Like the RACGP, the rural college tells a story of “disenchantment and disengagement” when it comes to Primary Health Networks.
In more bad news for the federally funded Primary Health Networks, rural GPs appear to have just as dim a view of them as their metro-based counterparts.
PHNs, which have been in place since 2015, ostensibly bridge the gap between state-funded initiatives, federal-funded initiatives and general practice, and also improve efficiency of health services for at-risk populations.
Policy settings on PHNs haven’t significantly changed over their first decade of life, prompting the Department of Health and Aged Care to kick off a review.
The RACGP’s response was somewhat scathing, alleging that many GPs neither like nor trust their local PHN, especially when it comes to managing conflicts of interest.
ACRRM’s submission, which was made public this week, said many GPs did not have a clear understanding of how PHN funding arrangements work, resulting in “disenchantment and disengagement with the relevant PHN when it fails to meet expectations”.
While the rural college said it recognised the challenges and expenses that come with serving regional and remote communities, but that this added complexity only serviced to make it even more imperative that rural and remote areas receive PHN support.
Like the RACGP, ACRRM also identified the significant variation in the organisational structure of PHNs across different regions as a source of confusion for primary care clinicians.
“It is not clear who the PHN stakeholders are as they do not appear to consider General Practice, GPs or community members as stakeholders,” one ACRRM member is quoted as saying.
“It appears that the federal government is the main stakeholder and that gaining data from the community to pass onto the federal government is the purpose of the PHN.”
College president Dr Rod Martin told The Medical Republic there was a sense among doctors that PHNs were externally directed.
“I’ve got a better understanding of PHNs [than many other doctors], and most of the time when you talk to them, they’re talking very much about commissioning,” he said.
“It is more so that they’re commissioning work that has been ordered by the Department, rather than work that’s been identified as necessary by the doctors and the allied health professionals and the practice nurses on the ground.”
Related
Dr Martin called for better strategies and structuring to ensure that smaller and more regional communities were included in PHN planning and service delivery, and a move back toward the local focus of Divisions of General Practice.
“The locus of influence has shifted from the old Divisions of General Practice way, where there was a locally based board that might look after three or four towns,” he said.
“And they would [ask] ‘what do we need, how do we commission it, where do we go to get this information’.
“That’s locus of control is now an external one where there’s not really very much ownership by the clinicians on the ground.”
