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Home > Ministers > The Hon Tanya Plibersek MP - Minister for Health > Media Hub > Speech - National Primary Healthcare Conference - Adelaide Convention Centre - 8 November 2012

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PDF printable version of Speech - National Primary Healthcare Conference - Adelaide Convention Centre - 8 November 2012 (PDF 219 KB)

8 November 2012

E&OE Only

Thank you for inviting me to be with you here today.

I’d like to begin by acknowledging the traditional custodians of the land on which we meet, the Kaurna People, and pay my respects to their Elders past and present.

I would also like to recognise:

• Dr Arn Sprogis, Chair of the Australian Medicare Local Alliance (AML Alliance);
• Leanne Wells, Transitional CEO of the AML Alliance;
• Adjunct Professor Russell Stitz, Chair of the National Lead Clinicians Group; and
• Ms Carol Bennett, CEO of the Consumers Health Forum.

Introduction

Today I wanted to take the opportunity to touch on three key things.

• Firstly, about how we’re shifting the centre of gravity in our health system towards primary care;
• Secondly, about how we can best support local decision making in primary health care by devolving more responsibility to Medicare Locals; and
• Thirdly, in return for that extra responsibility the critical role I expect Medicare Locals to play in spreading success throughout the health system.

Shifting the centre of gravity towards primary health care

The evidence is clear. Health systems centred on primary health care have better outcomes.

The World Health Report in 2008 found that where countries at the same level of economic development are compared, those that were organised around the tenets of primary health care produced better health outcomes for the same investment.

But there’s no doubt that challenges traditional community views about health care – and changing people’s minds can be tough.

There is still scepticism about the fact that treatment in a primary health care setting can be safer and more effective than treatment in hospital.

We can conquer that scepticism with the evidence and the compelling story it tells.

For example, we know that primary healthcare-led models have been shown to decrease hospital admissions and prescription use by about 25%.

But it’s also about how we in the health sector get consumers to reflect on how they access care.

As the ‘change agents in-chief’ across the primary health care sector, Medicare Locals and the AML Alliance have a critical role to play in articulating our shared vision for the system.

I find it interesting that when it comes to our schools you’d be hard pushed to find a parent that would disagree with a system focussed on the primary years.

A focus on the primary years in our schools means a coordinated approach to learning and support as a person enters the system, hopefully avoiding the need for major, more serious acute interventions down the track.

There are obvious parallels with our health system, but the primary healthcare-centred approach has not quite entered the orthodoxy. Not yet, but we’ll get there.

The way we get there is by empowering primary health care professionals with the power to make their own decisions in the best interest of their local communities.

Supporting local decision-making in primary health care

At the end of the day, our goal is to have more decisions made locally by local people – health professionals, consumers, and other skilled community members – rather than by public servants in Canberra.

That’s why we’ve given Medicare Locals more flexible funding and decision-making arrangements to allow health professionals to work with others and to better respond to local needs.

As you know, from 1 July next year, Medicare Locals will be funded specifically to ensure that people have improved access to after-hours services, regardless of where they live.

There are many examples of Medicare Locals across the country delivering home-grown solutions to local health problems and making it easier for Australians to see and contact a health professional, closer to home.


For instance, the Greater Metro South Brisbane Medicare Local has partnered with Mater Health Service and Micah Projects to make sure homeless people in the city get the right health care as they transition into their own accommodation.

And the Lower Murray Medicare Local has teamed up with the Royal Flying Doctor Service Victoria to help transport Indigenous people with chronic conditions to medical appointments.

It’d be no secret to anyone here that at the heart of successful Medicare Locals are good relationships between general practice, the broader primary health care sector, and consumers. As Medicare Locals continue to evolve, it is important that they continue to build on those relationships.

As a transition arrangement, my department has permitted some Medicare Locals to contract out these relationship management responsibilities.

But now the establishment phase is coming to an end, we’ll be looking to Medicare Locals to take the reins on the relationship management front. Strong long-term relationships with key stakeholders are core to the function of Medicare Locals, and those relationships need to be nurtured and developed internally – not contracted out to others.

