A welcome vision for Australian primary health care – but more details required. 

Globally health services are under pressure through a combination of national and international factors such as, of course, the Covid pandemic, ageing populations, increased prevalence of long-term conditions, lack of sufficient and appropriate healthcare workers for local contexts, rising costs which are not being adequately met, and many more.

I have worked in primary care in the UK and Australia.  Both are highly developed countries with predominantly taxpayer funded health systems.  Both systems are primary health care led in that, in theory, consumers have ready access to quality general practices and community health services for most of their health needs.  In practice, access has become difficult for many due to waiting times for appointments, increasing costs and problems with attracting and retaining GPs and other health professionals particularly in under-resourced areas.

The Australian Labor government released its Strengthening Medicare report on 3 February that outlines its vision for the future of Australian primary care. While aspirational, it is an only an outline and needs concrete actions to foster change.  More details including around budgeting are expected. The usual phrases occur – person-centred care, integrated care, multidisciplinary team-based care and value-based care.

Medicare is the government tax-funded health service for Australians and provides universal health care through primary care, though many general practices do charge a gap fee.  I hope that Medicare can be reformed but, as the health minister has warned, these changes will take time.  Reform of funding models is imperative and the sooner the better.

New health professionals do not appear overnight. Health professional students in training need to be attracted into community settings.  General practice is no longer a popular option for medical students nor recently qualified doctors (this is sadly the case in the UK as well as Australia).  Students need to spend more time in community settings during their programs rather than, as is the case for many, in hospitals. But community-based education requires adequate resourcing as well. 

It is heartening to see the call to encourage multidisciplinary team-based case and the ‘need to break down barriers to interprofessional collaboration and teamwork’ (p6). It is disheartening to hear already of negativity to this approach in the media.  We do not need ‘turf wars’ but greater understanding of each other’s roles, responsibilities and scopes of practice, and how to coordinate care to provide the optimal service to consumers.  And consumer held secure but accessible health records that can be shared easily when appropriate.

The report can be accessed at https://www.health.gov.au/resources/publications/strengthening-medicare-taskforce-report

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