GP Network News, Issue 12, Number 05 - 10 February 2012

AMA Federal Budget Submission 2012-13

The AMA 2012-13 Federal Budget Submission, lodged earlier this week, calls on the Federal Government to use the May Budget to strengthen the ‘pillars’ of the Australian health system at a time when the world is entering a phase of economic uncertainty. AMA President, Dr Steve Hambleton, said that in hard times it is important for governments to strengthen those parts of the health system that will provide the greatest benefit to patients and the community. For the AMA, general practice, public hospitals, and medical training and workforce are at the top of the list.

Recommendations with a GP focus include:

• GP Infrastructure – redirecting funding from the GP Super Clinics program into GP infrastructure grants and increasing funding to enable a third round of GP infrastructure grants providing an additional 575 grants
• Mental Health – restoration of funding for the Better Access Program
• Chronic Disease – restructuring and simplifying arrangements through Medicare to tackle chronic and complex disease

Personally Controlled Electronic Health Records Bill 2011 (PCEHR)

AMA President Dr Steve Hambleton appeared at the Senate Community Affairs Committee Inquiry into the PCEHR legislation via teleconference on Monday 6 February to explain the AMA’s Submission to the Inquiry. The AMA submission highlights that the safety objects of the legislation will be undermined by the opt-in design of the system and the ability of patients to effectively remove clinical documents from their PCEHR.

The submission also makes several recommendations to improve the transparency of the governance arrangements for the PCEHR and to clarify the operation of the civil penalty provisions.

Here is an edited extract of the President’s opening remarks to the Senate Committee.

AMA guidance for GPs regarding nurse practitioners

GPs have been asking what they should do if they receive documents about a patient from a nurse practitioner. Last year, the AMA held a forum with other GP groups, nursing bodies and Medical Defence Organisations. The forum agreed that a GP would be under a professional obligation to:

• review the information; and
• consider what, if any, action was required.

The same meeting concluded that, where a GP receives documents from a nurse practitioner, the following courses of action would be appropriate, depending on the general practitioner’s circumstances:

1. If the GP is in a collaborative arrangement with that nurse practitioner, he or she should comply with the terms of that arrangement.

2. If the GP is not in a collaborative arrangement with that nurse practitioner:

• If the results are clinically significant, the GP should satisfy himself or herself that appropriate action is, or has been, taken by the practitioner who initiated the investigation(s).
• If the results are not clinically significant, the GP should add the information to the patient’s file according to his or her usual practice.
• If the clinical significance of the information is not clear, the GP should satisfy himself or herself that appropriate action is, or has been, taken by the practitioner who initiated the investigation(s).

If you do not consider yourself to be the patient’s usual GP because you do not know or you have not seen the patient for an extended period, you should write to the nurse practitioner and the patient advising to this effect and not to be sent any further results in relation to that patient.

The same letter should also state that the results should be given to the patient’s usual GP and that the patient should consult the GP as soon as possible.

Alternatively, you can suggest that the patient make an appointment to see you to discuss the results. If the information suggests that the patient needs urgent medical attention, this should be highlighted, with the patient being advised as a matter of urgency.

Children’s visits to the GP

The Essential Baby/Essential Kids website (operated by Fairfax Media) provides information and advice for parents on a wide range of topics.

The site is putting together a feature on taking children to visit the family GP and is seeking tales and anecdotes from doctors about the worst/strangest behaviour from a small child in a GP’s surgery. The idea of the anecdotes is to inject an element of humour into the feature and reassure parents that it is not just their child that may behave ‘badly’.

The story aims to offer suggestions and advice on techniques that parents can use to smooth the way to get their little one used to going to see the doctor.

If you have a story (or two) to tell and would like to contribute, Rebecca Martin, the journalist writing the piece, is happy receive it via email at becmartin30@hotmail, or you can call her on 0422 660 182.

We welcome your comments and suggestions as well. Please tell us what you think.

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