improving primary health care for all australians

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IMPROVING PRIMARY HEALTHCARE FOR ALL AUSTRALIANS


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Improving Primary Health Care for All Australians

ISBN: 978-1-74241-420-1

Online ISBN: 978-1-74241-421-8

Publications Number: D0264

Copyright Statements:

Paper-based publications

Commonwealth o Australia 2011

This work is copyright. You may reproduce the whole or part o this work in unaltered orm or your own

personal use or, i you are part o an organisation, or internal use within your organisation, but only i you

or your organisation do not use the reproduction or any commercial purpose and retain this copyright

notice and all disclaimer notices as part o that reproduction. Apart rom rights to use as permitted by

the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not

allowed to reproduce the whole or any part o this work in any way (electronic or otherwise) without frst

being given the specifc written permission rom the Commonwealth to do so. Requests and inquiries

concerning reproduction and rights are to be sent to the Communications Branch, Department o

Health and Ageing, GPO Box 9848, Canberra ACT 2601, or via e-mail to [email protected].

Internet sites

Commonwealth o Australia 2011

This work is copyright. You may download, display, print and reproduce the whole or part o this work in

unaltered orm or your own personal use or, i you are part o an organisation, or internal use within your

organisation, but only i you or your organisation do not use the reproduction or any commercial purpose

and retain this copyright notice and all disclaimer notices as part o that reproduction. Apart rom rights to

use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved

and you are not allowed to reproduce the whole or any part o this work in any way (electronic or otherwise)

without frst being given the specifc written permission rom the Commonwealth to do so. Requests and

inquiries concerning reproduction and rights are to be sent to the Communications Branch, Department

o Health and Ageing, GPO Box 9848, Canberra ACT 2601, or via e-mail to [email protected].


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Primary health care is the part o thehealth system which Australians use the

most. Over our out o ve Australians will

see a GP or other primary care health

proessional at least once a year.

Primary health care is delivered in the

community, outside o hospitals. It

covers a wide range o providers such

as general practitioners, practice nurses,

psychologists, physiotherapists, community

health workers and pharmacists.

Under National Health Reorm, the

Commonwealth Government is aiming to

shit the centre o gravity o the health system

rom hospitals to primary health care.

A strong primary health care system is

crucial in ensuring that individuals and

communities can get the health care they

need when and where they need it.

A strong primary health care system helpspatients better manage their health conditions

in the community and prevent disease.

This results in ewer people using hospital

services. And it helps to ree up hospital

beds and emergency departments to look

ater those who need hospital based care.

This booklet explains why primary health

care is important, why it needs to be

improved and what the changes willmean. It also provides urther details on

Medicare Locals, and their central role in

improving the primary health care system.

THE COMMONWEALTH GOVERNMENT IS COMMITTEDTO IMPROVING AUSTRALIAS HEALTH CARESYSTEM SO THAT ALL AUSTRALIANS CAN ACCESSHIGH QUALITY SERVICES THAT MEET THEIR NEEDSAND THE NEEDS OF THEIR FAMILY.


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WHY WE NEED

TO IMPROVEPRIMARYHEALTH CAREAustralias health care system is one o the

best perorming systems in the world andhas a well trained and dedicated workorce.

However, the Government needs to

reorm the system to meet the demands

o an ageing population, increasing rates

o chronic diseases such as diabetes,

and to take advantage o improvements

in medical and other technology.

Under the Commonwealth Governments

National Health Reorms, the Commonwealthwill und 50% o growth in the ecient price

and service provision in public hospitals.

This will provide a powerul incentive to

the Commonwealth to ensure we make

better use o primary health care services

to ease the strain on our public hospitals.

Australias primary health care system

can be improved in a number o areas:

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1. HAVING THE RIGHTWORKFORCE TO PROVIDETHE CARE PATIENTS NEEDDespite increases in the number o medical

practitioners in recent years, many parts o

Australia are still experiencing shortages o the

health proessionals they need. Many people

nd it dicult to nd a local GP or other primary

health care providers including allied health

proessionals such as podiatrists and dieticians.

The number o practice nurses is growing, but

current unding arrangements limit their role to

particular tasks, rather than allowing them to

be a part o a team managing a patients care

2. HAVING THE RIGHTINFRASTRUCTURETO ENABLE THAT CARETO BE DELIVERED

Primary health care is mainly delivered in more

than 7,000 GP practices across Australia.

However, limitations in inrastructure

make it harder or patients to access all

the services they need in a convenient

location, and harder or health care

providers to work well together in teams.

