SSWAHS = SWSLHD + SLHD and the Medicare Locals - 72

Loss of divisions' support will hit rural GPs - ■ Michael Woodhead - 6Minutes

Rural areas may see an exodus of GPs if Medicare Locals do not maintain the support services to GP practices that have been provided by divisions, a Senate inquiry has heard.
 

Chris Mitchell, CEO of Health Workforce Queensland, says GPs are becoming “disenfranchised” in the transition to Medicare Locals as GP divisions have their funding terminated.

Speaking at a Senate rural health hearing in Townsville, Mr Mitchell said GP practices had relied heavily on divisions for areas such as IT support.
 

“The divisions did a lot of boutique work for practices and I do not think that stuff is going to continue [with Medicare Locals].
 

The IT support in some of these divisions has been sensational and it has kept those GP businesses going ... But I am not sure that that is going to continue,” he told the hearing. Mr Mitchell said the town of Weipa was likely to lose its GP practice because the GP division in Cairns that had supported the practice had lost its funding and been replaced by a Medicare Local.
 
He said Medicare Locals were preoccupied with setting up and focusing on developing after hours care and population planning programs rather than on support for local practices.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 71

Medicare Locals will be healthcare Polyfilla: Roxon

• By Michael Woodhead on  18 November 2011 - 6Minutes

Divisions selected to be Medicare Locals must lose their doctor focus and prepare to be like Polyfilla to “fill in the gaps” of local health services, health minister Nicola Roxon says.


Speaking to the GP divisions’ annual conference in Melbourne today, the minister said the first priority of the new organisations will be to identify gaps in local services and integrate care.

“You are no longer organisations for a particular group of professionals – you are responsible for overseeing the primary health care needs of your entire community,” she told the AGPN’s GP Network Forum.

“You will need to work together to address these gaps – with an initial priority of addressing gaps in after hours services when you are first established.

Nicola Roxon said Medicare Locals will be tasked with  supporting all health professionals in primary care,  to “improve the quality and responsiveness of local care services, including in safety, performance and accountability”.

She said it was also important for Medicare Locals to go out into the local community and “tell and re-tell the story” of how they will improve local health services and how they will work with patients, professionals, other organisations, and hospitals.

The minister told the five divisions yet to be announced as Medicare Locals “not to be too disappointed” but to listen to the constructive feedback and “work cooperatively” with the Department of Health and Ageing

“Likewise, I would encourage applicants in areas where another organisation is to become the Medicare Local to contribute constructively to the process. The interests of the patients and providers in your area are best served by a smooth transition.”

It would seem that Nicola Roxon is making it quite clear that the dominance of the Division of General Practice is over when it comes to determining the delivery of clinical services provided in the jurisdiction of the new Medicare Locals. This is something about which the Board of the Southern Highlands Division of General Practice needs to take note. Recent declarations in the 'Highland's Doctor' by the Chairman of the SHDGP Board were:

"............. this was softened with the recognition that there was a real need to bring GPs from the Divisions into cooperation and participation as leaders in the new MLs, and that experience serving in Divisions over the previous 18 years had created skills in governance, service delivery and population health that few other potential ML Board members drawn from other branches of healthcare would have in the short term."

Drs Roche and Ruscoe had better reconsider their view in light of this recent advice from the Minister for Health and Ageing in which their role is to be collaborators and not as "leaders".

SSWAHS + SWSLHD + SLHD and the Medicare Locals - 70

In a remarkable bit of spin by the CEO of the Southern Highlands Division of General Practice comes this short piece from the Wednesday publication of the Southern Highland News.

While there is nothing new about this news it does give a remarkable impression of "the tail wagging the dog". Does anyone really believe that the Southern Highlands Division of General Practice somehow pulled off this coup without the major contribution of the other partner?

At least, finally, the local community who are supposed to "find it easier to navigate the health system" are being told about it! Well done, Dr Ruscoe.

Enhanced health services for Southern Highlands
9th November 2011
By: Southern Highland News

The Southern Highlands Division of General Practice, in partnership with our neighbouring Division in Macarthur, has been successful in its bid to establish the new South Western Sydney Medicare Local.

This will become operational on July 1, 2012, and will eventually cover primary care services from Bankstown in the north to Wingecarribee in the south, mirroring the boundaries of our Local Health District.

