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Canadian primary care study useful for new Health Minister

A recent article in the Canadian Medical Association Journal should be top of the reading list for the new Minister for Health and his/her advisers. 

This article looks at the characteristics of primary care practices that are associated with quality and should be particularly relevant to the Review of Medicare Locals (MLs), promised by the Coalition in the lead-up to the election.  

Croakey was originally alerted to the article by Professor Stephen Duckett via the following tweet

The commitment to review MLs was announced after initial statements from the Coalition indicated that they did not see any value in the new primary health care organisations, established as part of Labor’s health reform agenda.

Croakey has no inside knowledge on what changed the minds of the Coalition leaders, however, has heard that visits to individual MLs by (then) Shadow Parliamentary Secretary for Primary Healthcare Dr Andrew Southcott, may have played a role.  

Apart from the commitment to review MLs, the Coalition has said little about its vision for primary health care and its role in tackling some of the major health problems facing our community.  

However, once Coalition politicians have finished sorting out the important details of forming government (for example, who gets the plum Parliament House offices closest to the Senate and House of Reps chambers ) they will need to turn their attention to other aspects of their role, like how to run the health system.

This will include working out what they want to get out the ML Review (as anyone who has had anything to do with governments knows, a review never takes place until those running it know what they want the outcomes to be).   

Reviewing MLs at this stage may seem premature when some of them have barely had the ink dry on their contracts.  Even those established as part of the first tranche in 2011 can hardly be expected to have achieved significant population health outcomes in this relatively short timeframe. Changing health-related attitudes and behaviours takes time and there are no easy shortcuts to improving the complex intersection of individual and structural factors which result in the significant health inequities in our community.

Had Peter Dutton consulted Croakey before making this decision, a number of other programs could have been suggested as more appropriate for evaluation and review.

For example, the private health insurance rebate, which has an annual budget over thirty times that of Medicare Locals ($5.5 billion vs $173 million) has been running for over a decade without any formal evaluation of its efficacy.  

However, given that the Coalition is unlikely to back down on its commitment to a review, there are some potential positives in looking at the progress thus far of MLs and how they are working to integrate and coordinate health care at the community level. 

If done properly, it could provide useful information on the challenges they are facing early in their implementation process and ensure the successes of individual MLs are highlighted and used to assist others.

It may also help the incoming government develop a vision for primary health care, something that was lacking in its pre-election policy statements.

The Canadian Medical Association Journal article may help the incoming Minister and advisors in this regard. The article identifies a number of characteristics of practices which are associated with quality in primary care, many of which relate to the roles and functions of MLs. 

The study contains a number of useful findings, particularly in relation to the complex relationship between quality, accessibility and efficiency.

Overall, it demonstrates the complexity of assessing performance in primary care and warns against using any single issue outcome measure, without taking its broad context into account.   

This may not be the simple message an incoming Health Minister wants to hear, but if s/he understands these issues now, it could make a real difference to the fate of Australia’s primary health care system over the next three years. 

 

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Croakey Conference News Service 2013 – 2023
2023 Conferences
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2022 Conferences
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Equally Well 2022 Symposium
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2021 conferences
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2018 conferences
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2017 conferences
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Australian Palliative Care Conference
2016 conferences
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2015 conferences
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Population Health Congress 2015
2014 conferences
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AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Healthdirect Australia series 2019
Lowitja Indigenous knowledge translation series
Croakey projects archive
#PHAAThinkTank 2022
Summer reading 2022-2023
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
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@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
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Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
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CroakeyGo 2017
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Elections and Budgets 2013 – 2021
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Federal Election 2013
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Federal Election 2010
Federal Budget 2009-2010

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