College Of GPs Response To National Health And Hospitals Reform Commission Report, Australia

Main Category: Primary Care / General Practice
Article Date: 17 Feb 2009 - 4:00 PDT

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The Royal Australian College of General Practitioners (RACGP) welcomes the report of the National Health and Hospitals Reform Commission (NHHRC), released yesterday, for its acknowledgement of the role of primary health care in our health system. A strong primary health care sector will make a strong contribution to improving health outcomes for our nation, particularly for our most disadvantaged.

However, the college is concerned the report has not recognised the central role played by general practice in delivering effective and integrated primary health care services. The evidence demonstrating the benefits of primary health care is based on continuity of care, comprehensive care and the coordination of care as compared to the delivery of care at other levels of our health care system.

"General practitioners care for our patients from cradle to grave and our care is grounded in whole-person, continuing, comprehensive and coordinated care. As supported by international evidence, a general practice based primary health care should be the foundation of our health care system. Primary health care teams should be built around a medical practitioner who treats people, not just diseases; this is the role of a general practitioner. Primary health care teams should be built around general practice," said Dr Chris Mitchell, RACGP President.

"Investment in Comprehensive Primary Health Care Centres is not a substitute for investment in general practice. A sustained, long term investment in general practice infrastructure is needed to build safe places to train the next generation of general practitioners and primary health care workers. Such investment will acknowledge the capacity already demonstrated by high quality general practices and support general practice to adapt in response to the needs of our patients.

"The RACGP welcomes a call to create a culture where teaching and learning are considered 'core business' for our health system and we agree that at the moment this is not possible because of the lack of infrastructure and ongoing educational support outside of the traditional hospital setting.

"All workforce projections predict dangerous shortages of general practitioners in the next few years. If this workforce crisis is to be addressed, there needs to be immediate and significant investment in teaching infrastructure and in support for general practice trainers.

"While there is merit in a national clinical training agency, there needs to be recognition that the medical colleges have set high standards for training to ensure that individual practitioners provide safe medical care to the community. In any reform, this central role of the medical profession must be recognised and preserved in the interests of patient safety," said Dr Mitchell.

The RACGP welcomes the recommendations for:

- a comprehensive electronic personal health record
- a patient travel and accommodation assistance scheme to be funded at a level that takes better account of the out of pocket costs of patients and their families
- general practice access to on-site diagnostic services
- new MBS item numbers for preventive activities in general practice
- incentives that support continuity of care
- the retention of fee for service rebates for general practitioners
- an increase in research and research infrastructure; we believe research and research infrastructure in general practice should be a high priority.

"We note the caution expressed in the report regarding the proposal that nurse practitioners or other health professional services be able to access fee for service rebates under Medicare," said Dr Mitchell.

"A core role of GPs is to coordinate the care of our patients. The proposal to extend Medicare provider numbers to other health service providers has the potential to fragment care, increase costs and to undermine the key role GPs play in providing high quality care for our patients.

"GPs provide care to patients on a daily basis and are in an ideal position to understand what is working in each sector of the health care system and in every corner of Australia. The RACGP will work with governments at all levels to ensure this health reform and investment translates into better health outcomes for our community," said Dr Mitchell.

The Royal Australian College of General Practitioners (RACGP) is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP has the largest general practitioner membership of any medical organisation in Australia and represents the majority of Australia's general practitioners.

Royal Australian College of General Practitioners

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