The Royal Australian College of General Practitioners (RACGP) has warned that although Budget October 2022-23 delivers on key election promises, significant funding for general practice care is urgently needed to address the GP crisis.
The Budget includes a re-commitment to $250 million per year in GP funding over three years following the Strengthening Medicare Taskforce Report which is due later this year, as well as $143.3 million for rural and remote healthcare, and $229.7 million in general practice support grants to build better infrastructure. However, it does not address the immediate challenges facing general practice care, including a lack of funding following years of Medicare freezes and inadequate indexation of patient rebates.
The RACGP holds grave concerns that without major investment into general practice care by the federal Government the current shortage of GPs being felt by communities throughout Australia will intensify, waiting times to see a doctor will increase, and the health and wellbeing of Australians will suffer.
In the college’s October 2022-23 Pre-Budget submission the RACGP called for a series of timely reforms including an increase Medicare rebates for longer consultations, the creation of a new Medicare item for GP consultations longer than 60 minutes, as well as support for longer telehealth phone consultations lasting more than 20 minutes, and increased investment in rural healthcare.
RACGP President Adj. Professor Karen Price said that although the Budget delivered on many key promises, major reform was sorely needed to secure the future of high-quality general practice patient care.
“The $750 million set aside for the Strengthening Medicare Fund, can’t come soon enough. While this is a welcomed confirmation, it is important to point out that this represents only 3% of Medicare funding for GP services,” she said.
“The provision of $229.7 million in general practice grants is also welcome and we look forward to more comprehensive information regarding the number of $25,000 and $50,000 grants available for each identified area, including grants to support for general practices to achieve accreditation. We also welcome confirmation of the $143.3 million in funding for healthcare in rural and remote areas, including $74.1 million over 4 years for tiered incentives, recognising doctors with additional skills practising in rural and remote areas, and $29.4 million to expand the list of eligible health professionals and increase the rural loading in the practice stream, via the Workforce Incentive Program.
“These are measures the RACGP advocated for and these, and other initiatives encompassing remote, rural and regional health, like support for further trials of Single Employer Models, are welcomed levers to address the GP crisis in rural areas.
“The RACGP also very much welcomes the federal Government’s commitment to the Uluru Statement from the Heart and the initiatives aimed at boosting the Aboriginal and Torres Strait Islander workforce in the health sector.
“However, the Government must go much further so that no patients are left behind in the years to come. By increasing Medicare patient rebates, boosting investment in rural and remote health, and making longer telephone consultations a permanent fixture of our telehealth system we can really transform general practice care and put it on a more sustainable footing.”
Adj. Professor Karen Price said that there was no time for delay and that the college would work hard to fight for general practice care ahead of next year’s budget.
“The pandemic has exposed cracks in our health system, including general practice care, that require urgent repairs,” she said.
“We must do more to ensure that GPs can really take the time to talk to their patients and get to the bottom of what is going on. The Medicare rebate structure we have discourages GPs from doing so and that must change. Right now, patient rebates decrease the longer a person spends with their GP, and we must reverse that through meaningful investment.
“This is not something new, in our submission to the draft 10 Year Plan we stressed that high-quality care offered by GPs is at risk if substantial reform does not take place. Also, the MBS Review General Practice and Primary Care Clinical Committee in 2019 – featuring representation by politicians from all sides of government – backed a substantive increase to Medicare rebates. This was also endorsed by the previous Government’s MBS Review Taskforce in 2020. So, let’s get it done, because reform, without the dollars behind it, is nothing more than talk and we have had enough of that.
“Unless strong action is taken, the profession will continue to decline, and we will have more and more trouble attracting and retaining GPs. So, we look ahead to the May Budget next year and urge the Government in the strongest possible terms to boost investment in general practice care and commit to meaningful reform. The RACGP will continue to work constructively with the Government to make that happen and ensure that the voice of general practice is heard loud and clear.”
The RACGP President also said that other elements of the Budget would be carefully considered by the college.
“We will, as always, carefully examine the Budget and seek more information where required to ensure that members interests are best served,” she said.
“As anticipated, the Budget confirms funding for 50 Urgent Care Clinics, which will be developed and piloted in consultation with the profession. While the RACGP notes that these will be GP-led, we require further information, including the funding model, workforce requirements, where the workforce will come from, and the impact on existing health infrastructure. So, that is something that we will work through with the Government because the devil really is in the detail.
“Finally, it’s disappointing that there was no investment in general practice mental health services. As our recent Health of the Nation report found, GPs provide the majority of mental health services in Australia, and mental health is the most common presentation in general practice. So, again that is something for us to prioritise and discuss with the Government because GPs are the first port of call for many people with mental health issues.
“It’s been an exhausting few years for GPs and general practice teams and a trying time recently given sensationalist media coverage that has impacted the morale of practices across the nation. My message to all GPs, practice managers, nurses, receptionists, and admin workers is that you are doing a tremendous job and you should not be taken for granted. We will continue working with Government and advocating strongly so that general practice care is properly valued and supported. The fight continues and we are up for it.”
The RACGP’s Vision for general practice and a sustainable healthcare system (Vision) 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. It will also promote health equity for groups who disproportionately rely on secondary care including treatment in hospitals.
Last year, PricewaterhouseCoopers Consulting found that implementing The Vision would create substantial economic benefits by reducing the need for more expensive secondary care and improving the nation’s productivity through a healthier workforce.