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No crisis, but change is needed: Ley

Health system funding is not in crisis but there needs to be an overhaul of the way the Federal Government pays for GP and hospital services, Health Minister Sussan Ley told the AMA National Conference.

Setting out markers for the future direction of Government health policy, Ms Ley put doctors and state governments on notice that there will be changes to how the Commonwealth funds health care.

But, in a marked change of tone from her predecessor Peter Dutton, the Minister dropped warnings that health spending was unaffordable and embraced a collaborative approach to change.

“The Government is not claiming that we are in a health funding crisis,” Ms Ley said, though she added that, “we are saying that we have to be realistic. If we don’t make changes now, we will face a funding crisis.”

While the Government has dumped the idea of a GP co-payment, Ms Ley nevertheless said the current fee-for-service model of GP remuneration had to change.

“We need to shift from a fragmented system based on individual transactions, to a more integrated system that considers the whole of a person’s health care needs,” she said. “Innovative and blended funding models will be needed to provide appropriate care for patients with complex, ongoing conditions.”

In a warning for adherents of the current fee-for-service model, this is one area of health policy where there appears to be bipartisanship.

In her speech to the AMA Conference, Shadow Health Minister Catherine King said that, “I don’t for a moment suggest we abandon fee-for-service,” but warned there needed to be a “serious conversation” about whether it was best serving patients and rewarding good care.

Ms King said there were hundreds examples across the country of practices providing innovative and preventive care, often involving multidisciplinary teams led by GPs, but “the system as it works at the moment…does not provide incentives to reward this sort of activity. Nor does it reward outcomes”.

The issue of GP funding was the focus of a separate policy session at the Conference (see Providing high quality care doesn’t pay, px), where several presenters expressed concern of any change to funding arrangements that was not backed by sound evidence.

Among the speakers, AMA Victoria President Dr Tony Bartone said there was as yet no substantiated claim that alternative funding arrangements would deliver better patient outcomes than the fee-for-service model.

But Ms Ley said part of the change was aimed at ensuring better care for patient with complex and chronic conditions, as well as those with mental health problems.

She added that the Primary Health Networks being set up to replace Medicare Locals would be funded to “commission health and medical services to fill gaps”.

The Commonwealth has been heavily criticised for last year’s decision to axe the popular Prevocational General Practice Placements Program and abolish General Practice Education and Training, but at the Conference Ms Ley announced that competitive tenders for general practice training had opened. Successful bidders will receive funding to administer the Australian General Practice Training program, including co-ordinating and overseeing placements for GP registrars.

Tenders close on 10 July, and successful bidders will be funded from 1 October this year to the end of 2018.


Adrian Rollins