National health reform efforts will focus on a new voluntary patient registration model called My Medicare, and supporting workforces to practise at the top of their scope of practice, as well as expanding the nursing workforce to improve access to primary care, and providing flexible funding for multidisciplinary team-based models of care.
These and other initiatives were announced today as part of a $2.2 billion package of measures that the Government said aims to address immediate challenges in primary care, take pressure off the hospital system, and lay the foundations for long-term Medicare reform. They follow the release of the Strengthening Medicare Taskforce’s report in February.
Further details will be announced in the May Budget, and Health Minister Mark Butler will elaborate further in a National Press Club address on 2 May. ABC reports the funding commitment is a combination of old and new money, with a breakdown of what proportion is new to come in the Budget.
Health reform will be the focus of a dedicated National Cabinet meeting in the second half of this year.
Meeting in Brisbane today, a National Cabinet meeting also addressed many other issues that are important for health.
One announcement causing alarm among disability advocates is a commitment to set an annual growth target for the NDIS of no more than eight percent by mid-2026.
This could amount to a funding reduction of $50 billion over the next decade, and advocates are upset about the announcement pre-empting a review looking at the sustainability and design of the NDIS, which was due to be finalised in October.
Other reform areas
Other important public health matters addressed by National Cabinet including housing and planning policy, with First Ministers agreeing to reforms to support a national approach to the growth of cities, towns and suburbs.
Housing Ministers will develop a proposal for National Cabinet in the second half of 2023 outlining reforms to strengthen renters’ rights across the country.
Within the next six months, Planning Ministers will develop a proposal for National Cabinet outlining reforms to increase housing supply and affordability, working with the Australian Local Government Association.
The Commonwealth is commencing an independent review of its Infrastructure Investment Program and adopting a refreshed approach to infrastructure investment. States and territories have agreed to support the review.
Also on the agenda are plans for a new five-year National Skills Agreement, to “ensure that high-quality, accessible education and training will be available to equip Australians with skills and prepare them for the jobs of now and the future”.
National Cabinet discussed how to best support regions that are exposed to socioeconomic changes associated with decarbonisation.
A national strategy for the care and support economy was also discussed. First Ministers agreed to progress a first tranche of reforms to streamline worker screening, improve worker safety, and grow the Aboriginal and Torres Strait Islander care and support workforce.
National Cabinet reaffirmed the unanimous support of State and Territory Leaders for constitutional recognition of Aboriginal and Torres Strait Islander people.
Other health reform initiatives include that wrap around primary care will be offered for frequent hospital users to improve access to comprehensive clinical care and support self-management for people with chronic conditions.
In 2023-24, this model of care will be designed and implemented to support general practices through a blended funding model linked to My Medicare to work in primary healthcare teams.
Starting later this year, a National Scope of Practice Review will review barriers and incentives for all health professionals to work to their full scope of practice.
The Commonwealth will strengthen the role of PHNs in commissioning allied health and nursing services to improve access to affordable multidisciplinary healthcare teams, beginning in 2023-24.
Also due to start in 2023-24 is an initiative to attract 500 enrolled nurses and registered nurses back into the primary care workforce, as well as Commonwealth support for 6,000 placements of nursing students in primary care. Funds will go towards the administrative and logistical costs associated with nursing placements.
From 1 January, the Commonwealth will expand the National Immunisation Program to pharmacies. People aged five and over will be able to have immunisations at their local pharmacy for $19.
The PBS Opioid Dependence Treatment program will broaden access to treatments in community pharmacies from 1 July. The Government said this will give patients another option to access treatment outside GP clinics and hospitals that are already under immense pressure.
An incentive payment will encourage GPs to attend residential aged care homes, with PHNs to match GPs to residents who do not have a regular GP.
First Ministers also endorsed the Independent Review of Overseas Health Practitioner Regulatory Settings Interim Report, led by Robyn Kruk. They said this recommends measures to immediately boost the health workforce and ensure Australia is a competitive destination for the global health workforce into the future, while maintaining high standards of quality and safety. (More detail about the review is here, and the interim report is here).
Health Ministers will work to progress as a priority recommendations that can be implemented immediately, and report back to National Cabinet with a fully-costed implementation plan for the remaining recommendations.
Health policy analyst and Croakey editor Jennifer Doggett said:
“One positive in this announcement is the overall quantum of funding, not sufficient to address the level of need but certainly more than was promised when the Government set up the Strengthening Medicare Taskforce.
“Another positive is the focus on changing the way in primary healthcare is delivered, including through supporting a greater role for nurses and allied health practitioners, rather than simply funding more of the same.
“The additional funding to PHNs allows for a better geographical distribution of Medicare funding and can help target groups who have been poorly served by traditional general practice. However, the patchy performance of PHNs and the lack of support they have among many health care providers may be a barrier to the effective implementation of these initiatives.”
Adjunct Associate Professor Lesley Russell, a Croakey columnist and health policy analyst, said:
“Although it is early days and there is much more detail to come, it is worrying to see that so far there is no mention of how to ease the burden on GPs due to lack of mental health services and the increasing inability to refer patients (especially those with chronic and complex conditions) on to specialist care.
“If the federal funding is also boosted with state and territory efforts, then some of this could be addressed via specialist clinics attached to public hospitals, with agreements about staffing, Medicare billing and limited out of pocket costs for patients.”
The Australian Medical Association said the May budget will be a real test for the Commonwealth. “It not only needs to deliver funding to support long term reform of general practice, it must also deliver an immediate injection of funding into general practice to ensure it remains viable and GP services are accessible and affordable,” said a statement.
Key links for more detail
Note from Croakey: This article was updated on 1 May to include a link to the interim report of the Independent review of overseas health practitioner regulatory settings.
See Croakey’s archive of articles on Strengthening Medicare