Like it or not, the powers that be believe voluntary patient enrolment is the way out of this primary healthcare jam.
With the Strengthening Medicare Taskforce report set to drop in the coming weeks, the top three funding recommendations are tipped to be expanding multidisciplinary team care, digital modernisation and voluntary patient enrolment.
Appearing on the Seven Network earlier on Monday, Prime Minister Anthony Albanese said the government was committed to fixing Medicare as a high priority.
As reported in The Australian, all major peak health groups have agreed that access to primary healthcare will be out of reach for millions of patient if there is no major Medicare reform within the next few years.
The brainchild of Health Minister Mark Butler, the taskforce is backed by $750 million in funding, which will go toward whichever reforms are deemed the highest priority.
“[Medicare] really is a system that was designed for much more linear episodic care that was more the state of things in the 1980s and 1990s,” he told The Australian.
“And at a time of skyrocketing patient demand and workforce shortages, it just doesn’t make sense not to have every health professional working to their scope of practice.
“We need doctors working hand in glove with practice nurses, allied health professionals and pharmacists.”
The newspaper speculated that the new funding model might include block funding to incentivise GP clinics to take on more allied health staff.
There is also the chance that the funding would be channelled through Primary Health Networks, rather than individual clinics.
RACGP president Dr Nicole Higgins told The Medical Republic that the college would not be celebrating just yet, with details on the proposed patient enrolment scheme still yet to be announced.
When asked if she was optimistic about what the government may have in mind for the scheme, Dr Higgins said she was instead “curious”.
“I want to ensure that we get the correct model of care,” she said.
“I don’t want a system like the NDIS, which is out of control – where there’s a fragmentation of care.
“We need a model with continuity of care, with the stewardship of a GP.”
Dr Higgins is likely to stay curious for at least a little while longer; the recommendations as they appear in the taskforce report, she said, are likely to be very high-level.
“It’s important that the money actually goes to the patient and general practice, and doesn’t get absorbed as more layers of bureaucracy and red tape through the PHNs,” the RACGP president said.”
#auspol
— QLDCountry GP (@QLDCountryGP) January 22, 2023
More talk of “unsustainable #Medicare” today & the need for new funding models.
The model isn’t the issue; the lack of funding is. If you’re not willing to put fuel in your car, then changing the model won’t help.
Aging population = increased health cost. Reality. pic.twitter.com/pmsmOgk87t
She also acknowledged widespread concern that a voluntary patient registration system would end up similar to the NHS model in the United Kingdom, reiterating that voluntary registration is just a patient committing to attending a certain practice.
“It is not a financial model, it’s not about payment, it’s just ensuring the patient identifies with a general practice,” Dr Higgins said.
AMA vice-president Dr Danielle McMullen said the taskforce had only discussed encouraging multidisciplinary team-based care in the context of a GP led model.
“Flexible funding, in addition to fee for service, [should] follow the patient to allow practices to hire more nurses through an increased WIP [Workforce Incentive Program] payment,” she told TMR.
“Another example would be that practices might hire a diabetes educator if they have lots of patients with diabetes, to increase their patient’s access to allied health in a well-coordinated way.”
The AMA is also pushing for short-term relief for the sector – smaller reforms like re-balancing the MBS and funding longer consults – given that any major reform is all but guaranteed to take the better part of a decade.
There’s also the matter of that $750 million, which multiple stakeholders have said will not be enough to deliver the scale of the reforms needed.
“Reform of general practice is going to take a lot more than 750 million over three years,” Dr McMullen said.
