Issue 23 / 30 June 2014

AUSTRALIAN GPs have a moral obligation to help improve primary care in other countries argues a leading GP, who says overseas aid is often too narrowly focused on particular diseases and patient subgroups.

Professor Michael Kidd, executive dean of the Faculty of Medicine, Nursing and Health Sciences at Adelaide’s Flinders University, has called for a “refocusing” of international aid efforts around strengthening primary care.
    
In an MJA editorial published online today, Professor Kidd said countries such as Brazil and China were focusing on further developing their primary care systems to achieve the goal of universal health coverage and their governments believe they could benefit from Australian expertise. (1)

“[Australian GPs] have an obligation as part of our commitment to humanity to share our experiences and our solutions to tackling the world’s greatest health challenges”, he wrote.  

“Australia can also, of course, learn from other nations … With 800 million people living in rural areas, the government of China recognises that one of its biggest challenges is training the family doctor workforce to meet the needs of the nation.

“If these problems can be overcome, especially in rural areas, it will provide lessons that will flow to many other parts of the world facing the same challenge of providing universal health coverage.”

Professor Kidd, who is also president of the World Organisation of Family Doctors (WONCA), told MJA InSight too much emphasis was currently put on vertical public health programs targeting specific overseas patient groups or diseases.

“While these are important, countries need a strong horizontal base of primary care to bring all of those programs together, otherwise people slip between the cracks”, he said.

“Strengthening primary care is harder than running vertical programs, but it is more sustainable because you are actually investing in the long-term infrastructure of a country’s health care system”, Professor Kidd said.

Individual GPs could contribute toward global primary care by practising or teaching medicine overseas, and organisations could also assist by posting resources online, including guidelines, curriculum and training manuals, he said.

Medical students and registrars also had an increasing array of opportunities to complete part of their training overseas, as a growing number of medical schools and training providers had international partnerships.

Dr Liz Marles, Royal Australian College of General Practitioners (RACGP) president, said there was no question a greater focus on primary care was needed within international aid and development programs.

“All evidence indicates that countries with strong primary care have more equitable, cost-effective health care systems with better health outcomes”, she said.

Dr Marles said the RACGP had a strong focus in the Asia–Pacific region, including a conjoint fellowship exam for Malaysia and Hong Kong, and a partnership with the Fiji College of General Practitioners to support improvements in standards and education and training.

The college provided medical registrars in Papua New Guinea with complimentary RACGP membership, including access to educational resources as well as sponsoring a small delegation to attend the RACGP annual conference.

It also hosted delegations of Chinese doctors to provide an understanding of the RACGP’s role in setting standards for general practice training, fellowship examinations and continuous professional development.

Dr Marles said accreditation of overseas training posts for Australian registrars was a “relatively straightforward process”. (2)

“There are good processes in place to ensure that the training posts meet the standards required for admission to RACGP Fellowship.”

 

1. MJA 2014; Online 30 June
2. RACGP: Regional Training Providers

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