Time to ditch GP management plans?

Chronic disease management is getting a shake up, but it might not mean much unless funding is fixed.

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As the government moves to refresh the national strategic framework for chronic conditions, one stakeholder group has suggested cutting out GP management plans.

According to the RACGP, the plans are not only an inefficient use of time but also poorly funded.

“The current MBS rebate system follows a one-size-fits all model, allowing for five visits per calendar year via time-consuming team care arrangements,” the college submission read.

“Shifting to a referral process like that used for medical non-GP specialists, using informative letters, could be considered as it would streamline access to allied health services.

“To increase access, rebates for allied health appointments should be based on an individual’s needs, rather than being limited to five visits for individuals with a chronic disease/s.”

The way Medicare is structured to favour short and procedural consults over longer, talk-based ones “systematically defunds care where it is most needed”, the RACGP said.

The original chronic disease framework was written in 2017 and mentions GPs only once, something the AMA pointed out in its own submission to the refresh.

RACGP president Dr Nicole Higgins told The Medical Republic that a lack of recognition for GPs at a policy level was, sadly, not an unusual occurrence.

“I’ve been disappointed that the common denominator through all of these reviews and strategies has been the lack of mention of general practice and our role in prevention and management of complex chronic illness,” she said.

“Without supporting GPs to do what we do, the burden on the rest of the healthcare system will just continue to increase exponentially.”

It also doesn’t help that primary care software doesn’t talk to hospital and allied health software, most research does not consider the general practice setting and guidelines tend to focus on single diseases but patients tend to present with multiple interrelated morbidities.

But those issues cannot be fixed without first funding general practice.

“Chronic disease and health prevention starts in general practice in primary care,” said Dr Higgins.

“We must make sure that the limited health funding goes into the foundations of the healthcare system, and not more and more expensive hospitals where people go once they have complications.”