And that includes, where appropriate, the AML Alliance building relationships with state governments. It might be that certain state government health programs could be better delivered by practitioners in the local community. Where that’s the case, I would encourage state governments to fund Medicare Locals to deliver its programs. The benefits are obvious - no one would be better placed than Medicare Locals at shaping health programs to meet community needs.

Along those lines, the Federal Government’s been looking at what other responsibilities we might sensibly think about devolving to a community level, including to Medicare Locals.

And I’m very pleased to be able to announce two of those here today.

Firstly, I can announce that responsibility for the Australian Primary Care Collaboratives Program will also be transitioned to Medicare Locals, through the AML Alliance. Under these arrangements, the Improvement Foundation will continue to deliver the Program. But transitioning the ultimate responsibility to the AML Alliance recognises the network’s role in improving the effectiveness, safety and quality of the primary health care system. The Government believes this will support continuous improvement across the system, including a reduction in unwarranted variation in disease management through the Collaboratives initiative.


Some 1100 of Australia’s 7300 general practices have been engaged through the Collaboratives process. The idea is that by entrenching the work of the Collaboratives as core business for Medicare Locals, we can make it a focus across the primary health care system.

And secondly, I’m delighted to the launch the new Disease Prevention and Health Promotion in Medicare Locals Program. The program will support Medicare Locals with up to $5 million for:

• a grants program targeting improvements in preventive health outcomes, particularly for disadvantaged, at-risk and hard to reach groups;
• a nationally consistent and rigorous evaluation to strengthen evidence; and
• development activities to promote the uptake of effective evidence-based preventive activities in primary health care through Medicare Locals.

Importantly, this funding promotes collaboration between Medicare Locals and their partners - including the Local Hospital Networks, consumers, community groups, universities, and non-government organisations such as the National Heart Foundation, and Diabetes Australia.

With the Australian National Preventive Health Agency, the program will also build a solid shared evidence base for preventive health interventions in primary health care that work.

Where evidence is currently lacking, the program will seek to generate evidence by gathering and evaluating robust data.

And it’s that kind of evidence - whether it’s through that particular preventive health program, or the work of the National Health Performance Authority, that will help to spread success across our primary health care system.

I know the AML Alliance and Medicare Locals across the country have been working hard to do that.

I’ve been impressed by your work with NACCHO, the masterclasses you’ve run for Medicare Local CEOs, and indeed the conference here this week.

Spreading success across our health care system

But I know we can do more.

Local health professionals are the best people to be making decisions about the health needs of their communities.

We’ve put our trust in them. And as a Government we’ve backed that up by devolving more decision making power to the local level.

All the Government asks for in return is for Medicare Locals to share their success – to share best practice to drive improvement across the system.

We need to hear the stories about how primary health care is working and making a difference to individuals, communities, and populations.

Medicare Locals should be talking and learning from their communities, from other Medicare Locals, and even from those outside the system.

Every time I talk about this, I think about the STRONG clinic in my electorate. The clinic works to integrate the use of exercise as a mainstream treatment within medicine. Many of the clients are elderly, and each new client undergoes a comprehensive health assessment before an individually tailored exercise program is developed and implemented. It’s hardly rocket science, it’s doing what we all know will work to keep people healthy, out of hospital, and actively participating in life.

I see the great work the team at STRONG is doing and I think: why isn’t this being replicated around the country?

That’s where I think the AML Alliance has a key role to play – extending best practice across our system. There are lessons to be learned from everyone’s experience, and we must take advantage of that knowledge.

While Government is leading the overarching policy direction through the National Primary Health Care Strategic Framework, it’s the on-the-ground work the AML Alliance and its members see and do every day that can most immediately translate to better practice.

I believe AML Alliance is uniquely placed to harness this expertise and drive lasting change across our primary health care system.

Conclusion

I know that through the changes the people in this room are making - through your drive, energy and commitment, we can make the most of this historic time for primary health care, for our health system, and for the people of Australia.

Together, and on the best evidence, we are making the case for shifting the centre of gravity to primary health care…

...we’re seeing the success of local decision making…
...and we’re working to spread that success right across the system.

Thank you.

ENDS