1999-2000
General practice the key to primary health care
In this Budget, the Federal Government has delivered a comprehensive package of initiatives worth $171 million to support general practice in its crucial role in the primary health care system.
Fact sheet 7
General practice the key to primary health care
General practitioners (GPs) are the heart of Australia's world class primary health care system. In this Budget, the Federal Government has delivered a comprehensive package of initiatives worth $171 million to support general practice in its crucial role in the primary health care system. Over and above the $171 million, new incentive will be available to GPs under a new program relating to quality prescribing.
This Budget sees a number of new Medicare measures designed to benefit older Australians and people who have a strong reliance on the health care system.
For the first time Medicare will provide funding for GPs for the work they undertake with other care providers in planning care for people with chronic and complex needs, particularly older Australians. This will encourage a more comprehensive team approach to the provision of primary health care.
Additionally, Medicare will now cover voluntary annual check-ups for all people aged 75 years and over. Spending for new Medicare Benefits Schedule items for enhanced primary care totals around $110 million over four years.
The problems faced by rural and remote communities in retaining GPs have also been addressed in this Budget with a commitment of around $43.1 million over four years in the form of retention payments.
New MBS items provide a boost for older Australians
New items covering the involvement of general practitioners in case-conferencing and planning care for people with chronic illness and complex needs will be a part of the Medicare Benefits Schedule from November 1999.
These new items will be particularly important for older Australians, especially people who rely heavily on the health system, helping to enhance their quality of life and increasing the likelihood of them continuing to live independently in their own homes.
Care planning improves patient care through better coordination of services and more efficient use of resources. In the past, Medicare did not provide rebates when GPs did this kind of work. This Budget measure will encourage team approaches by providing Government subsidies for medical practitioners when they plan care with other providers, for example when they work with Aged Care Assessment Teams.
The benefits of case conferencing are well established in Australia, particularly in aged care, and case conferencing involving several general practitioners has occurred in hospital settings and some community settings for many years.
The Government will also introduce for the first time an MBS item for annual voluntary health assessments for people 75 years of age and over. This new MBS item will encourage GPs to identify and address potential health problems of older Australians, helping them remain in their homes longer.
The medical profession will be closely involved in the development of all the Medicare Schedule Items discussed above.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m | |
| General Practitioner involvement in Coordinated Care Planning | 3.6 | 11.2 | 16.8 | 22.9 |
| Multi-disciplinary Case Conferencing | 0.9 | 2.4 | 3.6 | 4.8 |
| Voluntary Annual Health Assessments for those aged 75 Years and Over | 1.8 | 10.5 | 14.1 | 17.9 |
Practice Incentives Program (PIP) - new care plan targets
An incentive will be provided through the Practice Incentives Program for GPs to ensure that their patients aged 65 and over with chronic and complex needs have care plans if they need them. This incentive will complement the Medicare Benefits Schedule items for GP involvement in care planning and will encourage faster uptake of care planning by GPs.
This new incentive will be funded from within the existing allocation for the Practice Incentives Program.
Helping GPs participate in multi-disciplinary care planning
To support the introduction of the MBS initiatives GPs will be given the opportunity to participate in education, clinical audit and research in care planning and case conferencing, especially for older Australians. The Budget includes $8.1 million over four years for these activities.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 2.4 | 2.4 | 1.6 | 1.7 |
Working to keep GPs in the bush
The Budget provides around $43.1 million over four years to implement the Government's election commitment to provide retention payments for long-serving GPs in rural and remote areas.
Rural and remote communities are disadvantaged by the difficulty they face in attracting and retaining GPs. At present, about half the GPs who move to rural areas remain there for less than two years. Retention payments will provide an additional incentive for doctors to continue to practice in such areas, enabling communities to hold on to the GPs that they already have.
This measure builds on a range of other important initiatives the Federal Government has introduced to improve the recruitment and retention of GPs in rural Australia. These initiatives are already achieving positive results but the Government is aware, through talking to a number of rural organisations, that more needs to be done to help communities keep their doctors.
By encouraging GPs to stay longer in regional, rural and remote locations, the retention payments will enhance access to Medicare, create greater stability and continuity in medical services and improve health outcomes for Australians living in these areas.
