Related Articles


  1. 1

    Gavin Mooney

    “What people with chronic problems need to hear … is how services will be organised for them, not the other way round, in future.” Right on Steve! This is the challenge of Medicare Locals – not easy but about time in PHC. Health services are first and foremost social institutions and MLs at last and at least recognise that.

    Australia previously struggled in primary care with the all too many, all too small and all too resource poor “Divisions’ (almost as bad a name as Medicare Locals!). At least the philosophy behind MLs is right. And if the Social Determinants of Health are going to take off in Australia – and isn’t it about time? – the MLs are the bodies to lead that.

    My main worry on MLs is simply: will Canberra really let them be ‘local’?

    (It was her predecessor who gave them them the unfortunate name but can Tanya Plibersek now change the name please? I phoned one today and got an automated message saying in essence “Don’t come to us for your Medicare money, ring XXXX”!)

  2. 2

    Margelis George

    The big problem is that Medicare Locals do not include the entire health system, and the Local Health Districts or Networks depending on what state you are in operate in isolation of the Medicare Locals. In the USA the Accountable Care Organisations combine hospital and primary care and force them to both have combined goals, forcing them to work together. Whilst there is good intent between many MLs and LHDs the reality is that without systematic collaboration between them they will not be able to deliver.
    Whilst they remain structurally separate, they should at least aim for functional integration by linking up their information systems. Potentially the PCEHR may provide the infrastructure to do this, but it will require the relevant groups to take a much more active role in its future development. This will require them to be become much more active in the ehealth space, possibly replacing the current board of NEHTA with representatives of the MLs and LHDs to replace the current state and federal health department leads.

  3. 3

    See Limes

    “The patient with chronic lung problems who panics at 2am because of breathlessness is less likely to require ambulance and emergency department care if his or her panic attack can be handled over the phone by a nurse or doctor who knows them and can support them through it.”

    WTF? If I as a rural doctor have to answer the phone at 2am every night, I am going to be too buggered to work the next day…so cancelling the 40 or so people I am supposed to be seeing in my Clinic. medicare won’t pay me for a phone consult…and the insurers will have a hard time defending me if I make a wrong diagnosis over the phone – is this patients shortness of breath anxiety? Or life-threatening asthma? A PE? Heart failure?

    No evidence that phone advice lines work – indeed some emerging evidence that they INCREASE health costs and ED presentations

    No incentive for rural docs to engage in increased after hours…especially when the cost of doing so means the collapse of their ability to work next day

    All seems a bit pie in the sky, frankly. I reckon most sensible rural docs will walk away from Medicare Locals and after hours service provision

  4. 4

    Gavin Mooney

    OK “See Limes” I can understand your position. But what do you suggest for someone like me who lives in a rural area and might need medical assistance at 2am? There needs to be some way of dealing with this other than walking away from it. This is not a new situation and MLs are at least charged with trying to do something to address it. What is your solution?


Leave a Reply to Gavin Mooney Cancel Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

© 2015 – 2021 Croakey | Website: Rock Lily Design


Follow Croakey