The AMA has held up the hollowing-out of GP practice incentives as an example of why the government could again risk losing votes over health at the next election.
In its 2018-19 pre-budget submission, the AMA says the introduction of a new Quality Practice Incentive Program to replace the existing PIP system will have the “ludicrous” effect of leaving many GPs worse off.
It also warns the government not to expect GPs to bear the costs of guiding patients through the intricacies of the opt-out My Health Record next year.
Launching the document on Wednesday, AMA President Dr Michael Gannon said the lifting of the Medicare rebate freeze over the next few years meant a shift in focus to other healthcare issues in need of significant investment.
“There is now a greater focus on the core health issues that will form the health policy battleground at the next election,” he said.
“There is no doubt, as shown at the last federal election, that health policy is a guaranteed vote winner … or vote loser.”
The submission highlights the government’s decision to implement the QPIP by taking away funding for other PIP incentives, including the Aged Care Access Incentive (ACAI).
“This will leave many general practices worse off overall, and in the ludicrous position of being financially penalised for pursuing quality measures,” it says.
Successive funding cuts in recent years have already undermined the viability of many general practices and eroded the PIP’s effectiveness, the document says.
“If the government wants the PIP to properly support practices to undertake continuous quality improvement activities, it must genuinely recognise practices for their quality improvement efforts. This requires new funding, not fund shifting.”
The AMA also takes aim at the Health Care Homes trial as a case of fund-shifting disguised as a banner reform in primary care.
It says the planned two-year trial, intended to ease the burden of chronic and complex disease in the community, should be extended by at least 12 months, so it can be properly evaluated, with significant extra funding based on the model used for veterans’ healthcare.
It notes that the government has provided no new funding to support the HCH trial, but simply redirected Medicare funding, including chronic disease items.
“GPs will be asked to deliver enhanced care for patients with no additional financial support. This contrasts with successful initiatives like the Department of Veterans’ Affairs (DVA) Coordinated Veterans Care (CVC) program that provides significant additional funding support to GPs to provide comprehensive planned and coordinated care to veterans who are at risk of unplanned hospitalisation,” the submission says.
The AMA calls on the government to guarantee that doctors will not bear unnecessary costs for guiding patients through the intricacies of the My Health Record system for arrangements for opt-out, privacy and setting access controls in standing consent for health providers to upload health information.
The government needs to mount an opt-out communication campaign to avoid widespread fear-driven decisions to opt out, and to appreciate the high level of community concern about the My Health Record’s impact on privacy and health data security, it says.
On after-hours primary care, it urges authorities to adopt the recommendations of the MBS Review After-Hours Report to crack down on profit-driven medical deputising services.
The budget should pave the way for a new funding model for after-hours GP services, with some of the savings generated to flow into a specific funding program for MDSs linked to robust quality standards, the submission says.
It calls for more support for general practices that operate for extended hours by changing the Medicare definition of after-hours in rooms consultation items so they begin at 6pm on weeknights and 12 noon on Saturdays.