The controversial review has now signed and sealed its final report, which is on its way to Health Minister Mark Butler.
Patient registration will be central to the reforms recommended by the scope of practice review in its final report, according to committee lead Professor Mark Cormack.
Speaking on a workforce panel at Rural Medicine Australia 2024, ACRRM and the RDAA’s annual conference, Professor Cormack disputed the notion that the review would promote a fragmented system.
“Our review will strongly recommend the centrality of the Strengthening Medicare policy framework and the centrality of patient registration with a [GP] practice,” he said.
“The funding, payment and other reforms that we’re proposing – and of course, we’re proposing others that have got nothing to do with payment – will be built around the centrality of Strengthening Medicare and MyMedicare.
“[It will] in many ways provide a forcing function for multidisciplinary approaches to care in the primary care sector.”
The most significant ask in the report will be on payment models.
“Payment mechanisms drive and restrict scope unnecessarily, more than any other policy setting,” Professor Cormack said.
“The work that the [Department of Health and Aged Care] … has done through the GP Incentives Review is absolutely fundamental, not only to achieving the 2032 vision for primary care, but also for enabling health professionals to work to their full scope of practice.
“Put simply: if there’s not a payment available for a healthcare worker to work at their full scope of practice … they won’t do it.”
The review of WIP and PIP payments caused a stir earlier this year, when its draft report recommended that the payments be phased out in favour of a simplified GP architecture, which itself required practices to participate in MyMedicare.
While some of the more controversial aspects were ultimately walked back in the final report, it still recommended that non-fee-for-service Commonwealth payments to general practice (i.e. block funding) should increase from 10% to 40%.
“Health professionals are far more likely to be working at full scope of practice in the context of a multidisciplinary care team in a blended payment, block payment or salaried environment than they are in fee-for-service arrangement,” Professor Cormack said.
“It’s absolutely clear cut.
“The payment mechanism drives behaviour, and there needs to be a concerted focus on addressing that.”
Professor Cormack said Aboriginal Community Controlled Healthcare Organisations were the “stand out model” for primary care.
Related
The second consultation paper from the review, which was released in April, put forward reform options like allowing allied health professionals to write referrals to non-GP specialists directly and opening up the MBS to non-doctors.
Professor Cormack said the report will recommend a harmonisation of legislation and regulatory arrangements.
“Many of the reforms that are happening at a state-by-state level are enabled by virtue of the states having their own Drugs and Poisons Act, and the same for the Radiation Safety Act and Mental Health Act,” he said.
“At system level, we need to focus on harmonising where it makes sense and where there’s a common goal of health professionals working at full scope of practice in the context of a multidisciplinary care team.”
He also said the report would propose a formal mechanism be put in place to assess and evaluate significant changes to workforce models and scope of practice, in the same way that the PBS considers requests for new drug listings.
Rural Medicine Australia 2024 was held at Darwin Convention Centre between 24-26 October.