It is one of thirty-eight organisations selected to become the next Medicare Locals that will drive access to better primary health care across Australia, announced by Minister for Health and Ageing Nicola Roxon on Friday.

"Importantly, Medicare Locals will maintain and build on the excellent work already done by the local Divisions of General Practice, with GPs and general practice being at the centre of a strong, integrated primary health care system," the Minister said.

The new Medicare Local will be responsible for population health planning, identifying and filling gaps in primary care services and will have greater involvement in co-ordination and integration of services at the local level.

"The Federal Government’s Medicare Local concept is designed to make it easier for patients to navigate the health system", CEO of the Southern Highlands Division of General Practice, Dr Warwick Ruscoe, said.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 69

If ever we needed to see what the agenda of the College of GPs (and some of the existing Board members of the Divisions of General Practice) has been in their submissions for ownership of the Medicare Locals, this Media Release spells it out emphatically - "We intend to maintain control because none other than a medical practitioner can do the job of running the Medicare Local".

Local allied health practitioners and community members with health and/or business acumen should be champing at the bit to ensure that they can rein in the entrepreneurial plans of this Juggernaut.  

The only way to provide the diverse, effective and efficient community based health services to the Southern Highlands is for the community members delivering and receiving those services to have equality in the decision making of their Medicare Local. Only then will the Vision of the Bankstown Health Coalition be able to be replicated in the Southern Highlands.

7 November 2011
 
Medicare Locals – GPs must retain a strong leadership role

To avoid fragmentation of patient healthcare, the Royal Australian College of General Practitioners (RACGP) urges the Government to consult closely with the medical profession as it progresses the establishment of Medicare Locals.

On Friday, the Minister for Health and Ageing released a list of 38 organisations that have been selected to become the next Medicare Locals.

RACGP President Professor Claire Jackson said that Medicare Locals will have a broader focus than their predecessor Divisions of General Practice, and whilst this should provide a greater opportunity for integrated team based care, it is essential that GPs retain strong leadership roles, and that the general practice is seen as the patient's community healthcare home.

“Quality general practice is the foundation of primary care and must be the basis of Medicare Locals. Our focus needs to remain on enhancement of services to the patient and the community taking care to avoid fragmentation,” she said.

The College is pleased that Minister Roxon acknowledged the importance of ‘GPs and general practice being at the centre of a strong, integrated primary healthcare system’ and the need to ‘build on the excellent work already done by the local Divisions of General Practice’.

“The RACGP believes it is important we remain included in the discussions around the development of each of these organisations and we urge members to remain involved so that general practice continues to be the cornerstone of reform.

“It is likely that the governance of a Medicare Local will be through a skills based board rather than representative based board. GPs with such skills are encouraged to apply and have a voice,” Professor Jackson concluded.
– ends

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 67

TO anticipate what is expected to be delivered by the Sydney South West Medicare Local the only information we health consumers have are these comments by Mr Rene Pennock on the website of the SSW GP Link, the umbrella organisation which includes the Southern Highlands Division of General Practice.

 

Concerned health practitioners and other health service providers may take comfort from the final dot point in the Division's commentary:  

"They will be accountable to local communities to make sure the services are effective and of high quality."

 

 It will become our responsibility to ensure that this accountability is enshrined in this Medicare Local. To do that the health consumers and health care providers need to be proportionately represented on the Board of this Medicare Local. 

Already, the GPs on the Boards of the current two Divisions of General Practice (Macarthur and Southern Highlands) are moving to exclude non-GPs on the SSW Medicare Local by suggesting that only GPs have the organisational expertise to manage effectively a Medicare Local. 

Well, that's news to me and to other people who have effectively managed health service organisations of even greater magnitude.

  

What are Medicare Locals?

Medicare Locals will be primary health care organisations established to coordinate primary health care delivery and tackle local health care needs and service gaps.

They will drive improvements in primary health care and ensure that services are better tailored to meet the needs of local communities.

Medicare Locals will have a number of key roles in improving primary health care services for local communities.

