Delayed reporting is ‘just a symptom of a system that’s not working’. No word from the department about when it might catch up on evaluating its primary health networks.
The Department of Health and Aged Care has released its latest Primary Health Network annual performance report, suggesting everything is fine and dandy, a far cry from the damning Australian National Audit Office report published last year.
In February 2024, the ANAO released a scathing report showing that the efficacy of the PHN model was “not demonstrated” due to a lack of baseline data and relevant performance measures.
The report also chastised the lacklustre publication of annual reports, recommending that DoHAC report “as soon as practicable following the year to which the majority of the performance information relates” to improve transparency with the public. The department agreed.
As of December 2023, the latest report published by the department was 2020-21.
Yesterday, DoHAC release its latest PHN annual performance report … for 2021-22.
The department did not reply to The Medical Republic’s queries regarding the cause of the continued delay, whether and when the department expected to catch up and the regularity with which PHNs were reporting to the government.
According to the report, some recommendations from the ANAO report were unable to be included in the 2021-22 annual report as it was already in development.
Despite covid continuing to disrupt activities, all PHNs have met the three program indicators – addressing prioritised needs, improving health systems and supporting GPs and other care providers – since 2018-19, according to DoHAC.
Speaking to TMR, GP and practice owner Dr Max Mollenkopf – who resides within the Hunter New England PHN – said that data from the RACGP suggested that PHNs perform “relatively woefully in the eyes of most GPs” and serve as nothing more than a “PIP pimp”.
“This delayed reporting is just another symptom of a system that’s not working,” he said.
But there was some good news.
National potentially preventable hospitalisations were at an all-time low in 2021-22 of just under 2300 per 100,000 population, according to the report.
Low acuity ED presentations decreased by 124 per 1000, with the most substantial decreases seen in regional PHNs.
But the tardiness of the data meant that government policies might be plugging the wrong holes, said Dr Mollenkopf.
“They’re already talking about reducing numbers of low acuity emergency department presentation but then the government is introducing urgent care centers,” he said.
“If they were releasing data in a timely fashion, the government might be able to make decisions that actually [positively] affect the population.”
Dr Mollenkopf said the reporting lacked transparency and accountability.
“[PHNs] should be reporting on what they’re being advised by their local clinical councils,” he said.
“They should be reporting why they are or aren’t acting on those initiatives, which are driven by on the ground clinicians, and they should be regularly reporting what they are actually doing with their local population.
“The fact there’s been so many conflicts of interests and poorly aligned programs that are attracting controversy is directly because there’s such little oversight and such little accountability for what is a huge government body.”
Federal AMA president Dr Danielle McMullen said delayed reporting impeded policy.
“[This is] an example of how frustrating it is when data is slow to get,” she told TMR.
“It’s not uncommon in health for data to be some years before it’s released, but it really impedes policy development and accurate review of things.
“Obviously [in] 2021-22 we’re in the middle of pandemic. Things are different now, and we would encourage more up to date data collection and reporting.”
Despite the lack of validation for their effectiveness, as spelt out in the ANAO report, PHN program funding increased 16.3% to almost $1.6 billion in the 2021-22 financial year.
“Almost a quarter of the $218 million funding increase was new investment in Aged Care services,” said DoHAC.
“Primary mental health care represented the largest investment by funding schedule.”
However, a number of indicators across aged care, mental health and vaccinations decreased in 2021-22.
The number of primary care services in residential aged care homes and GP Health assessment delivered to old people fell in 2021-22, as did the number of PHNs meeting mental indicators relating to the number of patients accessing services, by as much as 35%.
The rate of children fully immunised at age five also decreased below the national target of 95% to 94.7%.
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DoHAC pointed the finger at covid for impacting outcomes.
“PHNs played a critical role in supporting and delivering pandemic response activities, while maintaining operations in their communities,” it said.
“In 2021-22 the Department invested $120.7 million in PHNs to implement a range of pandemic response activities.
“With PHNs prioritising these activities and adapting to the change in the healthcare landscape, progress towards program outcomes was affected.”
PHNs are also monitored for rates of general practice accreditation and participation in the practice incentives program after-hours incentive.
National general practice accreditation fell in 2021-22.
While the percentage of GPs regularly uploading to My Health Record increased, the proportion remained low at 21.9% up from 19.5%.
All PHNs were able to meet their performance targets for My Health Records education.
Over 90% met targets for the proportion of health care providers information systems like MHR.
