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Budget leaves room for improvement in general practice, GP says


Dr Edwin Kruys 9/05/2018 4:19:14 PM

The Government has committed to meeting the needs of rural and older Australians in the Federal Budget, but there is still much room for improvement in general practice, Dr Edwin Kruys writes.

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Dr Kruys said the Federal Budget signals some progress for Australia’s healthcare system, but limited detail makes it difficult to properly interpret.

RACGP President Bastian Seidel was cautiously optimistic and commended the Government for investing in college-led GP training.
 
AMA President Michael Gannon said that the budget is notable as much for what is not to be found in it, as it is for what is included.
 
RDAA President Adam Coltzau said this is the rural health budget that the RDAA has been waiting for.
 
ACRRM President Ruth Stewart was positive, indicating that ACRRM is broadly supportive of the changes in legislation and funding in the budget.
 
Last night’s Federal Budget signalled some progress for Australia’s healthcare system, with funding for aged care, mental health and research and medications. However, minimal detail and a lack of focus on primary care makes the budget difficult to interpret.
 
Here is a summary of some of the key areas affecting healthcare, based on the limited information available in the budget – which some have called an ‘election budget’.
 
The Government will invest in general practice training, which includes support for non-vocationally registered GPs to attain Fellowship. The Government also promises to address issues relating to the rural workforce, although little detail has been provided to understand what the future holds, what support is being offered, and when the proposed initiatives will start.
 
We know that better retention is achieved when doctors can complete all of their training in rural, remote and regional areas. There is an expectation that the strategy may address issues in rural workforce training to help achieve this outcome.
 
Workforce monitoring and planning is a welcome move in this budget. We are currently behind the eight-ball in ensuring we have the right workforce in the right areas to meet patient needs.
 
As we already knew, there will be new or amended items arising from the Medicare Benefits Schedule (MBS) Review impacting general practice, including:

  • that GPs will no long be able to order knee MRIs for people over the age of 50
  • better support for general practice-based spirometry
  • better support for dialysis in very rural and remote areas.
But, as the MBS Review has not been finalised, we will have to wait what this will mean for general practice.
 
The other significant area of funding (upwards of $5 billion) is for aged care, with a raft of measures covering quality, access and healthy ageing. Of note, $61.7 million will be spent on redevelopment of My Aged Care. The intent is to make it easier to use, with simpler assessment forms, which is very much needed.
 
At the same time, the GP aged care Service Incentives Payments (SIP) will disappear, which, if no alternative from of funding is found, may mean that GPs will have to stop visiting residential aged care facilities.
 
There has been some commitment to funding preventive health research ($18.1 million), aiming for a reduction in preventable hospital presentations, funding for research translation ($75 million over four years), and funding of $125 million over 10 years for mental health. Ensuring these research efforts support frontline GPs to provide high-quality care to patients will be critical.
 
A focus on suicide prevention and aftercare, as well as further support for the Mental Health Commission, seem to have become key parts of the Government’s commitment to mental health in the coming years.
 
While this year will see the reintroduction of indexation for patient rebates, announced in last year’s Federal Budget, patient rebates will increase by less than the Consumer Price Index (CPI) and significantly less than health indexation. This inadequate indexation follows the four-year rebate indexation freeze.
 
RACGP President Bastian Seidel advocates for an increase of Medicare rebates for GP attendances by 18.5% in order to align specialist GPs with other medical specialists. This advocacy clearly needs to continue if last night’s budget signals this Government’s efforts to reorient care toward our efficient general practice sector.


THE AUTHOR:


department-of-healthfederal-budgetMBS



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