• They will make it easier for patients to access the services they need, by linking local GPs, nursing and other health professionals, hospitals and aged care, Aboriginal and Torres Strait Islander health organisations, and maintaining up to date local service directories.
• They will work closely with Local Hospital Networks to make sure that primary health care services and hospitals work well together for their patients.
• They will plan and support local after hours face-to-face GP services.
• They will identify where local communities are missing out on services they might need and coordinate services to address those gaps.
• They will support local primary care providers, such as GPs, practice nurses and allied health providers, to adopt and meet quality standards.
• They will be accountable to local communities to make sure the services are effective and of high quality.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 66

THE following message is from the CEO of the SSW-GP-Link and posted on their website

http://www.macdivgp.com.au/site/index.cfm?display=288436

In this statement the CEO says:
"Our start date will be 1st July 2012 which leaves us just over 7 months to implement our plans and listen to the members and community we serve." 

One is driven to ask the obvious question - "Why didn't you do this before making the collective public of the South West Sydney captive to your plans, Mr Pennock! Now the public must listen to your plans as hatched by your Division and that of the Southern Highlands Division of General Practice!"

What can be suggested is, perhaps, the dis-enfranchised mass of health consumers, private and public healthcare providers, and the managers of the non-government health service sector should take up Mr Pennock's offer and use the  Contact Us  link to make your voice heard; ask the hard question; or ask the question what are you planning to provide to us in the Wollondilly and Wingecarribee Shires?

Perhaps you would like to start by looking at the scope of the SSW Medicare Local through the Department of Health and Ageing website: www.yourhealth.gov.au

 

Medicare Local Information

"Sydney South West GP Link in partnership with our colleagues Southern Highlands Division of General Practice, is very proud to confirm that on the 4th November 2011 the Hon Nicola Roxon MP, Minister for Health and Ageing, announced that we were successful in our application to form the South Western Sydney Medicare Local (SWSML). We will be one of 62 new Medicare Locals across the Nation implementing the new Primary Health Care Reform.

"Our start date will be 1st July 2012 which leaves us just over 7 months to implement our plans and listen to the members and community we serve. We are also extremely fortunate that South Western Sydney will have one Medicare Local and one Local Health District. This alone is a significant step towards improving integration between primary health care and the hospital system.

"As this link becomes more populated over the next few months please click on Contact Us for any questions or issues you wish to raise. I strongly encourage anyone to provide us with any feedback as we move towards our start date on 1st July 2012."

Rene Pennock
Chief Executive Officer

The boundaries of each Medicare Local can be viewed at www.yourhealth.gov.au

Medicare Locals to Commence from July 2012

Medicare Local	Applicant	State/Territory
Central Coast NSW	Central Coast Division of General Practice	NSW
Eastern Sydney	South Eastern Sydney Division of General Practice	NSW
Far West NSW	NSW Outback Division of General Practice	NSW
Inner West Sydney	Central Sydney GP Network	NSW
South Eastern Sydney	Sutherland Division of General Practice	NSW
Southern NSW	Southern GP Network	NSW
South Western Sydney	Sydney South West GP Link and Southern Highlands Division of General Practice	NSW
Eastern Melbourne	Eastern Ranges GP Association	Victoria
Gippsland	East Gippsland Primary Health Alliance, Central West Gippsland Division of General Practice, and General Practice Alliance South Gippsland	Victoria
Goulburn Valley	Goulburn Valley Division of General Practice	Victoria
Grampians	West Vic Division of General Practice	Victoria
Hume	Albury-Wodonga Regional GP Network	Victoria
Central Queensland	CQ Medicare Local	Queensland
Far North Queensland	Far North Queensland Rural Division of General Practice	Queensland
Sunshine Coast	Sunshine Coast Division of General Practice	Queensland
Wide Bay	GP Links Wide Bay	Queensland
Country South SA	Murray Mallee General Practice Network	South Australia
Bentley-Armadale	Canning Division of General Practice	Western Australia
Perth Central and East Metro	Perth Primary Care Network	Western Australia
Northern Territory	General Practice Network NT, Aboriginal Medical Services Alliance NT and NT Government Department of Health	Northern Territory

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 63

Second wave of Medicare Locals announced

• By Michael Woodhead on  4 November 2011 - 6Minutes

An additional 38 Medicare Locals have been announced by Health Minister Nicola Roxon today.

However, only 18 of the new Medicare Locals will be established from 1 January 2012, while the remaining 20 will be part of a third wave of 25 Medicare Locals to commence from 1 July 2012.

