Professor Mark Harris, Executive Director, Centre for Primary Health Care and Equity: writes:
“The proposal for the Commonwealth to take full responsibility for primary health care (PHC) services is certainly an encouraging development. For PHC the problem is less about “ending the blame game” of cost shifting between Commonwealth and State and more about the promise of better integrated service delivery – including general practice, private allied health and state funded community health services under the one funding body.
Access to allied health services is currently rationed either through GP care plans in the case of private allied health services funded under Medicare or through waiting times in the case of state community health services. Bringing them together to work more effectively as a team makes a lot of sense. Of course the announcements do not explain how this will be done.
It is not feasible for state community health services to be funded under Medicare on a fee for service basis (like most of general practice and private allied health). In other countries the solution has been for these services to be funded through local primary health care organizations – although there was no hint of these in these in the announcements.
GP Super-clinics were cited in the document as an ideal service model. However there was a hint that the government has recognized the very practical problems in scaling up these models to be able to provide equity of access for all Australians. It would obviously be inequitable if some patients who attend such clinics had good access to allied health while those attending the practice down the road did not.
Thus the document refers to “the type of care currently available through GP Super Clinics” being more available across the country possibly through virtual clinics which better integrate state allied health with GPs such as the GP Plus centres in South Australia. This suggests recognition that we will need a more distributed equitable model which links existing practices to state and private allied health and community nursing services.
This sort of “hub and spoke” approach may also allow patients more continuity and personal patient-centred care than is sometimes possible in very large centres. Obviously we need to watch carefully for both the possible angels and devils in the detail.”
