Vulnerable populations and rural areas are prominent, but insiders question whether the money is there.
The RACGP has called for increased primary care funding for people over 65, with mental health conditions and with disability in its pre-Budget submission, released earlier today.
Treasurer Jim Chalmers needs to allocate funding for new service incentive payments (SIPs) to support these populations when he hands down the Labor government’s first Budget in two weeks’ time, the college said.
However, sources who attended the RACGP’s recent crisis summit told TMR they were sceptical about the amount of money likely to be available in the Budget, which the Treasurer himself has framed as a conservative one.
The RACGP is also repeating a longstanding call for the Budget to fund longer general practice consultations to support patients with complex needs. This should include at least a 10% increase to Medicare patient rebates for Level C and Level D consultations, as well as a new Level E (60 minute-plus) consultation.
Following the summit, college president Adjunct Professor Karen Price called for “an immediate and substantial increase” in Medicare patient rebates, and a boost to the bulk-billing incentive by at least two to three times.
The college also wants improved access to telehealth, so patients can talk to their GP on the phone about complex issues. This should include reinstating Medicare patient rebates for long phone consultations, mental health and GP management plans as part of the permanent telehealth model.
To help prevent the risk of patients going back to hospital, the RACGP is calling for support for patients to see their GP within seven days of an unplanned hospital admission.
The college is also seeking funding for a range of measures designed to improve access to care in rural communities, by encouraging and supporting rural doctors to upskill in other areas such as internal medicine, mental health, paediatrics, palliative care, and emergency medicine.
To achieve this, the RACGP wants money for flexible rural procedural grants for GPs who provide both community GP services and hospital services; increased workforce incentive programs, with additional payments for those doctors who use additional advanced skills in rural areas; and more funding for GP supervisors and general practices in rural and remote areas to support GPs in training.
Funding for new SIPs to support the care of people aged over 65 years should include a health assessment for older people and/or a GP management plan with at least one review, as well as a frailty assessment. This measure should include expanding eligibility for the MBS health assessment to patients aged 65 to 74, and 50 to 74 for Aboriginal and Torres Strait Islander people.
Australians with mental health conditions should be supported through funding for a GP mental health treatment plan with at least one review plus a physical health assessment.
The college is also calling for the government to fund services for people with disability that include a relevant health assessment or GP management plan, with at least one review, as well as completion of NDIS reports and documentation.
“Our number one priority is ensuring that GPs can take the time to talk to their patients and get to the bottom of what is going on,” Professor Price said in a statement. “Unfortunately, the current Medicare rebate structure discourages us from doing just that. We have the absurd situation where rebates decrease as a person spends more time with their GP.
“Last, but certainly not least, let’s give GPs in the bush a helping hand,” she said. “Those practising in rural and remote areas are incredibly multi-skilled and often provide care that would usually be provided by other specialists in metro areas. It makes perfect sense to provide access to specialist Medicare items when a GP possesses advanced skills in areas such as palliative care, paediatrics, or emergency care.”