In total there will be 62 Medicare Locals, including the 19 that have already been announced and which are in the process of being established from “high performing”divisions of general practice.

The Medicare Locals to start in January are:

NSW: Illawarra-Shoalhaven, Nepean-Blue Mountains, North Coast NSW, Northern Sydney and Western NSW;

Victoria: Bayside, Frankston-Mornington Peninsula, Loddon-Mallee-Murray, Lower Murray    Macedon Ranges and North Western Melbourne, South Eastern Melbourne;

Queensland: Central and North West Queensland, Darling Downs- South West Queensland;

South Australia: Northern Adelaide, Southern Adelaide-Fleurieu;    

WA: Fremantle, Goldfields-Midwest, Rockingham-Kwinana-Peel.

Health minister Nicola Roxon said further work was needed for Medicare Locals for North Eastern Sydney and Hunter Rural in NSW, Great South Coast and South Western Melbourne in Victoria and Kimberley-Pilbara in Western Australia.

SWSLHD and Bowral's Health - 50

Senate inquiry ignores GP role in mental health: AMA

2nd Nov 2011 Byron Kaye   all articles by this author

Medical Observer

THE undermining of GP involvement in mental health care through the slashing of Better Access rebates has been ignored by a key Senate inquiry examining the impact of the government’s cuts to the program, the AMA has claimed.

The claims follow the tabling late yesterday of a report from a Senate committee investigating mental health funding – the same day the controversial changes, which include substantial cuts to GP mental health rebates, took effect.

While the long-awaited report made no specific recommendation on the MBS cuts, it questioned moves to reimburse only 10 visits to psychologists under the Better Access program. Previously, up to 18 visits could be reimbursed.

AMA president Dr Steve Hambleton said the report, including dissenting reports from the Coalition and the Greens, presented a “mishmash of views” that largely overlooked the impact on GP patients of cutting MBS rebates.

“I think GPs are entitled to be disappointed,” he told MO.

“It has missed a lot of issues. I think that the department of health really didn’t assist the committee with the evidence it provided. It seems that the department has listened to the advice of bureaucrats, not doctors.”

The government’s mental health funding overhaul was however broadly attacked from both sides of the political spectrum following the release of the Senate committee report, with the Coalition saying the government had “not fully considered” the impact on patients and the Greens calling for a postponement.

The report questioned whether the alternate Access to Allied Psychological Services (ATAPS) program – which is to receive more funding and be administered through the yet-to-be-operational Medicare Locals – could be expected to service patients previously treated under Better Access straight away.

Greens senator and committee chair Rachel Siewert wrote in the report that she was “greatly troubled” that “there will almost certainly be a substantial period where Medicare Locals and GP divisions will not be fully engaged with the ATAPS program, and consequently will not be able to deliver appropriate mental health care for consumers”.

She added in a statement today that cutting the number of psychology sessions under Better Access “is likely to, in the immediate term, exacerbate existing service gaps for people with severe and persistent mental illness.”

“The current system is not ready for the government’s proposed changes. The government should revise its scheduling for the 2011–12 federal budget changes to ensure continuity of care,” she wrote.

The AMA, along with other general practice groups under the umbrella organisation United General Practice Australia, had called for a one-year moratorium on the MBS rebate cuts for GP mental health visits. Senator Siewert’s remarks did not directly address that demand – one of the key concerns that led to the inquiry in the first place.

Liberal senators also gave no recommendation on the GP rebate cuts in the dissenting report but wrote that any MBS cut “ought to have been discussed and fully canvassed with key provider groups and stakeholders before being arbitrarily inserted into the budget purely as a cost-saving measure”.

Both the Coalition and the Greens said the inquiry aired concerns about problems attracting GPs to work for youth mental health initiative headspace, which told the inquiry its staffing problems would be made worse by the rebate cuts.

Senator Siewert wrote that since headspace was getting more funding, it could “employ GPs directly, ensuring a guaranteed funding base that provides a buffer”.

In its section of the report, Labor repeated its claim that the Better Access changes would “achieve a better balance between the Medicare fee-based model provided through Better Access and the low- to no-cost services directly targeted to hard-to-reach groups through ATAPS”.

 
Tags: Mental health, MBS, Better Access, ATAPS, United General Practice Australia

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 59

Southern Highlands Division of GPs - Is this its last Hurrah?

