GP Network News, Issue 13 Number 35
Dr Brian Morton, Chair AMACGP
The extent to which Medicare Locals have "added value" when it comes to the provision of after hours GP care is a hard question to answer.
In the AMA's opinion, many Medicare Locals mismanaged the initial roll-out of contracts with general practices, with the inclusion of onerous contract conditions. After lobbying by the AMA the Australian Medicare Local Alliance drafted a new, more reasonable, template contract and this has been taken up by many Medicare Locals. We understand that a number also issued contract variations to address concerns at some of the more objectionable clauses in earlier contracts.
Not all Medicare Locals have responded with the same degree of common sense. Last week GPNN ran a story about member concerns with the after hours contract put in place by the North Adelaide Medicare Local (NAML). NAML subsequently contacted the AMA to raise its concerns about how the article portrayed its contract, although it has been unable to allay the AMA's concerns at provisions:
I am pleased to see that, at the time of writing, a meeting between AMA South Australia and NAML had been organised to discuss the contract and hopefully next week's issue can report a positive outcome.
More recently, the AMA has been provided with copies of the Goldfields Midwest Medicare Local (GMML) After Hours Program request for tender (RFT). The RFT runs to 22 pages and requires practices to address multiple issues in their response to the RFT. PwC has been appointed by GMML to assess these tenders.
This RFT is a stunning example of how well intentioned policy has been completely bureaucratised. Practices have gone from a relatively simple application form under the old PIP system to a burdensome process that will disenfranchise many general practices and see GPs walking away from after hours services. Once they are gone, it will be hard to get them back.
Perhaps even more stunning is the appointment of one of the country's most high profile consultancy firms, PwC, to assist in the assessment of tenders from local practices. I am not sure how in touch with local conditions PwC is and I am sure local GPs would like to know how much this is costing.
It seems to me that one of the biggest winners from the Government reforms to GP after hours funding has been consultants. While the Government has provided additional funding, one has to ask how much of this has been diverted away from supporting front line GP services for patients. Hopefully, the current review commissioned by the Government will give some answers. Certainly, if the Coalition is elected we expect that it will undertake a root and branch review of these types of issues.
If you have feedback about the impact of your Medicare Local on the provision of after hours services, please do not hesitate to send it to me at firstname.lastname@example.org.
Big gaps in health policies from major parties
AMA President, Dr Steve Hambleton, urged the major parties this week to plug the gaps in their election health platforms before Saturday's election.
Dr Hambleton said that there are lots of votes in positive, forward-looking health policies and there is still time for Mr Rudd and Mr Abbott to pitch more comprehensive health policies to the electorate. Proposals should be moving us toward a joined-up, strengthened primary health care system built on team-based solutions.
The Labor emphasis to date in this campaign has been on hospital infrastructure, while the Coalition is concentrating on primary care, especially general practice.
The AMA released a Key Health Issues plan in July, which set out achievable policies that would deliver health service improvements at the front line, directly to patients. Some elements have been addressed, but many haven't.
For a break down of the issues where more policy action is required.
First-rate Defence personnel getting second-rate health service coordination
Dr Steve Hambleton this week called on the next Government to commission an urgent audit into the coordination of the delivery of health services to Australian Defence Force personnel by Medibank Health Solutions (MHS).
The call comes amid reports that doctors are experiencing long delays in receiving payment for providing quality off-base care to defence personnel. In addition, the AMA understands that MHS still faces problems in arranging access to off-base specialist services, particularly in areas where major defence facilities are located such as Canberra, Darwin, Townsville and the South Coast of New South Wales.
"We are concerned that first-rate defence personnel are being provided with second-rate coordination of their health services," Dr Hambleton said.
AMA Indigenous Peoples' Scholarship winner wants to close the gap in health inequalities
AMA President, Dr Steve Hambleton, this week awarded Ngaree Blow, the AMA Indigenous Peoples' Medical Scholarship for 2013.
Ms Blow, a third year Doctor of Medicine student at the University of Melbourne, is a young Indigenous woman who has embraced the fight to close the life expectancy gap between Indigenous and non-Indigenous Australians.
Valued at $9000 for each year of study, the scholarship provides support and encouragement for Indigenous students studying medicine.
Dr Hambleton said the scholarship is designed to encourage and support Indigenous students prepare for their careers in medicine, particularly in Indigenous health.
"The AMA acknowledges the unique contribution of Indigenous health professionals to improve health outcomes of Indigenous people," Dr Hambleton said. Assisting Indigenous medical students to complete their studies is a positive step toward ensuring there are more Indigenous doctors to serve their communities.
Continued Dispensing by Pharmacists
GPs in Western Australia, Victoria, South Australia and Tasmania are advised that legislation allowing 'continued dispensing' by a pharmacist has been passed.
Pharmacists in these states may now supply a standard pack of an eligible PBS medicine to patients without a prescription from a medical practitioner.
The AMA is deeply concerned at the risks to patients of 'continued dispensing' and is seeking feedback from GPs about their experiences with it.
For more information about the issue, eligible medications, guidelines pharmacists are expected to adhere to, and the specifics of the feedback required and how to provide it view the AMA webpage on Continued Dispensing by Pharmacists.We welcome your comments and suggestions as well. Please tell us what you think.