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What should Medicare Locals and Hospital Networks look like?

The Australian General Practice Network has released its suggestions for how the new primary health care organisations should look, in a report available here, and the Department of Health and Ageing wants to hear what others think.

The Department says the initial consultation on Local Hospital Network boundaries will be undertaken by the States and Territories. Following an initial consultation phase the Commonwealth will work with the States and Territories with the aim of producing a combined set of government endorsed LHN and Medicare Local boundaries for further consultation.

We are not going to run out of reading on health reform anytime soon….

There are so many uncertainties around how the reforms will be implemented (or even if we get that far, depending on the election result) – but at least one outcome seems certain.

There will be many people suffering from a debilitating condition known as health reform fatigue. I’m not sure what the cure might be though…

Update 5 July. The National Rural Health Alliance has released this statement, suggesting it is not much impressed by the AGPN’s plan:

The NRHA rejects proposals contained in the independent report commissioned by the Australian General Practice Network (AGPN) on boundaries for Medicare Locals and will work strenuously against the Report’s preferred options being adopted by government.

Dr Jenny May, Chairperson of the NRHA, says that by basing boundaries of the new primary care organisations on population size and organisational capability, the consultants’ report has come up with proposals which would be quite contrary to the interests of people in rural and remote areas.

“The idea that there should be one primary care organisation in the whole of Tasmania, one in the Northern Territory, and one for the whole of non-metropolitan SA is absurd – and would result in even less localisation of primary care management than now exists,” Dr May said.

Rural and remote Medicare Locals will have challenges that far exceed those of their relatively well-resourced metropolitan counterparts. There challenges will be to address major gaps in primary care services and disparities in the distribution of health professionals; to support the existing health workforce; and to integrate primary care with specialist services, Local Hospital Networks, aged care and mental health services.

“It is accepted that the new Medicare Locals must have capacity and capability, but there are other ways of ensuring this than simply rounding up 300,000 people however many square miles that takes,” Dr May said.

“Smaller Medicare Locals can share administrative support and buy in skills on a contract basis as they are needed. By far the most crucial capability is that they are relevant to and representative of the communities they serve, and can analyse and engage properly with local needs.”

The Alliance will lobby for the delivery of local primary health care services to ensure that community members, local government and clinicians in an area know who is responsible and can be involved in efforts to identify and fill health service gaps.

The Alliance accepts Minister Roxon’s invitation to be involved in consultations to ensure that the new Medicare Locals have what she describes as “strong links to local communities, health professionals and service providers, enabling them to respond more effectively to local need”.

Comments 6

  1. Weary Dunlop says:

    This all seems very odd.

    Did AGPN lay an egg, and then try to walk away from it?

    Apparently the backroom debates surrounding this boundaries report have been very long on filth and fury.

    I’m told that there has been a shitstorm of discontent from GPs nationally about this report on a national AGPN listserver for months.

    Unfortunately, the main thing this AGPN-commissioned document illustrates is how GPs across Australia are increasingly hostage to recommendations made by a small group of non-GP mates.

    More than anything, this boundaries report is the fruit of a frantic nest-feathering exercise for these mates, with AGPN their chief chicken.

    So, in commissioning this report, did AGPN lay an egg, and then try to distance itself?

    Not being an expert in such matters, I really couldn’t say.

    But I can imagine that in a back room in Woden tomorrow, someone may mumble,

    “Oh, but of course this report is based on a sound methodology, and was written in the best interests of the public at large, Minister…”

    Finally – interested parties are supposed to provide feedback to the boundaries report. However, it does make you wonder whether posting on this Croakey blog carries greater weight in the Department of Health and Ageing than the official channels?

    Just a thought.

  2. Gavin Mooney says:

    The AGPN Report argues “that PHCOs need to be designed around the needs of defined communities and populations and not just the current users of health services or health professional networks and communities of interest”.

    Agreed and surely to get away from the concerns of only “communities of interest”, we need citizens’ juries to assist in sorting out not so much needs as the design of services to meet these needs. What a great opportunity to get citizens engaged in their local health services!

  3. Ben Harris says:

    The question we’ve been asking is what is it that Medicare Locals are going to do? The form should follow function, about which we know very little.

    There are some interesting new articles on Medicare Locals published on http://www.supportfamilydoctors.com.au for those particularly interested.

    [Ben Harris is Director, Policy and Public Affairs, AMA Victoria]

  4. Tessa Jones says:

    Weary Dunlop
    From what I’ve seen I think your post on July 1, 2010 is right on the mark!

  5. Tessa Jones says:

    Oops, I meant July 2, 2010 Yes the AGPN have laid an egg and yes there are people feathering their nests with it. Such power over the private lives, private health information of individuals in local communities at the hands of those locals on boards and governance is a shortfall of this system.

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2016 conferences
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2017 conferences
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