AGPN acknowledges the financial support of the Australian Government Department of Health and Ageing

The Health Reform Agenda

What is it?

What are we up to?

What does it mean for us?

Helen MooreMay 2010

Health Care Environment Many challenges to overcome and opportunities to

be seized

Government needs to deliver on two years of reviews

Government health plan accepted by COAG

Agenda being pushed by PM

Why change?

Health system is complex, fragmented, too institutionally focused

Tertiary care too expensive - can’t continue to do tomorrow what we are doing today

Importance of primary health care building globally

Globally from the WHO

…..the experience of industrialised countrieshas shown that a disproportionate focus onspecialist, tertiary care, provides poor value formoney. And ……Hospital-centrism carries a considerablecost in terms of unnecessary medicalisation andiatrogenesis, and compromises the human andsocial dimensions of health.

Many studies done within countries both industrial and developing, show that areas with better primary care have better health outcomes, including total mortality rates, heart disease mortality rates and infant mortality and earlier detection of cancers….

The opposite is the case for higher specialist supply, which is associated with worse outcomes.

Starfield B. M.D.

Key reform directions from COAG

Major reform of:

Health and hospitals

Economy

Commonwealth/State relations

National Health and Hospitals Reform provides platform for reform of governance and financing on which other reforms can be built.

Key reforms for health …..

One national health system national leadership, local delivery

One major government funder for health

1 July 2011 Commonwealth covers 60% of efficient in-hospital costs

1 July 2012 established Local Hospital Networks across the country

Other Announcements to date Increase in GP, specialists and allied health

training places Post graduate support After hours and rural locums CDM package Commonwealth - 100% responsibility for

aged care Mental health initiatives Tobacco

The Budget….. PHCOs called Medicare Locals in Budget papers $290 million over 4 years to establish Medicare Locals PHCOs will have similar but extended roles to divisions $390.3 million over 4 years for 4600 full time GP

nurses $25,000 per full time GP for registered nurse, $12,500

for an enrolled nurse for eligible accredited general practices – to max $125,000

$34.1 million for rural locum programs to support 3000 nurses and 400 allied health professionals for leave to attend CPD

COAG outcomes

definite focus on hospitals with significantly more money for public hospitals,

establishment and operation of Local Hospital Networks to be role of states/territories

Funding will be from Commonwealth, pooled at state level and distributed to LHN

Commonwealth more input to hospital policy, funding and performance

Primary Health Care Organisations

Commonwealth to take full funding and policy responsibility for all GP and PHC services

By 1 July 2011 first wave of PHCOs established By 1 July 2012 remaining PHCOs to be established

PHCOs to be independent legal entities with strong links to communities, health professionals and service providers

What is a PHCO?

PHCOs will be built on GPNs PHCO will be big enough to be robust and

have capabilities and competencies to do job PHCO will not be responsible for

management of general practice and PHC services within boundaries

The number and boundaries of PHCOs determined by the Commonwealth

PHCO roles

Develop regional health plans and models of care for their communities

Support the health workforce (including practice support) and develop PHCO leaders and managers

Deliver programs that promote health Allocate funding and ensure delivery of services Direct health service provision to communities Community and provider engagement

Transferred services – initial group Community health centres services

Primary mental health care services

Primary and secondary prevention programs

Immunisation

Screening programs

Hospital avoidance programs

Transferred services – later

Community health promotion Population health Prevention programs Drug and alcohol programs Child and maternal health services Community palliative care Specialist community mental health services

Commonwealth’s aim …

Better integrate “the current patchwork of GP and primary health care services”

Reduce cost shifting and blame shifting

Drive efficiency

Encourage integrated care

Clear central message

PHC reform to be built around general practice Aim to create an integrated and comprehensive

platform of services, bringing together privately funded GP services with State-funded community health services

Potential significant benefits to community, patients and GPN members

Challenges and opportunities for GPNs/Divisions

What does it mean for general practice?

General practice key to primary health care

PHCOs to support general practice by —facilitating integrated services, —enhancing capacity of practice to manage chronic

conditions—ensuring greater access to services—assisting patients with hospital to home transition—providing preventive care programs

Our general practice network is …..

Unique, valuable part of Australia’s health system Only national, state and regional / local

infrastructure of its type Covers entire country, delivers local health

solutions through general practice, with national and state based capacity to lead, support and guide the system

Has scope, agility and position to respond quickly and effectively in roll-out of national and local primary health care programs

Change is coming whether we want it or not

It’s better to be there at the beginning and

have some input!