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The Sydney Morning Herald are reporting: Rudd plan for one-stop shop GP super clinics
Quote:
DOCTORS, health professionals and councils would be given grants to establish one-stop shop "GP super-clinics" in outer suburban and rural areas, under a policy announced yesterday by the Labor leader, Kevin Rudd.
He said a Labor government would spend $220 million to set up the clinics, as part of its drive to improve health services and take the pressure off public hospitals.
The clinics would bring together GPs, nurses and allied health professionals like physiotherapists, podiatrists and psychologists in one location, along with pharmacists and rooms for visiting specialists.
Mr Rudd said the clinics would be more convenient for patients and would strengthen primary health care in local communities by encouraging team work by health professionals.
"Labor's GP super clinics will help take the pressure off hospitals long-term, provide a greater focus for tackling the challenge of chronic disease in local communities and mean much greater convenience for patients," he said."And by having renovated or purpose-built facilities that allow space for group sessions and a range of staff, the super clinics will have a particular focus on assisting people to stay well or better manage existing chronic conditions."
The $220 million would come from a $2 billion national health and hospitals plan which Mr Rudd announced last week. It would pay mainly for the capital costs of setting up the clinics by providing grants of between $1 million and $10 million in most cases.
Funds would also be available to meet administrative costs and to employ practice nurses. Doctors would be eligible for incentive payments of up to $15,000 to relocate to one of the clinics.
Mr Rudd said a Labor government would work with state governments to identify locations for the clinics. Priority would be given to areas with poor access to health services and areas with high levels of chronic disease.
Once the areas had been selected, local consortiums including councils, GPs wanting to amalgamate practices and other health professionals and organisations would be able to tender for the grants to set them up.
The chairman of the Australian General Practice Network, Tony Hobbs, said providing the infrastructure for GPs to work with teams of allied health professionals in one location would improve patient outcomes.
"Patients [who] have complex conditions often require care from more than one health professional," Dr Hobbs said. "For example, people with type 2 diabetes quite often have problems with their feet that can require referral to a podiatrist."
But the Health Minister, Tony Abbott, said Labor was playing catch-up with the Government, which was already spending more on programs to expand local primary health care services.
Under Mr Rudd's broader $2 billion health plan, a Labor government would provide incentive payments to state governments to improve hospital performance. But if the states did not agree on the necessary improvements by 2009, federal Labor would take over financial responsibility for public hospitals.
Mr Abbott said federal Labor would be no better at running public hospitals because it "is going to have the same kind of ACTU-driven, big-government agenda as state Labor has".
The devil will be within the detail. Just as the GP controls the access to Enhanced Primary Care (which is their job to co-ordinate care!!), I can see an imbalance of power arising from this situation.
Allied Health Professionals (AHP’s) are not going to specialise in chronic disease management if all remnants of incentive are stripped away.
As I understand, the AMA was very vocal initially in the EPC program, wanting GP’s to be paid for AHP’s work, and they then pay the provider.
If we are serious about making chronic disease management a rewarding career for providers, the issue of ownership, control and of course money will need to be considered.
The devil will be within the detail. Just as the GP controls the access to Enhanced Primary Care (which is their job to co-ordinate care!!), I can see an imbalance of power arising from this situation.
Allied Health Professionals (AHP’s) are not going to specialise in chronic disease management if all remnants of incentive are stripped away.
As I understand, the AMA was very vocal initially in the EPC program, wanting GP’s to be paid for AHP’s work, and they then pay the provider.
If we are serious about making chronic disease management a rewarding career for providers, the issue of ownership, control and of course money will need to be considered.
Totally agree Clinton.
Personally I decline to treat ANY EPC patients referred to me for several of the aforementioned reasons. Yet GP's who know me and know my policy continue to refer patients and simply tell the patients ;"...tell him the Doctor said he must !". Some Health care Providers are more equal than others perchance....
I am in a fortunate situation where I can decline the EPC patients and still am very busy (NB: I do however, attend to a vast number of DVA patients) even to the point where several patients would rather pay me a private fee then go to a local colleague under the EPC scheme. This suggests that they also do not appreciate the limitations of choice that the scheme and GP's impose. So I wholehartedly agree with your imbalance of power / control sentiments.
As to your assertion that initially the AMA wanted to be paid, then, pay the provider.....well sounds about right!
Julian
__________________
A bientot...
Julian
Podiatrist-at-large
Quote:
Let him who is without sin , cast the first stone...
Of course the whole world revolves around the almighty dollar. The 'power/control thing' is more about control over these so called 'super clinics', and not the control over the patients care. As I said in my initial post, GP's are better at control of care than anyone else, as they should be.
The imblanance of power we need to be more concerned about, is the imbalace at a managerial/ownership level of these clinics.
The reason we get into owning our own practices is to have some autonomy.
Whilst the medical profession continues to have control over other health professions, and hold governments over the barrel with threats and contempt when things don't go their way - nothing will change.