A strange thing happened on the way to the Forum a few weeks ago! Sighted coming out of Springett's Arcade into the Oxley Mall carpark was a very distracted CEO of the Southern Highlands Division of General Practice, Dr Warwick Ruscoe. No doubt he was trying to work out if he will have a job (or a Division) after July 1st, 2012.


It has been interesting to follow the fall and fall of the SHDGP and its diehard Chair and CEO. I notice that even the Sydney South West GP Link (formerly the Macarthur Division of General Practice) is being very peripheral in its reference to any possible association with the Southern Highlands Division. Like an afterthought, the reference is tacked on the end of their latest news on their website. Possibly much like their expectation of what they think they can bring to the Southern Highlands.

In his September 2011 SHDGP Newsletter column the CEO says: "Successful applicants to establish Medicare Locals in rounds 2 and 3 are expected to be notified in October or November, for implementation in either January or July 2012." Hope springs eternal in his breast, it seems. Fortunately, the CEO has kept it a very brief comment this time round. Perhaps Dr Ruscoe has seen the fickle finger of fate writing on the wall of his office.


However, the Chair (Dr Vince Roche) of the SHDGP Board was a bit more forthright in the same September Newsletter - well perhaps a lot more forthright in his comments! He says: "In my last piece in May, I wrote that “the pace of threatened Primary Care reform quickens!” I would qualify this now with the further words “for some”!" This was possibly a reference to their failed attempt at convincing that the combined Macarthur-Southern Highlands Medicare Local submission should have been one of the Round One successes. Is this sour grapes? 

Dr Roche states in the Newsletter: "A great deal of time and energy has been invested by Warwick, Sally and myself in getting our Medicare Local (ML) proposal – in conjunction with the Macarthur Division of General Practice (now known as SSW GP Link) – ready for the second application deadline in July. Huge efforts were made to have Bankstown GP Division join Southern Highlands Division and GP Link in this proposal, as Bankstown lies in the ML footprint determined by the Federal Government. However, at the last moment, negotiations fell through and Bankstown again lodged an independent proposal."

What is not stated is that the Bankstown GP Division rejected the advances of the Macarthur-Southern Highlands consortium because they felt that itwas not in the best interests of their consumers. They knew this because they had frequent and extensive community forums with consumers, NGOs and public and private health providers. They also felt that the Macarthur-Southern Highlands proposal did not understand the social demography of their population, nor did it respect the GP and other healthcare providers in the Bankstown area.


Says Dr Roche: "The first 19 MLs were announced in June – and four in NSW. Why four? A cynical observer might postulate that one went to an urban ML (Western Sydney ML), one regional (Hunter Urban ML), one rural (Murrumbidgee ML) and one to an Independent MP's seat (New England ML)." Perhaps the only cynical observer is Dr Roche. Perhaps those four NSW Medicare Locals simply put in the best submissions by complying with all the criteria that the Commonwealth had required. Something which the SHDGP did not.

"The federal Government will announce the successful bidders in October or November, and these MLs will become operational from January or July 2012", says Dr Roche. Alarmingly, Dr Roche is suggesting a: real need to bring GPs from the Divisions into cooperation and participation as leaders in the new MLs, and that experience serving in Divisions over the previous 18 years had created skills in governance, service delivery and population health that few other potential ML Board members drawn from other branches of healthcare would have in the short term." This is the sort of self-promotion which seems to have been the cause of the failure of the Macarthur-Southern Highlands sortie into the Bankstown GP Division's jurisdiction.

Perhaps, the people of the Southern Highlands can do without the entrepreurship and empire building of the Macarthur (SSW GP Link)-Southern Highlands consortium. Let's just depend upon the GP Practices to continue to deliver all the services we need.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 57

Medicare Locals show their new DNA

• By Michael Woodhead on  25 August 2011

The new branding for Medicare Locals has been unveiled at a meeting of some of their leaders with the Prime Minister and health minister Nicola Roxon in Canberra today.

“Australia’s network of Medicare Locals will be easily identifiable as a cohesive national network with its new ‘ribbon helix’ branding,” said AGPN chair Dr Emil Djakic at a Medicare Local Forum held at Parliament House.

“But it’s the changes Medicare Locals will bring to local health care services for both health care professionals and consumers that will make the difference over time,” Dr Djakic said.

