AMA advocacy delivering for GPs
In reflecting on the last six years as Chair of the AMA Council of General Practice, I was reminded of the significant work the AMA does in advancing the interests of GPs and patients.
Much of this work has been in the background. The AMA has seen off many thought bubbles that thankfully have never seen the light of day.
There have, of course, been some very public battles, because successive governments have failed to appreciate the value and role of general practice.
In my time as Chair, we have had five prime ministers (albeit one twice) and four health ministers. Over that time we’ve seen some big visions in health, but progress has rarely matched the ambition.
When I first came to the role of Chair, funding had just been announced for the Practice Nurse Incentive Program (PNIP), Medicare Locals, additional GP Super Clinics, the establishment of Personally Controlled Electronic Health Records and chronic disease reform in the form of capped funding for bundled care for patients with diabetes.
The AMA welcomed the PNIP because it supported a GP-led model of team-based care, and offered significant extra funding for practices to employ a practice nurse. The AMA also won grandfathering arrangements to ensure practices were not disadvantaged by the removal of practice nurse items in the Medicare Benefits Schedule.
The former Government’s Diabetes Plan proposed the introduction of a capitated model of payment, replacing fee-for-service for eligible patients. The plan lacked detail and would have rationed access to care for patients. It was quickly dumped by the Government in favour of a trial that ultimately confirmed that the plan would have failed.
Over my term the AMA has continued to prosecute the reform of chronic disease items through its plan Improving the care for patients with chronic and complex care needs, and has outlined principles for formalising Medical Homes in Australia – elements of which have been incorporated in the Government’s recent Health Care Homes proposal.
AMA advocacy has helped ensure policy failures such as Medicare Locals and GP Super Clinics were short-lived, and after hours funding was returned back to practices via the PIP.
The inclusion of GP-referred MRI in the MBS may have taken a while, but we got there in the end. The introduction of these items is good for patients and has improved access to timely care.
I have also been delighted to see the importance of teaching championed by the AMA, with our efforts resulting in the PIP teaching incentive doubled and the ongoing funding of rural and regional teaching infrastructure grants. Our campaign to increase GP training places has borne fruit. There are now record numbers of doctors in training entering the GP training program.
Maldistribution of the GP workforce remains an issue, although the AMA has supported expansion of GP training places in rural and regional settings. We also played a big role in the establishment of the Rural Junior Doctor Innovation Fund to finance rural GP rotations for interns.
From a professional perspective, it is reassuring that more young doctors than ever want to be GPs, and that the colleges are to have a greater role in trainee selection.
I would have liked to have seen a commitment to fund the Pharmacist in General Practice Program in my time as Chair, but the ground work has been laid, and I am confident that in time the common sense of this proposal will prevail.
Of course, there are still challenges ahead, particularly around ensuring policies and funding arrangements that truly support GPs in providing quality preventative, holistic, coordinated and longitudinal care.
In closing, I wish to thank you and the members of the Council of General Practice for all the support. It has been a privilege to serve you. To my successor, I wish you all the best and every success as you lead the profession forward.