1st Mar 2011
THE Gillard Government has come under fire for failing to consult GPs about the fund-holding role of Medicare Locals (MLs), with doctors now calling for reassurances that the new bodies will only be able to directly fund primary care services in cases of “severe market failure”.
Announcing the new guidelines for MLs, Prime Minister Julia Gillard last week flagged the new bodies would evolve to take on a greater fund-holding role.
“I also want to make sure that Medicare Locals over time become fund-holding organisations… so if there isn’t enough of a particular service available, Medicare Locals can make a difference to that,” she said.
AMA president Dr Andrew Pesce voiced concerns that MLs could end up using this type of funding mechanism to fund services that were already adequately provided by GPs via fee-for-service. He added that while the AMA supported fund-holding to provide services where there had been market failure, he was sceptical that MLs would quarantine funds only for such circumstances.
“The fact that the profession wasn’t involved in this discussion makes [the AMA] think that there is a likelihood that fund-holding models are being considered for other services,” Dr Pesce said.
But AGPN chair Dr Emil Djakic disagreed fund-holding would be used broadly by MLs.
“Fee-for-service is a very valuable asset in our system and works very well for a whole range of health issues, but doesn’t serve chronic disease as well as it should,” he said.
“Block funding to fill those gaps and address needs in communities is required.”
Professor Alistair Vickery, chair of the Perth-based Osborne GP Network, said more evidence was needed to determine in which circumstances fund-holding worked before enacting policy.
“We need to find what works and get evidence that a certain funding mechanism improves care,” he said.
Invitations for organisations to apply to become MLs were issued by the Government last week; the first 15 are expected to be operational by 1 July.
1st Mar 2011
7:34pm
It was pretty obvious from the start that MLs were going to be fund-holding models. What surprises me is that the AMA supports it. I wonder if at the grass roots levels within the AMA, that they are aware of the policy. Perhaps they should reconsider their membership.
Under no circumstance should it be introduced, because it will be expanded and there will be no stopping it and fee for service could largely disappear for GPs and Specialists alike. There could become a two tier system, where MLs see the socially disadvantaged and the Private Doctors attended by the more discerning.