Leaders for the first 19 of the planned 62 Medicare Locals met in Canberra and heard the Prime Minister say that they would be “front and centre in the push to “ shift the centre of gravity from hospitals towards primary health care”.

She said Medicare Locals would play a key role in helping to improve access to after-hours care, chronic disease prevention and management programs and mental health initiatives.

“Medicare Locals will deliver home-grown solutions to local health problems and make it easier for Australians to see and contact a health professional,” a statement said.

However, a critic (link)  this week blogged that the creation of Medicare Locals was the Federal government’s way of exerting control over previously independent bodies. He claimed that the Federal health department would have the final say over staff appointments, programs, membership structure, and would have to sign off on any contacts contracts over $22,000.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 56

AMA sets up GP voice for Medicare Locals

• By Gemma Collins on  20 July 2011

The AMA is creating GP consultation groups in each of the Medicare Local districts to “empower” doctors to have a leading role in how the organisations are run. 

AMA President Dr Steve Hambleton said he would be travelling to each of the first 19 Medicare Local areas to help the groups ensure the AMA primary care message is “spread” throughout the communities.

Speaking in Canberra today, Dr Hambleton said that the organisations needed GPs on their boards in order to work, and he had already written to Health Minister Nicola Roxon and chairs of the Medicare Locals to express his concerns.

“Our view of Medicare Locals is that, if they are implemented correctly and with the right intentions, they can work,” he said.

“But doctors have to be core parts of the process.”

The announcement came as the AMA released the results from its latest online poll in which 760 GPs responded about the planned cuts to Medicare patient rebates.

Around a quarter of GPs said they would stop using Medicare GP Mental Health Treatment items following the cuts.

Around 85% said they believed fewer patients would receive vital care and just over half said they thought the budget cuts will lead to them spending less time with patients with mental health problems. 

Doctors also revealed that the average time taken to prepare a mental health plan during and outside a consultation is 52 minutes, not the 28 minutes suggested by the government.

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 52

First Medicare Locals urged to retain GPs’ central role

10th Jun 2011 - Medical Observer

Byron Kaye   all articles by this author

THE AMA has written to the first 15 Medicare Locals urging them to keep doctors central to governance, rule out holding funds and commit to working closely with GPs at every stage of setting up the new primary health hubs.

The AMA has strongly opposed the $416 million Medicare Locals program, arguing the Federal Government has failed to explain how it will improve GP services and is rushing through the reform with just weeks before the supposed 1 July start date.

Four of the first 19 Medicare Locals – all in Victoria – have not been publicly announced with the Government citing a need to redraw the boundaries as the final stumbling block.
The are expected to be named next week.

Yesterday, AMA president Dr Steve Hambleton wrote to the 15 publicly announced successful tenderers – all currently divisions of general practice – asking them to address concerns that the Medicare Locals structure will dilute the governance input of GPs and weaken patient care.
“We are concerned that the Government is rolling out its Medicare Local policy with desperate haste, despite a lack of detail and genuine consultation with the broader medical profession,” Dr Hambleton wrote in the letter.
“Integrating and coordinating the range of organisations and service providers operating within primary healthcare, and better linking primary healthcare and other sectors, is something that can deliver benefit if it is done well.
“However, there is a significant potential for Medicare Locals to get this wrong if they fail to listen to the views of the medical profession.”

The AMA has asked the Medicare Locals to confirm that local doctors would be represented at all levels and have “strong majority representation” on boards and rule out any fund-holding arrangement for GP and other specialist medical services.

Several divisions chosen among the first 19 Medicare Locals, contacted by MO this week, indicated that they would change their board structures to reflect the broader range of primary health professionals expected to be represented by the new bodies.

Tags: Medicare Locals; AMA; Hambleton; governance

Comments: 

Detracter
10th Jun 2011
3:34pm

This is essentially a Labor governments attempt to centralise power and influence over what used to be a non-government operational area. Labor, and particularly Gillard, are doing this in the industrial relations area and the wider economy with the Carbon tax, Mining tax and Flood tax.
If she wins the next election, I could well anticipate a push for universal bulk-billing across the profession to reflect her central control agenda, dating from thirty years ago.
The AMA move to increase GP representation on these Medicare Locals seems to reflect my thinking on this matter.

