AMA plan to make Primary Health Networks more effective than Medicare Locals

Your Family Doctor – Keeping You Healthy

AMA FAMILY DOCTOR WEEK, 20-26 July 2014

AMA President, A/Prof Brian Owler, said today that the AMA wants to work closely with the Government to make Primary Health Networks (PHNs) more effective facilitators of primary care services than the under-achieving Medicare Locals they are replacing.

A/Prof Owler said that the implementation of Medicare Locals had been slow and uneven, and few had reached the potential that the former Government had predicted for them.

“The AMA wants PHNs to be better targeted and more driven by family doctors at the local level,” A/Prof Owler said.

“The AMA has been working on a plan for effective PHNs to improve access to care for patients”

The Government announced the establishment of PHNs from 1 July 2015, in line with the recommendations of the Horvath Review, which examined the performance of Medicare Locals.

Key findings of the Horvath Review include:

• the performance of Medicare Locals has been highly variable and, while some have achieved a great deal, as a network they have failed to present a compelling argument to continue in their current form;
• many patients were continuing to experience fragmented and disjointed health care that negatively impacted on health outcomes and increased health system costs; 
• Medicare Locals have generally failed to appropriately involve or engage with GPs despite their role at the centre of the primary care system; and
• Medicare Locals have been duplicating existing services that are already available, and this must end.

The AMA plan proposes that PHNs should focus on the following areas:

• Population Health – Identifying community health needs and gaps in service delivery; identifying at risk groups; supporting existing services to address preventative health needs; and co-ordinating end of life care.
• Improve the capacity for General Practice to deliver quality primary care – Supporting practice infrastructure through:

·         IT support;

·         Education and training of practices and staff;

·         Supporting quality prescribing;

·         Training and supporting the use of e-Health technology and systems; and

·         Facilitating the provision of evidence based multidisciplinary team care.

• Engage with Local Hospital Networks/Districts – Identifying high risk groups and developing appropriate models of care to address this (e.g. those at high risk of readmissions including noninsulin-dependent diabetes mellitus, congestive cardiac failure, chronic obstructive pulmonary disease and other chronic diseases); and improving system integration in conjunction with local health networks.

A/Prof Owler said that evidence from countries such as New Zealand shows that GP leadership and input is vital for PHNs to be effective.

“GPs are generally the first point of call in the health system and they can provide high quality clinical input as well as first-hand knowledge of where improvements in the health system need to be made,” A/Prof Owler said.

“Not only should GPs be included in Clinical Councils, they should also participate at all levels of governance, including on the PHN Board.

“While some Medicare Locals have clearly done a good job in improving access to care, the overall Medicare Local experiment has clearly failed – largely due to deliberate policy decisions to marginalise the involvement of GPs.

“We can’t afford to get it wrong a second time, and the AMA stands ready to work with the Government to ensure that PHNs are an effective and integral component of the health system.”

The AMA has produced videos to promote Family Doctor Week 2014:

• Family Doctors provide targeted health care for patients at all stages of life with expertise, understanding, and distinction https://www.youtube.com/watch?v=y-n2mEfFdIg
• The wide range of preventative care administered by family doctors ensures quality of life for patients and a sustainable heath system https://www.youtube.com/watch?v=_i4c0-lFHdc

This video (mute) has been produced so that general practices can play it in their waiting rooms for the information of their patients:

• General practitioners can help people reduce their risk of illness and disease, such as diabetes, heart attack, obesity, and depression https://www.youtube.com/watch?v=J79_1LdJApA

All the videos can be downloaded from the AMA Family Doctor Week website at https://ama.com.au/familydoctorweek2014

AMA Family Doctor Week is sponsored by Australian General Practice Training.

24 July 2014

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

                            Sanja Novakovic                 02 6270 5478 / 0427 209 753