Feature

Federal Budget 2018–19: An overview for general practice


Doug Hendrie 10/05/2018 3:22:59 PM

There has been plenty written about this week’s Federal Budget. The RACGP has praised big-ticket spending in specialist GP training, rural health, aged care, and medical research, but there remains little detail on these and other areas.

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The RACGP’s ’Overview of the Federal Budget 2018–19’ provides an analysis of the items relevant to general practice.

Patient rebates will increase from 1 July after a four-year indexation freeze, but by only 55 cents per standard consultation, below consumer price index (CPI) and significantly below health indexation.
 
RACGP President Dr Bastian Seidel said the current indexation is inadequate.
 
‘Increasing support for general practice care will remain a focus for the RACGP,’ he told newsGP.
 
Dr Seidel repeated his call for greater investment in general practice.
 
‘Public hospitals will get $130 billion over five years. While it is important to properly fund hospitals, GPs and their healthcare teams provide 150 million services a year at a fraction of the cost of the more expensive and overcrowded hospital system,’ he said.
 
‘Now is the time to look at innovative models in general practice. Greater investment in general practice will mean fewer hospital admissions, less prescribing of expensive medication, and less need for pathology and diagnostic imaging.’
 
Dr Seidel said the RACGP will lobby for a portion of the $100 million allocated to the Health and Innovation Fund to support preventive health innovation in general practice.
 
He said the $550 million commitment to a rural workforce strategy for healthcare professionals demonstrates a strong focus on the healthcare needs of rural and remote Australians by supporting medical students and junior doctors to start and complete training in regional and rural areas. He noted, however, it appears that only $83 million is new funding.
 
A key part of this strategy is encouraging non-vocationally registered (VR) doctors to gain their Fellowship of the RACGP or the Australian College of Rural and Remote Medicine (ACCRM). In addition, new non-VR doctors will be able to get a Medicare provider number to offer services attracting 80% of the patient Medicare Benefits Schedule (MBS) schedule if they are working outside cities with a population of more than 50,000 (Modified Monash Model areas 2–7).
 
Services provided by a new non-VR doctor will attract 100% of the patient rebate if the doctor is on a pathway to Fellowship.   
 
The numbers of visas for overseas-trained doctors will drop from 2300 to 2100, but an extra 100 vocational training places for rural generalists undertaking GP training will be available from 2021.
 
The significant funding boost to aged care will see $1.6 billion spent on 14,000 new high-level home care packages and 13,500 new residential aged care places. In addition, $83 million will be spent on mental health for people in residential aged care facilities.
 
The RACGP has welcomed this boost to aged care, but has called on the Government to work closely with GPs to ensure they remain engaged in the sector while the changes are being implemented.
 
Dr Seidel said ensuring sufficient support for GPs providing care in homes or residential aged care facilities is crucial to improving the health and wellbeing of older Australians.
 
Similarly, the RACGP has called for the general practice profession to be involved in the boost to spending on preventive care research.
 
The Government will spend $275 million from the Medical Research Future Fund on research, including the Million Minds plan to research mental health and suicide prevention, and $18 million on research focused on keeping Australians out of hospital using preventive care and behavioural economics.
 
Dr Seidel said the RACGP supports research in preventive health.
 
‘It is important for any research on preventive health to be conducted in conjunction with general practice, given its central role in prevention and health promotion,’ he said.
 
The budget allocates $9.5 million to improve Medicare compliance through more investigations of alleged fraud and incorrect claiming. 
 
The funding boost of $200 million over four years for Aboriginal and Torres Strait Islander health organisations and programs has been broadly welcomed by the RACGP. However, Dr Seidel said concerns remain about a lack of focus on the social and cultural aspects determining health.
 
‘We can’t yet see how these programs will contribute to prevention if social and cultural aspects aren’t taken into account,’ he said.
 
The RACGP’s Overview of the Federal Budget 2018–19 provides an analysis of the items relevant to general practice.


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