Pav
10th Jun 2011
3:46pm

I don't really give a s#%t.

Just so long as the ML's take full responsibility and are accountable for their own actions when they stuff up - not just turf them back to the GP for patching up their mistakes.

ed
10th Jun 2011
4:39pm

Pav' arguement assumes that GPs who work in the Locals are not responsible and have inferior knowledge and skills. The same arguement was put across when the Corporates had commenced business. Errors are made by any type of a GP. What we have to worry is under GILLARD-ROXON AXIS OF SOCIALISED MEDICINE, SOON WITCH DOCTORS Will be employed . Then there will be trouble.And in the famous word of the bard' there was movement at the station'.

John Wellness
10th Jun 2011
5:01pm

A medical dominance of divisions of general practice has led to a fragmentation of primary health care and probably poorer health outcomes, especially for patients with complex chronic illnesses. We need practices that have multidisciplinary teams with each occupation contributing its own strengths. We also need a more preventative approach embracing behavioural as well as medical perspectives. The Medical Locals need governance systems that will allow us to become a health system - not a bunch of independent doctors and allied health practitioners. Doctors have a leading role to play in clinical governance but a lesser role in business governance.

khanGP
10th Jun 2011
6:19pm

When the concept of ' Super Clinics ' was being mooted, a lot of the GPs were stating - but where will the Govt. get the GPs from to work in these Clinics. At that point in time, I told my Colleagues, that the Govt. has a Master Plan in place - they will not need GPs to run these ' Super Clinics ' - they will run them without GPs - they will have their ' Nurse Practitioners ' running them. What with these NPs being given Prescribing Rights / Radiology & Pathology requesting Rights / Rights to refer these Patients ( sorry, ' Clients ' ! ) to Specialists & to Emergency Depts., GPs will be made redundant.
I was then, told that I am being ' Paranoid '.
My GP Colleagues felt then, that we, GPs would be elevated to a ' Consultant ' Role. Why would a NP refer a Patient to a GP, when he / she could refer to a Specialist or an ED ?? Our Local Divisions still feel that we, GPs would have a Lead Role in these ' Medicare Locals ' !! When there is a Collection of ' Primary Care ' Practitioners, each one of these Groups would want an EQUAL Voice in the Board of such an Organisation. So, the Board of these Medicare Locals, will have a Representative from each of the Groups - i.e. one each of a GP/ NP / Pharmacist / Chiropractor / Herbalist / Physiotherapist / Iridologist / Naturopath , etc.etc. The Voice of the GP would be only a ' Whisper in a crowded room '.
Wake up my dear GP Colleagues.
DR. AHAD KHAN, GP Glenbrook NSW

jadugar dar
11th Jun 2011
1:28pm

Ahad has summarised it beautifully!!!! I have said the same for a long time. Nicola has always regarded that GP's are unnecesary.We have one of two alternatives available to us now. 1. Register as a NP with our Medical Degrees and 2. Qualify and elevate to a Specialist level & register accordingly. And of course the 3rd is quit because GPs will not unite and take Industrial Action. Any alterations in the status of the AWU members would by now resulted in Libya-like turmoil. Good luck to those GPs who are retiring, dying or quitting.

Green Demon
11th Jun 2011
3:33pm

so....The 2010 Intergenerational Report, Australia to 2050: future challenges found that total government spending on health will rise from 4% of GDP in 2009/10 to 7.1% in 2049/50 and the bulk of the increase will be on MBS, hospital services and the Pharmaceutical Benefits Scheme.
Aged care expenditure is also projected to rise significantly from 0.8% of GDP in 2009/10 to 1.8% by 2049/50 with residential aged care recording the highest growth.

It's ok to moan; be chicken little with sky falling in but what will happen we can't afford to pay for health? Having a greater emphasis via MLs on population; prevnetaive health has to be a no brainer! or do we head down a teared system like the US who will be facing 20% of GDP spending for the same period? Some words of actual wisdom may be helpful

Amateur Observer
12th Jun 2011
11:52am

Why does General Practice seem to be the only specialty group singled out for special attention by the Federal Health department in their recurrent trial-and-error attempts at health reform? I'm sensing a bit of gutlessness amongst the Feds when it comes to foisting experimental programs onto other medical specialties.