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Medicare Locals and the future of primary health care research

The 30th of June saw the end of Medicare Locals, the primary health care bodies that evolved from Divisions of General Practice and were recommended by the Rudd Government’s National Primary Healthcare Strategy.

After only four years (at most) of operation, these organisations had yet to reach their potential but many had made promising gains in the areas of consumer engagement, population health planning and chronic disease management.  

Hopefully these gains will not be lost in the transition to the next evolution of primary health care meta-organisations, Primary Health Networks.

In a statement this week, Walter Kmet, CEO of one of the new Primary Health Networks, WentWest, made it clear that his organisation will be building on its previous achievements as a Medicare Local, “As an organisation committed to improving the health of western Sydney, we will continue to work with General Practitioners, Allied Health Professionals, our long-standing partners and numerous other not for profit organisations to fulfil our responsibilities and focus on the common health priorities”.

“Much of the foundations we have laid over the past three years, including our work in integrated care, chronic disease, Child and Family Health, Aboriginal Health and mental health, will allow us to quickly transition into this new era with minimal disruption,,” continued Mr Kmet.

It is worth noting however that many Primary Health Networks will not have such a seamless transition as they involve the creation of new organisations, in some cases with outside partners and different geographical boundaries from that of the previous Medicare Locals. 

Meanwhile, the future of primary health care research is in doubt with the winding up of the Australian Primary Health Care Research Institute (APHCRI) and no clear direction for the future of this important area of research.

This leaves the primary health care research community in a state of limbo and risks losing the gains made over recent years by APHCRI in bringing together researchers and policy makers with a unique focus on translational research.   

In outlining the situation to stakeholders, Deb Turnbull, Chair of the Research Advisory Board, provided the following information:

APHCRI is funded until December 2015 by the Commonwealth Department of Health under the latest five-year phase of the PHCRED program.  This phase has now ended and the program has been externally evaluated.  I understand that the Department of Health is considering options for investment in future primary health care research as part of a Departmental wide approach to the support of research. 

Although the APHCRI contract ends this year a number of commissioned research projects (including Centres of Research Excellence) will not be complete until 2016/2017, and one will conclude in July 2018.  The necessary funds have been set aside to meet these commitments and contingency plans are being put in place with APHCRI’s host, the Research School of Population Health (RSPH) at ANU to ensure that the remaining research contracts are appropriately monitored and final reports disseminated.  These plans will come into effect should there be no renewed funding for APHCRI or a successor organisation with these functions.

The former in-house research program of APHCRI, known as APHCRI@ANU, has already been separated from the research commissioning/capacity building functions and incorporated into a new Health Services research stream in the RSPH.

Future of Primary Health Care Research Funding

APHCRI on behalf of the network and other stakeholders has developed and submitted a paper outlining views on the future of dedicated primary health care research funding.

The key messages are;

Primary health care is a vital part of an integrated and sustainable health system

Targeted priority driven primary health care research, firmly embedded with the key stakeholders groups, i.e. policymakers, consumers and service providers, is too important to leave to the lottery of mainstream academic research funding

The model for delivering this targeted research and impact focused program should be based on inclusive governance and partnership arrangements between academics and the key stakeholder groups

We have valued the benefits and legacy of APCHRI to PHC Research, and recognise the potential for new models of PHC Research that support the implementation of research findings.

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