02 March 2023

RACGP: Help GPs and practice teams care for people experiencing poverty

The Royal Australian College of General Practitioners (RACGP) has called on government to help GPs get on with the job of caring for people experiencing poverty.

It comes following the RACGP’s submission to the Senate Community Affair’s inquiry into the extent and nature of poverty in Australia.

RACGP President Dr Nicole Higgins said that the solutions to poverty must include general practice care.

“A key part of tackling poverty is improving the health of people living in poverty,” she said.

“If people are experiencing poor health, it makes it harder to work, and to care for themselves and their family. We must make sure general practice care is available to everyone. I don’t want an Australia where people living in poverty are left out in the cold.

“There are concrete steps government can take to help patients experiencing poverty get the right kind of care when they need it. Longer consultations with a GP are crucial for many people experiencing poverty when you consider that these patients are more likely to present with poorly managed chronic conditions and increased rates of mental health issues. GPs also spend lots of time helping out with complex paperwork for agencies including Centrelink, the NDIS and state housing, just to name a few.

“So, we need time to help these patients and that is a commodity we just don’t have. The current Medicare structure devalues longer consultations, with patient rebates decreasing significantly the longer a person spends with their GP. Let’s change that by increasing patient rebates for longer consultations by 20% so that GPs can take the time to help people experiencing poverty and ensure their complex needs are met. GPs will play an essential role in any effort to reduce poverty in Australia, and this change will help us to improve health outcomes and give people living in poverty opportunities to beat the challenges they face.”  

Dr Higgins said that improving access to general practice care was more important than ever.

“We must ensure all patients, including those experiencing poverty, can access general practice care,” she said.

“There is a strong and clear connection between health and socio-economic status. Unless governments commit to ensuring all Australians can access the healthcare they need, we risk condemning vulnerable communities to worse health outcomes.

“Unfortunately, people across Australia are finding it increasingly difficult to find a bulk-billing GP or even just a practice taking on patients. The situation is particularly dire for people living in poverty because it is becoming more and more unviable to run a practice in a low social economic status area where patients cannot afford non-bulk-billed care. So, it is no surprise that 11% of GPs work in Australia’s most deprived areas and almost a quarter in the least deprived areas.

“Keep in mind too that for many people living in poorer areas, access to non-GP specialist care is limited and hospitals serving these communities are also underfunded. For example, in New South Wales funding per patient is less for Liverpool and Campbelltown hospital in the southwest of the city than it is for the central hospitals.

“The solution is boosting investment in general practice care. That way, we can put primary care on a more sustainable, long-term financial footing and ensure that no patients anywhere are left behind. If patients living in poverty can access care from their GP when they need it, they are far less likely to end up in a hospital bed with a condition that could – and should – have been managed in general practice. Even aside from the consequences of enabling people to work, care for their families and live their lives to the fullest extent possible, it just makes sense economically. To take one example, every dollar invested in primary health care in a remote Indigenous community results in savings in hospital care from $4 to $12.

“Social prescribing is also gaining momentum in Australia and that’s a great step forward for patient care. It involves referring patients, including those with mental health issues, to non-medical activities such as fitness programs or a walking or a gardening group to improve health and wellbeing. It holds tremendous potential and I urge all GPs to consider how it could help many of their patients.”

The RACGP President said that tackling poverty must be top of the agenda for government.

“We shouldn’t put people experiencing poverty in the ‘too-hard basket’, they must be front of mind at all times,” she said.

“At the end of the day, health is not just a measure of illness and disease but is a measure of community functioning. By acting on poverty and ensuring all patients can access general practice care, we can transform the lives of many people right across Australia. It will allow people to function without the constant, day-to-day stress of living in poverty and improve health outcomes right across the nation.”

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