10-year plan ‘abandoned’, says AMA

4 minute read

Two weeks out from the budget, the doctors’ association says it’s been told there is no more money for health.

Has the pandemic drained government coffers so badly that there is nothing left for the health sector?

In a media blitz today, the AMA claimed it had been privately told by the government that there is no money available for the Primary Health Care 10 Year Plan in the next budget, thanks in part to pandemic spending. 

Just as we were going to press, however, the Department of Health told us the plan would in fact be released in the budget on 29 March.

The Morrison government first committed to the plan in October 2019, and it was touted as a blueprint for strengthening and modernising Australia’s primary health system over the next decade. 

A consultation draft of the plan was released in October last year and was open for feedback for about a month. 

At its heart were three basic reform streams

Stream one, “future-focused healthcare”, looked at the future of telehealth. 

Stream two was by far the biggest, and most relevant for GPs: it proposed a voluntary patient enrolment or registration scheme, which would set up a shift from 90% fee-for-service funding towards more quality incentives and outcomes payments. 

Only patients who registered with a GP would be eligible for certain MBS items, like telehealth and chronic disease management.  

Stream three looked at “local solutions” and “cross-sectoral leadership”. 

There is also the matter of the $450 million included in the 2019-20 budget – and then carried over to last year’s budget – which was meant to support a voluntary patient enrolment model. 

A Department spokesperson told The Medical Republic: “The Primary Health Care 10 Year Plan will be released in the 2022-23 Budget context.

“In addition, over $800m in non-covid Primary Care support has already been added in the last 2 years including major structural reform through telehealth. The government has also invested over $2.6b in covid measures in the same period.”

This is somewhat at odds with what AMA President Dr Omar Khorshid told us earlier: “[The AMA has] been told very clearly by the government that there is no more money for health in the budget,” Dr Khorshid told The Medical Republic

“[We believe] that this is largely behind its inability to release the primary healthcare plan, because the government knows it can’t release it without the associated funding for implementation.”

Dr Khorshid said that while the industry was accustomed to being let down by promises of reform, it was still frustrating to see a plan that so many industry groups had contributed to potentially fall by the wayside. Now with Health Minister Greg Hunt retiring, whoever wins the election will be installing a new health minister, with a lot of catching up to do. 

“Regardless of the outcome of this election, we will be going into a government with a new health minister, and there’s no guarantee that the next government is going to go back to all the work that’s been done over the last two years,” he said. 

The natural response to the AMA’s claim that this government has not delivered on health system reforms, Dr Khorshid anticipates, will be to hold up telehealth.

“The investment in telehealth has been substantial, but actually voluntary patient enrolment will save money on telehealth because it will restrict it to people who do have a relationship with a GP,” he said. 

“That kind of direction will improve the quality of healthcare and actually save some money, which we’d love to see reinvested [in the health system].” 

When Australians head to the ballot boxes later this year, the AMA president said, it’s only fair that they understand each party’s track record on healthcare.

In the wake of the AMA’s claims, the RACGP called for additional funding and said it was unfortunate that progress toward voluntary patient enrolment had stalled.

“General practice is not often front of mind come election time and that must change,” RACGP President Dr Karen Price said. 

“GPs and general practice teams go about our work quietly and don’t make a lot of noise, so the pressures facing general practice don’t often receive a lot of attention.

“The Royal Australian College of GPs strongly believes that the government’s general practice plan must include additional funding that supports high-quality general practice care.”

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