The blended funding model is the 'thin end of the wedge', one advocate says, and the profession should be consulted.
At a snap press conference two weeks ago, Prime Minister Anthony Albanese unexpectedly revealed that voluntary patient enrolment would be funded in this year’s budget.
The motivation behind it is to incentivise chronic disease management, not just the discrete episodes of care that Medicare was designed for.
The reception from GPs, at least judging by the TMR comments section, was lukewarm at best.
Melbourne-based GP Dr Chris Irwin, founder of the Australian Society for General Practice, who has long been outspoken in his opposition to the scheme, has gone a step farther and launched a petition asking the RACGP and AMA to survey members on the issue.
“Primarily, all I’m asking for is that representative organisations represent their members, which doesn’t sound like an extraordinarily big ask, but it is what it is, I suppose,” he told TMR.
“I’m just quite shocked that the biggest funding shake up for general practice for 40 years is about to slowly put its foot in the door and no one has bothered to actually ask GPs what they think.”
Dr Irwin, who won the first round of the voting in last year’s RACGP presidential election, was confident that a member survey would reveal very little grassroots support for the initiative.
If proven wrong – through a fair survey that accurately represented the pros and cons of fee for service versus VPE that acknowledged the risks of giving governments more power over funding – Dr Irwin promised that he would “just shut up”.
“I am absolutely sure that would not be the outcome,” he said.
Dr Irwin’s main argument is that VPE is the “thin end of the wedge” through which the government intends to introduce a capitation model similar to the UK’s NHS.
According to his logic, once introduced it would be enticing for the government to keep the freeze on fee for service items and only introduce new funding under VPE, thus attracting more practices to the program.
“There’s a clear motive for any government to preferentially fund capitated payments over fee for service because, through the capitation, they can attach all the strings and all the KPIs they want,” he said.
The dollar amount attached to VPE will be revealed in the budget on Tuesday night.
RACGP president Dr Nicole Higgins said the college “cautiously welcomes” the VPE announcement, but that the “devil is in the detail”.
The AMA, on the other hand, has been a slightly more vocal proponent.
“My Medicare, a system of voluntary patient enrolment, should reinforce the central role of general practice in the care of patients, ensuring patient care is well coordinated as part of a GP-led approach to the delivery of care,” AMA president Professor Steve Robson said.
“While it is important that other health professionals can work to their full potential, this should not be allowed to fragment patient care.”
