24 November 2022

RACGP releases white paper on future of GP care

The Royal Australian College of GPs (RACGP) has doubled down on calls for government to boost investment in general practice care so that no patients are left behind.

It comes following the release of the General Practice Crisis Summit White Paper, which resulted from the Crisis Summit held in Canberra last month. The Summit was convened to gather GP leaders, peak bodies, health organisations, consumer representatives, clinicians, and academics to discuss the future of general practice patient care and highlight solutions for reform.

Reflecting the discussions at the Summit, the White Paper affirmed that decades of significant underfunding and cost-cutting has left general practice on the brink of collapse, with high upfront costs affecting vulnerable patients’ access to timely care and future doctors discouraged from pursuing a career in general practice, leading to a growing shortage of GPs.

The White Paper includes a range of recommendations that were raised on the day by the broad range of participants. Several recommendations that were strongly supported by participants include:

·         an immediate increase to Medicare rebates for general practice by at least 20%

·         tripling of the bulk-billing incentive

·         regular indexation of Medicare rebates and other general practice payments by an independent body

·         reducing red tape in general practice, including streamlining, and simplifying the Medicare system

·         re-introducing a program of junior doctor placements in general practice

·         developing an overarching data strategy for general practice.

RACGP President Adj. Professor Karen Price urged the government to act now on reforms to support general practice.

“This White Paper tells us what many GPs have been saying for years – general practice care is on life support and reform is urgently needed,” she said.

“There are many positive, forward-thinking solutions in this White Paper. Whilst not all are endorsed RACGP policy, they are all centred around the same outcome – securing the future of general practice care in Australia so no patients are left behind. There was a consensus at the Summit that funding for primary care is woefully inadequate. Funding for patient care through general practice constitutes just 7.4% of total government healthcare expenditure in Australia, which is completely counterintuitive given that GPs are the most accessible doctors seeing almost 90% of Australian patients every year, and GPs prevent people ending up in hospital with urgent health problems.

“The Medicare Benefits Schedule has remained largely unchanged since its inception almost 40 years ago and was designed before the management of complex chronic disease was commonplace. In 2022, we have increasing rates of chronic disease, an ageing population, and a much more complex health system, so the funding system simply isn’t fit for purpose. Medicare rebates have not kept pace with the cost of providing high-quality care and without real reform backed by strong investment, the future of general practice care looks bleak. No one wants patients in any community to miss out on the care they need, yet we are sleep walking toward that inevitably happening.

“Off the back of this Summit, the RACGP is calling for an immediate increase in Medicare patient rebates of at least 20%, and an increase to the bulk-billing incentive by three times. We are also calling for appropriate and ongoing indexation for MBS items, so that it is in line with the real-world costs of providing high-quality care in communities across the country.

The RACGP President said that considering the training of a GP specialist takes around ten years, the time to act is now.

“The evidence is clear that general practice is in crisis and this impacting the health and wellbeing of people in communities across Australia, who are struggling to access and afford the care they need,” she said.

“Without genuine change, the future of patient care is in jeopardy. More people will struggle to access a GP and bulk billing will continue to collapse, making it harder for people to get the care they need when they need it. It is not a stretch to predict health outcomes declining and missed opportunities for preventive care putting more people in hospital. This will be felt most acutely by patients in rural and remote areas, and patients who are financially disadvantaged.

“We need to ensure equitable access to care, with enough GPs to care for people in every community, because everyone needs access to high-quality care no matter their income or postcode. A key part of this is ensuring junior doctors have opportunities to experience general practice for themselves and understand what a rewarding and diverse career it can be. We also need to make sure that junior doctors who do choose to specialise in general practice aren’t at a disadvantage compared to other medical specialties.”

The RACGP’s Vision for general practice and a sustainable healthcare system outlines the urgent need to restructure the healthcare system into one that provides the right care for patients at the right time and in the right place, and that is sustainably funded into the future.

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