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Every year eventually becomes the year for the older person

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Case conferences demand a degree of organisation that does not occur easily in general practice

Does anybody remember that 1999 was the International Year of Older Persons? Does anybody remember the statement made by Bronwyn Bishop, as the Minister for Aged Care at that time, titled “Our commitment to Australia’s seniors”?1

There were two pages on enhanced primary care and three pages on residential care, much of which was devoted to aged care challenges in rural Australia. Individually, some of the proposed recommendations were very sensible. However, the problem with so much of government rhetoric is in joining up the points to form a coherent whole.

Medicare payments are based on general practice being a one-to-one episodic consultation. Chronic medical conditions in an increasingly ageing population demand reliable communication between health care professionals. “Multidisciplinary” is one of those words beloved by the ministerial scribes; however, in the way primary care is structured, it is difficult to organise because general practice is based around doctors not multidisciplinary teams.

The Medicare item for case conferences, introduced in 2000 by then Minister for Health and Aged Care, Michael Wooldridge, for general practitioners and consultant physicians acknowledged that teamwork is an essential part of chronic disease…