AMA President, Dr Steve Hambleton, said the AMA submission highlights significant problems in the design and implementation of Medicare Locals, and recommends fundamental changes to the model implemented by the former Government.
“We recognise the need for a network of primary health care organisations (PHCOs) to improve the integration of health services within primary health care and improve the interface between primary care and hospitals, but the current Medicare Locals model has not delivered,” Dr Hambleton said.
“The performance of Medicare Locals against their objectives has been patchy, and there is little evidence of improvement over the divisions of general practice structure they replaced – despite significant additional funding.
“The starting point for the Review is to change the name – ‘Medicare Locals’ means nothing to the people who need access to quality primary health care services in their communities.
“It sounds like another layer of bureaucracy. The name should project an active role in looking after people’s health.”
In its submission, the AMA recommends reforms that focus on moving to a network of PHCOs that are:
- GP-led and locally responsive;
- focused on supporting GPs in caring for patients, working collaboratively with other health care professionals;
- not overburdened by excessive paperwork and policy prescription;
- focused on addressing service gaps, not replicating existing services; and
- better aligned with Local Hospital Networks, with a strong emphasis on improving the primary care/hospital interface.
Dr Hambleton said GP leadership is vital.
“GPs are the lynchpins of the health system and are acutely aware of existing gaps in access to care and the impact on patients of badly designed or poorly integrated health care services,” Dr Hambleton said.
“There must be a principal role for GPs in decision-making if PHCOs are to succeed in targeting service gaps, supporting continuity of patient care, and facilitating patient access to much-needed services.”
The AMA submission is informed by a recent survey of 1212 GPs from around Australia. The GPs were invited to share their views on the role being played by the current Medicare Locals.
The survey responses indicate that Medicare Locals have:
- failed to improve the coordination and delivery of primary health care services;
- increased red tape and compliance costs;
- failed to communicate effectively with GPs;
- not engaged meaningfully with general practice;
- duplicated existing services; and
- been unable to demonstrate any improvement to access to after-hours GP services, despite significant extra funding.
Dr Hambleton said the AMA has lobbied for the Medicare Locals Review for some time, and welcomes this opportunity to provide input, including the very important grassroots GP feedback.
“The AMA will work with the new Government to implement sensible reforms that support improved access to care for patients,” Dr Hambleton said.
The AMA submission is at https://ama.com.au/submission-australian-government-review-medicare-locals
19 December 2013
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