As you may have seen from previous posts, Croakey is hosting a discussion on how the new primary health care organisations to be known as Medicare Locals might engage their communities.
This will involve many challenges, notes Professor Mark Harris, Executive Director of the Centre for Primary Health Care and Equity at the University of NSW.
Mark Harris writes:
The Commonwealth Government envisages that the new “Medicare Locals” will have a much broader range of functions than existing Divisions including:
- facilitating allied health care and other support for people with chronic conditions;
- identifying and filling gaps in the provision of local primary health care services including after hours services;
- work with Local state Health Networks improve patients’ transitions out of hospital;
- work with aged care services to ensure that aged care needs are met;
- deliver health promotion and preventive health programs
- undertake population level planning and potential fund-holding roles in areas of market failure.
This implies a need for them to be more broadly constituted (with broader representation from community members, local government and a range of primary health providers) and that they engage and are more responsive to local communities.
This is a difficult task, especially ensuring that the voice and needs of disadvantaged groups are heard. The latter often respond poorly to surveys or other mechanisms for engagement.
It may also be uncomfortable for local health service providers. Consumers and community members are often especially concerned about issues such as the availability of services (eg after-hours), waiting times and their cost to consumers. This is important not only for GP services but also allied health services.
The community’s voice needs to be linked in some way to the accountability of the new organisations to their community.
In the UK, many Primary Care Trusts share anonymised information on the quality of care provided by their primary care providers with the general public. This has at times been controversial. They have also sought to systematically collate information from patient surveys and this has been included in performance criteria funded under the Quality Outcomes Framework.
While these may not be feasible or desirable in Australia, especially in the short term, it is important that the input from consumers and communities is both sought and taken notice of. This will be a major test for the new organisations and their credibility.
The States, in particular, are viewing them with some caution – holding off transferring responsibility for any community and allied health services until it is clear how well these will function.