The Strengthening Medicare Review produced so many spinoff reviews that the government needed a review of its reviews.
A report newly released under Freedom of Information laws reveals the key challenges and learnings across five major health department-led reviews.
From the scope of practice review to the GP Incentives Review, reviews were a hallmark of federal health minister Mark Butler’s first four years in office.
In all, the 2022 Strengthening Medicare Review begat five spin-off reviews: Unleashing the Potential of our Health Workforce – Scope of Practice Review, Working Better for Medicare Review, General Practice Incentives Review, After Hours Review and the Independent Review of Australia’s Regulatory Settings Relating to Overseas Health Practitioners.
The most-anticipated of these was the scope of practice review, which released a final report in late 2024 recommending opening up referral pathways to non-doctors and introducing a new blended payment model that would reduce reliance on fee-for-service.
Last week, the Department of Health, Disability and Ageing released a draft report of an evidence review which captured all five Strengthening Medicare sub-reviews under Freedom of Information laws, comparing findings across the documents for the first time.
The document, which is described as a “review of reviews”, broke down the findings into workforce design and planning, education and training, leadership and culture, mentoring and research, legislation and regulation, funding and payment policies and technology and digital transformation.
In relation to general practice, the key findings under workforce related to the decline in the number of junior doctors choosing to train as a GP.
The report also cited gaps in evidence-based workforce planning approaches that were capable of addressing the underlying issue of why fewer medical students choose general practice.
Related
Across the five reviews, the policy options and recommendations for workforce broadly focused on how to increase the scope of practice of non-doctors or primary healthcare professionals as a whole rather than just GPs.
Under service or system design, the review report noted that governmental programs were not keeping pace with changes in the sector and that the reliance of many practices on incentives for financial viability may undermine the goal of incentivising specific behaviours.
The recommendations and policy directions include direct referral pathways for allied health professionals and integrating planning and incentives for increased scope of practice and after-hours primary care.
For legislation and regulation, the key takeaways in terms of challenges and barriers were that regulations were “highly restrictive” and limited scope in primary care.
The corresponding policy option included expanding the authority of Health Ministers to “provide policy direction to APHRA and national boards about accreditation”.
Challenges and barriers across funding and payment included the observation that fee-for-service rewards fast and episodic care, while the recommendations included introducing blended payment models to encourage multidisciplinary care that involved allied health working to full scope.
The draft version of the report released under FOI was completed in October 2024.
