At the second GP incentives review webinar today, the panel faced more tough questions on payroll tax, indigenous health and the ‘c’ word.
One member of the expert panel in charge of overhauling the GP incentives scheme has hit back at accusations that the proposed new system will amount to capitation.
“The ‘c’ word has come up in many media streams and social media posts that I’ve seen,” practice manager and health economist Tracey Johnson told a webinar on Thursday.
“Moving to an accountability framework around the new money that we’re proposing to have invested in primary care does not equate to capitation.”
Thursday’s webinar was the second information session run by the Department of Health and Aged Care on its ongoing review of general practice incentives.
A consultation paper with draft recommendations was released earlier in August.
“This report in no way, shape or form, says that all of a sudden the way you will get your payment is by a payment for outcomes model,” Ms Johnson, who is on the expert panel advising the review, said.
“There will be more data sharing, because that’s how you get needs-based funding, but in terms of a capitation model – that was never part of our plan, nor is it part of our recommendations.”
What the draft recommendations did include were a proposal to phase out the existing Practice Incentives Program and the Workforce Incentive Program for a new architecture that would hinge on practices being enrolled in voluntary registration system MyMedicare.
The other component of this plan was to direct payments to practices rather than individual clinicians.
It’s the requirement to participate in MyMedicare that prompted the “capitation” comparison from the RACGP.
When asked what the incentive was for patients to enrol with MyMedicare, Ms Johnson said Canada had seen success in converting its general practices to a team-based structure with blended funding.
“[The patients] quickly saw the scale of the team and the different resources that they could access – they could get health coaching, they could get preventative health input, they could see their health literacy improve,” she said.
“They could actually get a whole bunch of on-the-day support and follow-up support that might not currently be available in a doctor-only relationship.
“I have been in Canada in the bitter cold of winter and seen patients queuing around the block to enrol at practices where this is the model of care.
“I think patients will see the experience and the difference, and they will make choices.”
Canberra GP Dr Clara Tuck Meng Soo, who is also on the expert panel, reiterated that it would be up to practices to opt into the new system when it was up and running.
“Everyone is not going to be forced to do it – [but] obviously, if you want to get the money, you have to provide a certain amount of data to satisfy the government,” she said.
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Dr Soo also said the new funding model would allow allied health staff to free up GP time.
“I suspect that [what I’m about to say] is going to be a little bit controversial,” she said.
“As an experienced GP, do I actually need to see all my patients who have come in with a simple cold?
“Do I actually need to see all my patients who have come in to ask for repeat scripts for their oral contraceptive?
“The answer to that is no, you don’t need someone with my level of expertise to do that.
“Somebody else in the team who is suitably trained can potentially perform all those roles, and it therefore frees me up to do more complex work with the patients who have more complex health needs.”
Naturally, there were also questions as to how a new system would impact on payroll tax.
Ms Johnson had a ready answer.
“Let me start with a fundamental premise,” she said.
“I think the view of the panel is that you don’t start designing a healthcare system based on a taxation system.”
