Coalition Health Policy - strong initiatives to stimulate the health debate

AMA President, Dr Andrew Pesce, said today that the Coalition has made some strong commitments on hospital beds, support for GPs, and clinician involvement in hospital governance arrangements through community boards, all of which are consistent with AMA policy.

“The AMA has been calling for investment in health care, with a priority focus on funding more beds in public hospitals, and more support and capacity for GPs to meet the increasing demand for medical care in the community,” Dr Pesce said.

“While short of the 3870 beds the AMA believes are needed to make a real difference, the hospital bed commitment is significant,

“The general practice commitments are well targeted.

“We have also called for a more streamlined governance structure for our health system, with input from doctors at all levels, and today’s commitments would be a good step towards this.

“On face value, the Coalition appears to have delivered a substantial package of commitments to address many of the priorities that we identified in our Priority Investment Plan and Key Health Issues election document.

“We will need to closely examine the detail of how the changes are intended to work and we would want input to the detailed design and implementation of many of these measures, should the Coalition be elected.

“However, on the important issue of reform of the health system, it now appears that both the Government and the Coalition have failed to give a commitment to properly get rid of the blame game.

“We are disappointed that neither side has properly committed to end the blame game between the Commonwealth and the States, particularly in respect of public hospital funding.  The major parties must give an unequivocal commitment that there will be a single funder of public hospitals, which ends the blame game.

“We also note that there is no commitment from the Coalition yet on e-health.

“This is a major concern because, without e-health, we cannot make the best use of existing health care services and avoid errors, duplication and waste.

“Both the major parties are weak on strategies and funding to ensure that there is appropriate access to medical care for the elderly people in residential aged care.

“The AMA is pleased that the major parties are both now talking about health policy.”

On the details of individual measures in the Coalition’s announcement, the AMA makes the following points:

Hospital beds

The AMA has been calling for an investment plan for health, and hospital beds were a high priority in our plan.  We welcome the Coalition commitment to fund more hospital beds.  It would be an investment to address some of the real pressure points in the health system.

More beds will ensure hospitals have the capacity to cope with demand and to ensure safe patient care.

There is strong evidence that patient safety and quality of care are compromised when hospitals consistently run at average occupancy rates higher than 85 per cent.  Major metropolitan teaching hospitals typically operate at average occupancy rates above 95 per cent. 

The AMA calls for accelerated implementation of these new beds so they can be available as soon as possible.

The new hospital beds must be fully staffed and fully funded once they are opened.

Our public hospital bed plan also called for Bedwatch – a formal stocktake of the actual number of beds needed in each hospital.  This must be followed by an intergovernmental agreement on the timeframe for their establishment and the introduction of a robust accountability system to ensure they add to existing public hospital bed capacity.

If elected, the Coalition must guarantee that the Commonwealth takes a lead role to ensure the beds actually come to fruition.  There must not be an opportunity for the States and the Commonwealth to blame each other and delay implementation.

Community boards

We support governance arrangements for public hospitals that allow local clinicians to have input into the resource allocation and decisions of the hospitals they work in.  Local clinicians know what is needed to provide safe and quality patient care.

The Coalition’s plan allows for local clinicians to be on community boards and we want clear terms of reference on the composition of the board to ensure there is an appropriate balance of local clinicians included on the board’s membership.

Health Financing

The Coalition has committed for the first time that the Commonwealth will provide funding for every public hospital service, which will provide more clarity and certainty about the Commonwealth’s funding contribution into the future.  We note in particular the important commitment to ensure appropriate and dedicated funding for teaching and research in public hospitals.

However, the Coalition’s commitment to fund only around 40 per cent will not end the blame game between the Commonwealth and the States.

Until we see a single funder for public hospitals, there will still be the opportunity for blame and cost shifting between governments in terms of hospital funding.  And there will be cost shifting between governments across different parts of the health system.

Medical Research

The AMA fully supports additional funding for medical research.

GP Infrastructure

The AMA welcomes the Coalition's commitment to provide additional funding for existing general practices to improve infrastructure so that they can expand the primary care services they offer to patients, as well as teach and train the next generation of GPs.  This is a good first step that is in keeping with what the AMA has been calling for during this election campaign.

GP After Hours

The Coalition's decision to improve support for after hours services, through better funding for Medicare rebates and increasing the incentives provided to practices, is the right approach to improving access to care for patients outside of normal hours.

If the Coalition is elected, we look forward to working with them on the best way to structure the additional funding arrangements.  Changes to funding for after hours GP services announced by the Government in the recent Budget would involve more bureaucracy and red tape and potentially disadvantage many general practices currently providing these services, particularly in rural and remote areas.

Chronic and complex conditions

We welcome more money to support GPs to spend more time with patients, particularly those with chronic and complex conditions, by increasing patient rebates for longer consultations.  We also welcome the commitment to reduce the red tape in Medicare chronic disease items as well as streamline arrangements for accessing health services that support team-based multidisciplinary care.  This proposal is superior to the limited and capped diabetes-funding plan that the Government has announced.

Practice nurses

The AMA supports the Coalition’s commitment to direct investment in Medicare rebates for the critically important services that practice nurses provide to patients around Australia.  However, the overall level of funding for this commitment should match the Budget allocation for additional practice nurse funding.  If the Coalition is elected, we look forward to working with them on the best way to structure these funding arrangements.

GP-referred MRI

The AMA has been calling for this to be funded for some time.  We welcome the Coalition’s commitment to work with us to develop the guidelines to implement this.

Implementation and need for ongoing consultation

On all of these measures, particularly those affecting general practice, the AMA would be looking for early consultation with the Coalition, if elected, to ensure they are implemented effectively and that they support, rather than disadvantage, existing general practices.

5 August 2010

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