SSWAHS = SWSLHN + SLHN and the Medicare Locals - 26

More is less for Medicare Locals

18th Feb 2011

Caroline Brettingham-Moore all articles by this author

THE Gillard Government’s decision to increase the number of Medicare Locals (MLs) has received a mixed reaction from the divisions of general practice, with some claiming it will stymie and delay health reform.

As part of the revamped COAG deal, Prime Minister Julia Gillard raised the number of MLs beyond the planned 57 to ensure the organisations were more responsive to community needs.

But AGPN chair Dr Emil Djakic said the decision would result in weaker, less effective organisations.

“Creating a larger number of what will be less capable organisations with a dilution of funding and capacity will stymie [the] reform agenda,” Dr Djakic said.

He added that any changes to ML boundaries would delay invitations to apply, which could see the government miss the scheduled implementation date for the roll-out of the ML program. The first MLs are scheduled to be up and running by 1 July.

“We want to get operational by 1 July and every day that ticks by is going to really impair the current Government’s ability to get things up and going,” Dr Djakic said.

A spokesperson for the Department of Health and Ageing said it was not known how many more Medicare Locals would be established but confirmed that some boundaries would be re-mapped in certain areas according to population size.

Chair of the Dandenong Casey GP Association in Victoria, Dr Nicholas Demediuk, said the constant changes from the Government were taking a toll on the divisions.

“You start losing your enthusiasm to put too much effort into planning because the goal posts could be changed next week,” Dr Demediuk said.

But in NSW, Bankstown GP division CEO Andrey Zheluk, welcomed the changes.

“It is interesting that the government is talking about the importance of engaging with local communities – the importance of smaller MLs is something we strongly advocated. We have a multicultural population and it is important to respond to local needs,” he said.

Tags: Medicare Local, AGPN, COAG

Comments:

John Wellness
19th Feb 2011
2:17am

It's always a balance between the economies of scale and the more personal relationships that can occur with smaller organisations. Personally I feel that smaller organisations are more attuned to their communities and there is significant loss of function when primary health care gets too big. Lets go for the largest practical number we can. Some of the proposed MLs are simply too big.

Solidarity

19th Feb 2011
5:03am

"Engaging with local communities"-I can't think of a more worn cliche. There is nothing that keeps a local community running better than a thriving General Practice free of political interference in the form of superclinics. Glib badges and new dollar dazzlers, the marks of this Federal Government to date, are no substitute for leaving General Practices intact and strengthening it by concentrating on training more and more GPs without any Marxist social engineering.

Stratmatonman
19th Feb 2011
4:07pm

17 years and $2Billion to prove the network is utterly indispensable to the daily working life of a GP - it hasn't happened HAS IT!. As an inaugural director of my own division in 1993, 1 of the 5 founder subscribers of AGPN (then ADGP) and a WA Founder SBO member, I lost the faith last Nov and finally left my local board.

The DHA has progressively strangled the Divisions with paternalistic, top down micro-management, loss of innovation opportunities and over-rigid one size fits all programs - the gulf between what could have been (why I got involved) and what became of it all, makes me weep. And I care too much........

Dr Harry Hemley, President AMA Victoria
21st Feb 2011
12:01pm

I am especially concerned that Medicare Locals will control access to allied health care for patients with diabetes, and patients needing after hours care — cutting across existing services and in many cases leading to reduction of access to patients of services already available. For instance in many localities — particularly rural — the family doctor is available on the phone, after hours and throughout the night. These services which are very effective are threatened to be lost to an inefficient and faceless triage.

Sterling
25th Feb 2011
2:22pm

In response to Solidarity: 19 Feb 2011

Well, personally, I can't think of a more worn cliche than the entrepreneurial GP running a thriving practice based on free market principles, with a copy of Ayn Rand's Fountainhead under one elbow.

Wakey wakey - you get most of your income from the government. Let's see how far you get straying away from the government teat you so despise.

At the end of the day, GPs are but an instrument of government policy, and the government will exercise its right to purchase the most cost effective and efficient services it desires.

I would strongly counsel you to read some recent health services literature about public attitudes towards GPs effectiveness vs nurse effectiveness, as well as literature related to health outcomes by various health professions.

The picture for GPs in the medium term is not great. It is reasonable for any government to control uncontrolled costs in any policy domain by all policy instruments at its disposal.This means substitution of overpriced medical services for equally effective allied health and nursing services.

There, at last, is the free market.