Dr Pesce, Speech at Breathing New Life into General Practice Conference
GPRA PRESIDENTS’ FORUM
BREATHING NEW LIFE INTO GENERAL PRACTICE CONFERENCE
PARLIAMENT HOUSE CANBERRA
THURSDAY 24 MARCH 2011
AMA PRESIDENT DR ANDREW PESCE
General Practice - Quality, Capacity, Sustainability
Way back in 2001, the AMA was one of the first organisations to recognise the impending serious workforce shortage in General Practice in Australia.
We instantly took the GP shortage message to governments, the media and the Australian community.
At the start, nobody wanted to listen. But we kept going with the message year after year after year.
And eventually the Government got the message.
There have been recent increases in the number of medical undergraduates to begin to reverse this shortage – if we can convince enough of them to pursue a career in general practice.
There have been battles and there are ongoing battles to get the necessary infrastructure needed to produce fully trained GPs like many of you in this room will soon be.
Governments do not do good works spontaneously.
It has been the AMA’s role to provide constructive criticism and constructive solutions – to cajole, to encourage, and to convince.
It is my belief that criticism alone will not bring about political decisions.
You need to engage, advise, and offer answers to complex problems.
As AMA President, I have been constructive about the need for health reform.
Health reform is needed because, among other reasons, doctors are often locked out of decision-making in our major institutions.
I have made it clear that this situation must change.
The AMA has sought clinician engagement in Local Hospital Networks, Medicare Locals, plans for caring for people with diabetes, and medical training – among other things.
One of the great strengths of the AMA is that we represent working doctors who know what is happening on the ground.
We have been openly critical of Medicare Locals recently.
We are not opposed to the concept of primary health care organisations to help GPs lead the way in providing care in their communities.
GPs work very hard and they are dedicated to their patients.
But they are seeing older and sicker patients with more complex care needs.
And they are doing this within a consultation structure that discourages longer consultations.
It is difficult for them to find the time to deal with more complex, sicker patients in 15 minutes, which is the average consultation time these days.
General practice nurses have helped for those practices that have them, but there are many gaps.
GPs need help but can they get it from the Medicare Locals as they are currently proposed?
Who knows? Nobody knows?
There is not enough detail. There has not been enough consultation.
The Medicare Locals cart is well and truly in front of the horse – by a long shot.
The Government has issued guidelines for the establishment of the first 15 Medicare Locals.
But we do not think that GPs have been given strong enough acknowledgement as the leaders in primary care.
We think GPs are pretty important people in our community and a major part of the primary care space.
Australians obviously value them because they visit them 120 million times a year.
We were surprised and shocked that there was very little mention of General Practice in the guidelines.
The AMA cannot support primary care reforms that do not explain how they would benefit patients or communities, and which do not guarantee they would maintain and support the leadership role of GPs in primary care.
We strongly oppose Medicare Locals as proposed and urge the Government to put a stop to their establishment to allow meaningful dialogue with the medical profession about a way ahead that is best for patient care.
The Government is well aware of our objections to fundholding for GP services.
We think patients – not fundholders - should decide when they need a doctor.
If government wants to ration care, let them do it – but they should not expect GPs to do it on their behalf.
The Prime Minister has used the ‘F’ word – fundholding – on a number of occasions recently. She is yet to retract it, but she must.
We don’t believe that GPs will be adequately represented in the governance structures of Medicare Locals as proposed.
We don’t believe that the role of the General Practitioner in the delivery of primary care services is adequately recognised in the guidelines.
From the documents provided, we cannot see how Medicare Locals – as currently proposed - will improve services on the ground for patients.
We have no choice but to oppose them. Nobody has provided an argument to convince us otherwise.
The AMA has a position statement on Medicare Locals.
It sets out the principles for the type of organisation we could support.
We have asked the Government to put the Medicare Locals show on hold to discuss our proposals.
We think proper consultation with the medical profession can only improve the ultimate outcome for patients and for GPs.
Australians value their GPs.
It is important that we preserve the best aspects of general practice, and remove the worst.
GPs love their work.
Recent surveys show that around 90 per cent have said that they are satisfied or very satisfied with their work.
But they vigorously dislike Government red tape and bureaucracy. It stops them from helping more people.
Unless the Government engages and consults with the medical profession, Medicare Locals could well become another layer of bureaucracy, another ream of red tape.
The AMA urges the Government to urgently rethink Medicare Locals.
And the AMA wishes you here today – the future of Australian general practice – all the best in your careers.
24 March 2011
CONTACT: John Flannery 02 6270 5477 / 0419 494 761
Geraldine Kurukchi 02 6270 5467 / 0427 209 753
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