We have a health workforce of 1000's of people who are not in medicine (ie nurses and allied health professions) screaming to be given greater clinical freedom and autonomy by government, but none of the major parties are interested in the type of wholesale changes in health policy that could facilitate solving the workforce crisis around the country within a few short years. Remember the Productivity Commission report - that went down like a lead balloon. Why? They are immensely afraid of the backlash from the AMA, RACGP, RACS and other professional societies in medicine. Obviously forget about the Liberal party, and even Labor would dare not tread there.
Simple changes: e.g. free up PBS to non-medical prescribing, allow Medicare Item Numbers to be billed by any registered health provider and not just one professional group.
I know of no other segment of our society where the taxpayer funds, almost to 100%, the cottage industry of solo and small group private GP clinics. What sense is there in this? GPs are even funded for such things as broadband access, "practice incentive payments", bonuses for doing immunisations - hello? - isnt that just part of the job?
If we were serious about health reform, GPs would be salaried in public GP clinics, and those that chose to work privately would face the same funding model as other private health providers.
Whilst the medical profession continues to have control over other health professions, and hold governments over the barrel with threats and contempt when things don't go their way - nothing will change.
We have a health workforce of 1000's of people who are not in medicine (ie nurses and allied health professions) screaming to be given greater clinical freedom and autonomy by government, but none of the major parties are interested in the type of wholesale changes in health policy that could facilitate solving the workforce crisis around the country within a few short years. Remember the Productivity Commission report - that went down like a lead balloon. Why? They are immensely afraid of the backlash from the AMA, RACGP, RACS and other professional societies in medicine. Obviously forget about the Liberal party, and even Labor would dare not tread there.
Simple changes: e.g. free up PBS to non-medical prescribing, allow Medicare Item Numbers to be billed by any registered health provider and not just one professional group.
I know of no other segment of our society where the taxpayer funds, almost to 100%, the cottage industry of solo and small group private GP clinics. What sense is there in this? GPs are even funded for such things as broadband access, "practice incentive payments", bonuses for doing immunisations - hello? - isnt that just part of the job?
If we were serious about health reform, GPs would be salaried in public GP clinics, and those that chose to work privately would face the same funding model as other private health providers.
Imagine the AMA revolt!
LL
Here..Here.........
__________________
A bientot...
Julian
Podiatrist-at-large
Quote:
Let him who is without sin , cast the first stone...
The rest of it will be much tougher.
The medical profession has a level of protection in the Australian Constitution, preventing "civil conscription" in Part V 51 xxiiiA.
which is yet to be tested in the High Court, but caused a lot of fuss when Medibank was initially introduced in 1973. initially the AMA was very opposed to Medibank, and as part of the negotiation Dental and other AH services were not included.
__________________ Stephen Tucker Eastern Health
Podiatry Manager
If the government was in any way serious about improving health services, it would make medicine and dentistry an undergraduate course with a complusory 5 year service in the rural areas. The gov. kowtows to the Unis in every aspect of health care, check out the UK entry rules with Aus entry rules. Why are pod courses here 4 years, and the UK 3? So the unis get an extra year of fees. carole
If the government was in any way serious about improving health services, it would make medicine and dentistry an undergraduate course with a complusory 5 year service in the rural areas. The gov. kowtows to the Unis in every aspect of health care, check out the UK entry rules with Aus entry rules. Why are pod courses here 4 years, and the UK 3? So the unis get an extra year of fees. carole
Hello Carol.
The way podiatry appears to evolving in Australia, eg clinical service, what do you think of the idea that podiatry education should be...
(1) under the auspices of a university Faculty of Medicine, Dentistry & Health Sciences, and...
(2) a 5-6 year full-time medical degree that includes eg surgery?
A two year course at Tafe, and so should Dental Hygiene, and nursing.
Too much power, and not enough reasponsibility for getting people out there working is given to the unis. Carole
A two year course at Tafe, and so should Dental Hygiene, and nursing.
Too much power, and not enough reasponsibility for getting people out there working is given to the unis. Carole
Provocative, Carole
Perhaps you have spent too much time grooming you cats, and not enough time looking at the career you have chosen.
Let's see what you say after you have been graduated a couple of years. Maybe you will then agree that 2 years would be OK if you wanted to graduate as simply a "podiatric hygienist".
If you happen to graduate in Victoria from now on, with the responsibility of prescribing a range of significant S4 drugs, then I think the community will be safer with a 4-year graduate who has taken their time to learn these matters well. Just one example, lets not start on surgery...
That's a great idea Carol!!! Then when a patient phones to say they can't make an appointment because they have a hairdressers appointment, they can be forgiven. After all my hairdresser has trained longer than 2 years.
To continue to have a voice at discussions, like these Super GP clinics, we should be only moving forward! Certainly not loosing the ground we have already covered.
A two year course at Tafe, and so should Dental Hygiene, and nursing. Carole
Golly gosh, if that's the ideal educational way to go for such a rapidly progressing profession then I think I'll take 3...yes, THREE Apros and go back to seismic surveying. Banging wooden pegs and metal star droppers in the ground out in the Australian bush sure sounds a lot better than banging my head against the wall.
Rudd plan for one-stop shop GP super clinics
Re: Rudd plan for one-stop shop GP super clinics
Hello Carol.
Re: Rudd plan for one-stop shop GP super clinics
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