Many thanks to Jason Trethowan, CEO of Barwon Medicare Local for this eye-witness account of the impending move from Medicare Locals to Primary Health Networks.
There has been much discussion about the future of Medicare Locals and what the federal government is recommending for the 24 new Primary Health Networks (PHNs). This week in Canberra, the Chairs and CEOs of Medicare Locals are meeting to discuss the latest information and how we can best ensure that valued services for our communities are sustained.
At a local level, from 1 July 2015, Barwon Medicare Local (1 of 61 Medicare Locals) will no longer be funded by the federal government but be replaced by a PHN that will likely cover the Barwon South West and Grampian regions of regional Victoria.
GPs, general practice, community based nurses, allied health practitioners and hospitals will need to build on the shared interests they have for their patient’s, for the future sustainability of our region’s health system. This discussion is not new to Barwon, as we have established an environment where clinicians from all areas come together in the interest of creating improved pathways of care. This removes unnecessary processes, reduces variability in clinical practice, reduces waiting times for patients and enables a better connected system through eHealth technologies.
Recent examples that will lead to better health outcomes for patients include the development of our new HealthPathways for behavioural concerns in children, low back pain and managing alprazolam dependent patients. Resource pages on HealthPathways continue to increase and now include access to disability support and refugee health services, amongst others. Since going live last August, HealthPathways has had more than 42,000 page views.
Barwon Medicare Local was also recently complimented by Robert Gottliebsen in the Business Spectator (How to Save our Sick Health System without GST Hikes – 21 May 2015), where he highlighted that successful primary care developments use small business connections and local systems. In his article, Gottliebsen referred to Barwon Medicare Local’s work in eHealth and how our pragmatic approach has led to greater efficiencies compared with other regions, where big government sponsored IT systems don’t work locally. There is a lot to learn from the nimbleness of small business approach to achieving outcomes.
In eHealth, there has been some great work in reducing snail mail and faxes through ReferralNET and now HealthPathways, but significant change is at the very best, patchy. Specialist clinics and hospital outpatient services are structured very differently to general practice. It is a source of major frustration for GPs, when specialist practices and outpatient clinics are resistant to electronic patient referrals and sometimes slow to discharge patients from specialist care, back to the GP. However, this is not a one way street. General practice has changed over the last 20 years, GPs rarely work in hospitals, many work part time, group practices are larger and nurses and allied health have a greater role in chronic disease management. New GPs are coming through with new ideas, greater expectations and their experience working in multidisciplinary teams conditions them from the start.
In the Barwon region, the issue isn’t around workforce alone or capability in demonstrating what increasing efficiency and quality of care actually translates to. The opportunity is how we can leverage off the solid foundations, past experiences and innovative approaches to clinical practice, patient engagement, research and eHealth adoption.
Our closer to home reality is continuing our work, while planning for the transition of services to a PHN. Our staff will continue to provide high quality service continuity, supporting primary health care development during the transition. Meanwhile, our organisational leaders will navigate the PHN tender process and establishment from July 2015, as well as winding up our Medicare Local.
There is still much to be achieved in working towards a sustainable and well-connected health system at the local level.
