Page 1801 - Week 06 - Wednesday, 4 June 2014
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In their current form, Medicare Locals cannot fulfil this role.
This is the former chief medical officer. He said:
In their current form, Medicare Locals cannot fulfil this role. They are constrained by their lack of clear purpose, variability, conflicts of interest (provider vs. purchaser) and lost goodwill with general practice. New entities in this space must have a clearer purpose and role, and focus on being system enablers.
Any attempt to improve integration in the primary healthcare system requires general practice to be front and centre. The Horvath review recommended that general practice needed to be “the cornerstone of integrated primary health care”. However, the experience generally across Australia with Medicare locals is that general practice has not seen itself as central for the new delivery model. Indeed, in many cases, attempts by Medicare locals to broaden the net of professional engagement appear to have come at the expense of GP goodwill. That is certainly the experience of a number of GPs I have spoken to here in the ACT. It is vital that this goodwill be rebuilt if any future organisation is to be successful. It must be recognised that GPs are, by their nature, the first authoritative point of contact for primary health care. They start the patient on their care pathway and remain critical to their ongoing care.
Research shows that communities with well-developed primary healthcare systems have healthier populations and reduced healthcare costs. Anything that can reduce our unsustainable dependence on repeated high-level, high-cost hospital-delivered medical interventions in chronic disease management must be a significant priority for all governments.
The experience of Medicare locals has highlighted the system’s shortcomings and inefficiencies and provided a guide for evolution to a new model of primary health care. There is a vital need to reduce fragmentation and improve integration across the healthcare system, using clinical pathways across sectors to improve individual patient outcomes. A new model will need to work with GPs, private specialists, local hospital networks, private hospitals, aged care facilities, Indigenous health services, NGOs and other providers to establish clinical pathways of care that arise from the needs of patients, not organisations, and that would necessarily cross over sectors to improve patient outcomes.
We on this side of the chamber are pleased to embrace the new primary health networks to be established by the Abbott government. This will be an evolution from the division of GPs and replace the Medicare locals set up by the previous Labor government. We are glad to see that the primary health networks reflect the recommendations of the review into the Medicare locals undertaken by Professor Horvath.
It has been announced that the primary health networks will be established following a tender process in 2014. Organisations will be able to apply and there will be strong emphasis on minimising bureaucracy and red tape to ensure that activities are focused
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