Private health role in General Practice must be targeted and limited

20 Mar 2014

AMA Position Statement on Private Health Insurance and Primary Care Services 2014

The AMA today released its new Position Statement on Private Health Insurance and Primary Care Services 2014.

AMA President, Dr Steve Hambleton, said today that the AMA believes it is time for the Government, Private Health Insurers (PHIs) and the medical profession to look at models that would support a greater role for GPs in caring for privately insured patients.

Dr Hambleton said that GPs provide holistic and well-coordinated care for patients, including preventive health.

“By supporting a greater role for GPs in private health insurance arrangements, there is the potential for the coordination of patient care to be improved, for care to be provided in the most appropriate clinical settings, and unnecessary hospital admissions to be avoided,” Dr Hambleton said.

“Private health insurers provide their members with access to services such as telephone coaching, exercise physiologists, dieticians, and physiotherapists to better manage their chronic conditions.

“While these programs can potentially be of benefit to patients, they generally work in isolation from the usual GP who understands the patient’s overall care needs.

“This is a significant problem with the potential to fragment patient care.

“The AMA supports limited and well-targeted reforms that have the potential to improve patient care and save the health system money.

“We do not support any move to completely deregulate the funding of GP services by PHIs, or any changes that would undermine the principle of universal access to health care.”

Areas that the AMA believes could be explored are wellness programs, maintenance of electronic health care records, hospital in the home, palliative care, minor procedures, and GP directed hospital avoidance programs.

Any model implemented would need to:

  • recognise and support the usual GP as the central coordinator of patient care;
  • adopt a collaborative approach to care, with the usual GP retaining overall responsibility for the care of the patient;
  • provide patients with appropriate access to care based on their clinical needs;
  • preserve patient choice;
  • protect clinical autonomy; and
  • recognise the rights of medical practitioners to set their own fees.

“The AMA believes that any move to expand the role of private health insurers (PHIs) should be carefully planned and negotiated with the profession to ensure that the outcome is in the best interests of patients, and does not compromise the clinical independence of the profession or interfere with the doctor-patient relationship,” Dr Hambleton said

The AMA Position Statement on Private Health Insurance and Primary Care Services 2014 is available at https://ama.com.au/position-statement/private-health-insurance-and-primary-care-services

 


20 March 2014

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