General Practice Solutions for Enhancing Primary Health Care

AMA President - Dr Rosanna Capolingua
RACGP President - Dr Vasantha Preetham
RDAA President - Dr Peter Rischbieth
ACRRM President - Dr Dennis Pashen

General practice provides high-quality continuous care that is patient centred and cost effective. Medical competency, diagnosis and management and effective team-based care are the foundation of best practice and safe primary care. The international literature demonstrates that accessible general practice/primary care improves patient satisfaction and health outcomes while reducing health system costs.

General practice in Australia is at the forefront of team-based care, has extended the role of practice nurses and developed appropriate working arrangements with allied health professionals. Skilled practice nurses and other health providers are respected in their roles, and contribute to quality patient care as part of practice teams. New integrated care and service models have extended the capacity of multi-disciplinary teams across private-public and not for profit boundaries.

Best practice health care delivery occurs when the overall care of a patient is delivered under medical supervision with assistance from other trained health service providers. General practitioners have the comprehensive training required to care for the patient as a whole, not just treat an ailment or disease. This does not always mean that the care is provided from a traditional general practice in one physical location. But it does means that there is a strong relationship between the providers of care, that care protocols are in place and that good communication exists with the patient and between members of the health care team.

Doctors are highly skilled and trained in taking comprehensive patient histories, examination, investigation, diagnoses, treating the patient holistically, and ensuring that team-based care is well managed and coordinated. If the doctor is at the centre of clinical supervision, unnecessary tests and inappropriate referrals are minimised and patients are able to access treatment in clinically appropriate timeframes.

The evidence also demonstrates that effective health systems depend on strong integrated primary health care. Reforms that do not support the important role of general practice will progressively erode the health system's function, patients will experience more fragmented and uncoordinated health care, and primary health system costs will inexorably rise.

Any reform of our primary care system needs to ensure that:

• The quality of care provided is of the highest standard possible and does not increase the risk of adverse health outcomes;
• Coordinated and comprehensive health care is provided;
• Our health system continues to be efficient and effective for patients; and
• Our overall health system continues to be cost-effective for the community as a whole.

Delivering best practice primary health care services must involve building on the team-based framework already in place in general practice around the country.

The Government's proposed National Primary Care Strategy should ensure that:

• Australians continue to have access to high-quality general practice services;
• General practices are given additional support to allow them to deliver more preventative health care services and tackle the growing burden of chronic disease;
• General practice is the gateway to allow patients enhanced access to other health professionals - including general practice nurses and allied health service providers such as physiotherapists and dieticians;
• Primary health care services in workforce shortage areas such as rural Australia are improved through incentives and assistance to get more general practitioners and primary health care teams in these parts of the country;
• General practice training opportunities and incentives are enhanced so that many of the new medical school graduates choose to enter general practice over the next few years.

Australians have confidence in their general practitioners having overall responsibility for their primary care needs. Eighty per cent of Australians visit a GP at least once each year and general practices see 280,000 patients every day of every year.

The future of primary health care in Australia should build on this system not undermine it. The AMA, RACGP, RDAA and ACRRM look forward to working to further enhance the quality of health care deliver in Australia.

CONTACT: Kylie Butler/Kylie Walker (AMA) 02 6270 5466/71

Jason Berek-Lewis (RACGP) 03 8699 0484

Patrick Daley (RDAA) 02 6273 9303

Sharon St Pierre (ACRRM) 07 3105 8200