23 January 2023


RACGP cautions Medicare reforms must support GP stewardship of patient care

The Royal Australian College of General Practitioners (RACGP) is warning that any Medicare reforms must support GP stewardship of patient care, which is proven to improve patient health and wellbeing.

It comes following media reports that the Albanese Government is devising a plan to open delivery of primary care to other health professionals, with a new funding model that funds nurses and allied health professionals working in teams delivering complex care.

The largest representative body for GPs, the RACGP has today announced a revised plan for governments to address the current health crisis, with action now to stem the bleeding and long-term reform that ensures the future of GP care for all Australians.

This includes:

  • improving access to care by tripling bulk billing incentives, increasing Medicare rebates for longer, complex consultations by 20%, funding enhanced primary care services for people over 65, with mental health conditions and disability, and funding patients to see their GP after an unplanned hospital visit.
  • boosting the GP workforce by fast-tracking entry for international doctors, re-instating the subsidy for their training, supporting junior doctors to intern in general practice, and introducing payroll tax exemption for independent tenant GPs to prevent more practices closing.
  • Long-term reforms based on the RACGP Vision to build the role of GPs as the stewards of patient care in multidisciplinary teams, with serious investment to improve the health of Australians and reduce spending on expensive hospital care.

RACGP President Dr Nicole Higgins said GP stewardship of patient care in the community needs to be central to any long-term reforms.

“While it’s great that our nation’s leaders recognise the need for reform, I am concerned the government’s proposed new model to overhaul Medicare will not go far enough to improve the situation for patients and may make matters worse.

“The problem is decades of neglect and underfunding has made is harder and more expensive to see a GP, and this has caused the crisis in our hospital system, with wait times blowing out and ambulances ramping.

“We need short-term action now to stem the bleeding and improve access to care, particularly for those most in need.

“Australia also needs long-term reforms that build the role of GPs as the stewards of patient care in multidisciplinary teams, because one person needs to be responsible for managing a patient’s care and GPs are best placed to do this.

“We have seen other counties such as the United Kingdom try to address GP shortages by broadening delivery of primary care to other health professionals - this approach failed to meaningfully improve patient health and wellbeing. Instead, it further fragmented the health system, which leads to worse health outcomes, inefficiences and wastage.

“GPs are best placed to manage patient care because we have the required training and expertise in generalist care and diagnostics. The evidence shows seeing the same GP over time, also known as ‘continuity of care’, leads to fewer hospital visits, lower mortality, and reduced costs to the health budget. 

“So, we need GPs working hand in glove with allied health professionals, pharmacists, and practice nurses, and they should be supported within general practice, with GPs working as the stewards of patient care.  

“We need to get any long-term reform right, bandaid solutions won’t work. That means serious investment in general practice care and building the role of GPs as the stewards of patient care in multidisciplinary teams. All the evidence shows that this will improve the health of Australians and reduce spending on expensive hospital care, it just makes sense.”

The RACGP President urged governments to act now to stem the bleeding.

“Long-term reforms will take time, but we have a health crisis on our hands that demands immediate action,” she said.

“Funding has been stripped from general practice care by successive governments over decades, while the need for care has been skyrocketing due to Australia’s ageing population, rising chronic conditions, and mental health concerns. 

“As a result, we are seeing GP clinics forced to close, people are struggling to access a GP, hospitals are overstretched, and this is leading to worsening health outcomes for all.

“There are simple measures government can implement quickly to improve access to care, particularly for those most in need, including tripling bulk billing incentives, and increasing Medicare rebates for longer consultations for complex care by 20%.

“We are also calling on governments to act now to boost the GP workforce by fast-tracking entry for international doctors to work in rural communities and re-instating the subsidy for their training to be a specialist GP in Australia.

“And we need state and territory governments to introduce payroll tax exemption for all independent tenant GPs who rent rooms from clinics – because if practices are slugged with exorbitant new tax obligations, they will be forced to pass costs on to patients, and some will be forced to close.

“There is no substitute for GP care, that path results in worse health outcomes for patients, and longer wait times at already overstretched hospitals.

“Our nation’s leaders need to recognise this, and make the changes needed to ensure that all Australians can access high-quality GP care, regardless of their postcode and income. Anything less is not enough.”


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