require additional infrastructure funding as well as clear resourcing to assist in managing the complex navigation of patients with chronic disease, leveraging our skills further with judicious and intelligent use of GP-led multidisciplinary care.

General practice can provide more focused leadership for community level public health, education, and preventive health activities. GPs are part of the community and they know their patients and their conditions.

We need the Government to put an end to any moves that fragment primary care. The health professions must concentrate on their scope of practice – stick to the practices for which they trained.

Policies that allow and encourage non-GPs to do the work of GPs are dangerous and will prove costly in the long run. Short-term cost savings can lead to health harms for patients and cost blowouts to the health budget.

And we must do more to encourage medical students and young doctors to pursue the noble profession and specialty of general practice – in the suburbs, the regions, and the country towns.

If we can build a strong, well-distributed GP workforce with significant and strategic investment in general practice, the pressure will come off the other stressed parts of the system.

In coming columns in the months ahead, I will talk about further about these pressures and the importance of a connected solution.

 


Published: 27 Jun 2018