3. IDENTIFYING ANDADDRESSING GAPSIN LOCAL SERVICES

The primary health care system works wellor patients when there is a GP there, and

when they can get to a GP. However, there

are oten gaps in local services. For example,

in some areas it is hard or patients to access

ater hours GP services, and many people

living in residential aged care nd it dicult to

receive the primary health care they need.

Local communities can also have particular

health needs, or example particularly high rates

o diabetes but there is currently little fexibilityto match health services to those needs.

4. MAKING SURE THAT THEHEALTH SYSTEM WORKSFOR PATIENTS AND HEALTHCARE PROVIDERS SO THEYKNOW WHAT IS AVAILABLE,HOW TO ACCESS IT, AND HOWDIFFERENT PARTS OF THESYSTEM WORK TOGETHER

Many patients have real diculty in navigating

Australias complex health system. It can

be particularly dicult or patients moving

rom one part o the health system to

another. For example, when they aredischarged rom hospital, or when they

need a range o health providers, such as a

psychologist, dietician or physiotherapist.

Currently, no one is responsible or ensuring

that each local community has the right mix

o services to meet its health needs and it is

dicult or patients to know whether things

are working and, i not, who should x them.

REAL IMPROVEMENTSCAN BE MADE IF WE

ADDRESS THESE ISSUESBY MAKING SURE THAT:

Australians are able to more

easily access the care they

need, where they need it. Fewer people need to use hospital

emergency departments or go

into hospital as they would receive

their care in the community.

Local communities have

health services that respond

better to their needs.

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HOW WE ARE

IMPROVINGPRIMARYHEALTH CARE

MEDICARE LOCALS

Medicare Locals are a central component o

the Governments primary health care reorms.

General practitioners will remain the centre o

the primary health care system and continue

to work with individual patients to determine

what clinical care they require but Medicare

Locals will take responsibility or the primary

health care needs o each local community.

Medicare Locals will have a number o

key roles in improving primary health care

services or their local community: They will make it easier or patients

to access the services they need, by

better linking local GPs, nursing and

other health proessionals, hospitals

and aged care, and maintaining up

to date local service directories.

They will work closely with Local Hospital

Networks to make sure that primary

health care services and hospitals

work well together or their patients.

They will plan and support local ater

hours ace-to-ace GP services.

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THE COMMONWEALTH GOVERNMENT WILL BUILD

ON ITS NATIONAL HEALTH REFORMS THROUGHREFORMS TO PRIMARY HEALTH CARE WHICH WILLSEE KEY IMPROVEMENTS DELIVERED SOONERAND WITH A GREATER FOCUS ON THE SPECIFICNEEDS OF LOCAL COMMUNITIES.


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They will identiy where local

communities are missing out onservices they might need and coordinate

services to address those gaps.

They will support local primary health

care providers, such as GPs, practice

nurses and allied health providers, to

adopt and meet quality standards.

They will be accountable to local

communities to make sure that services

are eective and o high quality.

These roles mean that, in all o the areas where

the Government is improving primary health

care, Medicare Locals will play a key part in:

supporting the right health workorce

or the local community

assisting primary care providers to adopt

new technology such as eHealth

identiying and addressing

gaps in local services

better connecting local health services

or patients and providers.

The Government believes that Medicare Locals

are critical to driving improvements in primaryhealth care as they will operate at a local

level to support patients accessing the health

services they need in their own community.

The Government will establish more Medicare

Locals sooner. Under the new timetable:

up to 15 Medicare Locals will be

established by 1 July 2011

a urther 15 will be established 6

months later by 1 January 2012

the remainder will be operational

by 1 July 2012.

Establishing more Medicare Locals will

ensure that each Medicare Local is

responsive to their local community while

being sustainable and retaining critical mass.

Medicare Locals will support the

Governments plans to address each

o the areas where Australias primary

health care system can be improved.


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THE RIGHT

WORKFORCETO PROVIDETHE CARE

PATIENTS NEEDAs part o National Health Reorm, the

Government is investing $1.2 billion

in training more GPs and medical

specialists, and better supporting nurses

and allied health proessionals.The Government is investing $345 million

to increase training places or GPs. This will

deliver an additional 5,500 new GPs or GPs

undergoing training over the next ten years.

The Government is also investing

$390 million to support nurses in general

practices. This will allow general practices

to employ practice nurses to the ull scope

o their ability, as part o the team within

a practice managing a patients care.

In addition, the Government is doubling

the number o clinical training scholarships

or allied health students providing an

extra 1,000 scholarships over a decade.

Medicare Locals will be responsible or

working with local health care providers

to ensure that the right mix o health

proessionals is available to provide the care

required by the members o the community.

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The Government is building GP Super

Clinics across Australia to provide a wide

range o health services in one convenient

location especially in areas where the

population is growing, where there is

high demand or health care services

or identied workorce shortages.