It is envisaged that the retention payment will be based on a GP's length of service, the remoteness of the area they are practising in and the level of services they provide. The exact nature of the payments system and eligibility arrangements will be negotiated in discussions with rural doctors over the next few months.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 10.5 | 10.7 | 10.9 | 11.0 |
Assisting rural medical students through their studies
This measure provides additional ongoing funding of $1 million each year for the next four years to provide medical students from rural areas with scholarships to meet their accommodation and other support costs while studying.
Research indicates that students from rural areas are much more likely to return to rural and remote areas to practise medicine once they have completed their studies.
This scheme could support up to 100 scholarships per annum.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 1.0 | 1.0 | 1.0 | 1.0 |
Prescribing more appropriate medicines
The Quality Incentives for General Practice program is designed to encourage GPs to change their prescribing behaviour to improve the quality of patient care, while at the same time reducing prescribing costs.
There are three high-cost, high-growth medicine treatment areas being targeted under the program: cardiovascular medicines; medicines for peptic ulcer and reflux disease; and antibiotics.
For example, patients with mild hypertension or high cholesterol and no other heart risk factors could be encouraged to improve diet and exercise rather than immediately commence on lifelong drug therapy. Similarly, there are now alternative treatments for patients with duodenal ulcers other than taking long-term antacid therapy.
Savings resulting from these changes in prescribing practices will be shared equally between general practice and the Government. Initial incentive payments to general practitioners will be made early in the financial year 2000-01. The savings shown below are net of the incentive payments to general practitioners that will commence in 2000-01.
The detailed design of the package will be developed in consultation with the medical profession.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| -28.3 | -38.9 | -55.5 | -64.7 |
Taking care of rural women's needs
Women living in rural and remote areas will benefit from the Federal Government's election commitment to improve access to female GPs. This Budget will provide $8.2 million over four years for a "fly-in fly-out" female GP service.
This initiative is in line with the Government's strategy of providing greater choice, recognising that some women prefer to receive services from a female general practitioner.
It will provide services such as cervical cancer screening, breast and skin examination and other preventative health care for women of all ages living in remote locations. In addition, the service aims to detect and provide the necessary intervention for other conditions such as cardio-vascular disease, diabetes, psychosocial problems and conditions related to the reproductive system and/or sexual health.
The Royal Flying Doctor Service will be centrally involved in the administration of this initiative. Arrangements with the Service will seek to complement and draw together existing services in this area.
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| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 2.0 | 2.0 | 2.1 | 2.1 |
Improving access to health services for Aboriginal and Torres Strait Islanders
The Government has introduced additional measures to improve the health status of Aboriginal and Torres Strait Islander peoples. This includes funding of more than $78 million over four years to enable better access by Aboriginal and Torres Strait Islanders to primary health care services. The new arrangements will provide a framework for the planned and coordinated expansion of primary health care and will be invested in areas where health needs have been identified, and where extra services can make a real difference. The new arrangements will be built on the existing services in collaboration with general practice, Aboriginal and Torres Strait Islander health services, State and Territory governments and other health professionals.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 6.8 | 16.0 | 22.5 | 33.5 |
Strengthening the Professional Services Review Scheme
This measure provides an additional $11.9 million over the next four years to improve the capacity of the Professional Services Review Scheme to ensure that Medicare funds are not paid for inappropriate medical practice. The Scheme also helps ensure that the Medicare Benefits Scheme, which costs in the region of $6.9 billion a year, is protected against over servicing and abuse.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| 1.5 | 2.1 | 3.9 | 4.4 |
Making Medicare claims faster and easier
The Health Insurance Commission (HIC) is pursuing innovation in the use of electronic commerce in processing Medicare claims. When current trials are completed, improvements flowing from the HIC electronic commerce initiative will mean that over time, more patients will be able to lodge their claims for Medicare rebates directly from doctors' surgeries, making it easier for Australians to access Medicare claiming facilities.
| 1999-2000 $m | 2000-2001 $m | 2001-2002 $m | 2002-2003 $m |
| -4.0 | -6.0 |
For further information on related initiatives refer to Fact Sheet No 2 on Enhanced Primary Care.
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