New funding needed to support primary care

11 Oct 2012

AMA Submission on National Primary Health Care Strategic Framework

The AMA has lodged a submission in response to the draft National Primary Health Care Strategic Framework, which has been developed by the Commonwealth and State/Territory Governments under the auspices of the National Health Reform Agreement.

The draft Framework is intended to build on the key priority areas from the Commonwealth’s National Primary Health Care Strategy, released in 2010.

AMA Vice President, Professor Geoffrey Dobb, said today that the AMA supports many aspects of the draft Framework in principle but is astounded that the whole strategy is currently based on there being no new funding to support primary care over the next three years.

Professor Dobb said it defies logic for governments to shift a greater patient care burden onto the primary care sector without a single dollar of new funding.

“It does not make any sense for the Framework to state that the centre of gravity in health care is going to shift to primary care to take pressure off the hospital sector and expect that this can be done within existing resources in primary health care,” Professor Dobb said.

“We support the recognition that general practice is the foundation of good primary health care in Australia and the admission that a strong GP-led primary health care system keeps people well and saves lives.

“The GP-patient relationship is one of the strongest features of the Australian primary health system, and it must be supported and encouraged, but it cannot survive on goodwill alone.

“The primary care sector, general practice particularly, must be properly funded to meet future demand and to maintain the high quality that makes the Australian health system one of the best in the world,” Professor Dobb said.

Key arguments in the AMA submission include:

  • E-health - the AMA considers that any National Primary Health Care Strategic Framework must address in detail what needs to happen to ensure that the PCEHR and any other e-health initiatives are supported by GPs and general practices and well-integrated into primary care.
  • Investment in GP consultations - GPs provide all the care needed for 90 per cent of the problems they encounter and, in addition, GPs account for less than one tenth of per capita expenditure on health.  In other words, the services provided by GPs provide very good value for money and are an efficient means of using scarce health dollars.
  • Tackling chronic disease – to effectively tackle chronic disease, GP items in the Medicare Benefits Schedule (MBS) need to better encourage longer consultations. This would support GPs to engage in preventive health care and take the time needed to communicate with other parts of the health system.

Professor Dobb said that the draft Framework also raises a number of controversial issues that contain little detail or discussion, and upon which there has been no consultation, including:

  • blended payments systems;
  • pre-payments and payment for performance with salaried arrangements; and
  • development of performance indicators, which identify circumstances in which consumers may not be receiving the most appropriate care. 

“These issues require extensive discussion and consultation with the AMA and other groups before the Framework is finalised,” Professor Dobb said.

The AMA submission is at

The AMA has developed the AMA Chronic Disease Plan: Improving Care for Patients with Chronic and Complex Care Needs – Revised 2012, which builds on existing MBS items with streamlined access to allied health and other services across levels of care relevant to the complexity of the patients’ needs.

The Plan provides for enhanced access to a broader range of services, including the services of a care coordinator for those patients with chronic and complex disease that need greater support and are at risk of a preventable hospital admission.

The Plan is at

The AMA Council of General Practice (AMACGP) is meeting in Canberra this weekend to discuss a range of primary care issues.


11 October 2012


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