Page 1799 - Week 06 - Wednesday, 4 June 2014
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In the ACT, the Division of General Practice became the ACT Medicare Local in August 2011. It is my view that this organisation, not without challenge, has made great efforts in embracing the challenge of engaging in the delivery of quality primary health care in the ACT. I have had numerous meetings with the Medicare Local. I have spoken to the ACT Medicare Local, to Rashmi Sharma, twice, I think, within the last 48 hours. I have reasonably regular contact with her. I would be interested to hear what engagement Mr Gentleman had with the ACT Medicare Local in the lead-up to this motion.
Mr Gentleman: She is my personal doctor.
MR HANSON: No conflict of interest then. The ACT Medicare Local has worked to improve the health of all Canberrans by connecting primary healthcare services. The local staff have worked hard and made this model as successful as it could be.
I think that it is true to say that when this model was first devised by the former federal Labor government, there was significant confusion about what the model for the Medicare local would be. If the minister was going to be honest, I think she would agree with that. It took a significant amount of time for Medicare locals to work out what their role was going to be, how it would all bolt together and how it would interact with the rest of the primary health community, local hospital networks and so on.
There is no doubt that in the past our health system has generally been designed for episodic care. That was a model that served us well 40 years ago, but it does not necessarily suit the structure for current health service delivery. Many illnesses are chronic and complex and require multiple integrated and coordinated services centred on the ongoing needs of patients. To enable this, we need organisations that can work in partnership with the broader health system and facilitate better integration, coordination, access and care pathways.
In 2011 the Medicare locals were supposedly the response to that challenge. However, in their current form, as a national network, they are not proving effective, generally speaking, or successfully achieving many of their objectives.
The Medicare local model has not been without serious problems. A Deloitte audit of Medicare locals found evidence of variability in expenditure on administration, with 40 Medicare locals spending more than 25 per cent of their core funding on running costs. That is money aimed to be delivered to front-line services. Twenty-five per cent being spent on admin! That is unsustainable and it is grossly inefficient. Deloitte also discovered that there were varying levels in funds allocated to front-line services, inconsistencies between planned and actual budgets and cross-program funding, and variable accounting practices.
This all pointed to mixed financial capabilities across Medicare locals. The federal government commissioned a review of Medicare locals by Professor John Horvath, previously the commonwealth chief medical officer. His report found serious deficiencies. I will say that again: he found serious deficiencies in the coordination
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