The Government is investing $650 million

in 64 GP Super Clinics across Australia.

As at mid February 2011 there were

29 clinics either operational, delivering

early services or under construction.

The Government is providing about

425 inrastructure grants to general

practices across Australia to expand

and improve their services.

These grants support the expansion o general

practices to allow, or example, practice

nurses, diabetes educators, physiotherapists

and mental health workers to work in new and

upgraded acilities with the latest equipment.

As well as capital investments the

Government is investing in inormation

technology electronic health records and

new technology which will allow primary

health care practitioners to deliver better

and saer services. Improvements in

technology will also allow more services

to be provided within patients homes

allowing or greater convenience.

The Government is investing $352 million

to support Medicare rebates or online

consultations or GPs and specialists,

THE RIGHTINFRASTRUCTURETO SUPPORT

THE BEST CARE


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and incentives or GPs and specialists

to participate in online services.

This could enable, or example, a patient

with heart disease who usually travels to

see their cardiologist, to videoconerenceat their usual GP practice instead.

The Government is also investing

$467 million to establish a secure personally

controlled electronic health record system,

which will improve the saety o care

and reduce duplication and waste.

Medicare Locals will become key agents

in driving technological change. They

will support general practices and other

primary health care providers to adopt

eHealth, and the new telehealth initiatives.

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IDENTIFYING ANDADDRESSINGGAPS IN LOCALSERVICES

A key role or Medicare Locals will be to identiy

the health needs o their local community,

and address gaps in local health services.

Two areas where many local communities

are experiencing gaps in health services are

access to ater hours services and services

or people living in residential aged care.

The Government is accelerating the investment it is

making in ater hours services. As each Medicare

Local is established it will be provided with unding

to plan, coordinate and support comprehensive

ace-to-ace ater hours GP services.

Each Medicare Local would use

this unding, or example, to:

compile local ater hours service directories

identiy gaps in ater hours services

arrange local on-call rosters

und local GPs to expand their

reach or extend their hours.

The Government is also establishing a

national GP ater hours advice line rom

1 July 2011 so that everyone can get advice

ater hours rom a registered nurse and, i

necessary, a GP over the telephone.

These reorms will mean that local

communities across Australia will have

better, more consistent access to ater

hours care increasing convenience or

amilies, and reducing unnecessary visits

to hospital emergency departments.

To improve older Australians access to

care, rom 1 July 2010 the Government

increased incentives or GPs who provide

services to people in aged care homes.

Complementing these increased incentives,

rom 2012-13 Medicare Locals will be provided

fexible unding to target gaps in primary health

care services or people in aged care.

In addition, over time Medicare Locals will

be provided with more fexible unding

so that they can target services to their

local communitys specic needs.

These initiatives give Medicare Locals a key

role in unding services that complement

the Medicare-unded services provided

by GPs and allied health providers.

INDIVIDUAL LOCAL COMMUNITIES ACROSSAUSTRALIA HAVE DIFFERENT HEALTH NEEDSAND DIFFERENT HEALTH SERVICES AVAILABLE.

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MAKING THE

SYSTEM WORKFOR PATIENTSAND PROVIDERS

GPs will remain the cornerstone o primary health

care, providing clinical care or individual patients but Medicare Locals will become responsible

or ensuring the primary health care system

meets the needs o each local community.

Medicare Locals will be expected to

understand and identiy issues such as:

What the health needs o

their community are.

Whether the right health practitioners

are available locally to treat them.

Whether ewer people could be going into

local hospitals, i more appropriate care

were to be available in the local community.

Whether the right services are

easily available when people are

discharged rom hospital.

Medicare Locals will use this inormation

to work with local primary health care

providers to ensure appropriate care isbeing provided or the local community.

Medicare Locals will provide support to

local primary health care providers to assist

them to meet saety and quality standards,

and to adopt best practice care.

Medicare Locals will be accountable to

their local community through robust andtransparent perormance indicators.

These indicators will provide local

communities with a clear sense o how

well their local primary health care system

and Medicare Local are perorming.

Medicare Locals will report on areas including:

Need, including:

local population and demography

number o people with particular

health needs, such as the prevalence

o obesity or diabetes.

Access to health services, including:

the number and local availability o doctors,

nurses and allied health providers

opening hours o GPs and other

primary health care services

availability o bulk billed GP services.

Quality of local health services, such as

rates o accreditation

Patient health outcomes, such as local

rates o preventable hospitalisations

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www.yourHealth.gov.auAll information in this publication is correct as of February 2011

Follow yourHealth on Twitter: @yourHealthgovau

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improving primary health care for all australians

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