Establishment of Medicare Locals and better access to after hours care

The Government will invest $417 million to establish a nation-wide network of primary health care organisations (Medicare Locals) to support health professionals, to improve the delivery of primary care services at a local level and to improve access to after hours primary care.

Establishment of Medicare Locals and better access to after hours care fact sheet (PDF 44 KB)

How will the Medicare Locals work?
How will the after hours primary care initiative work?
What has the Government done so far to improve primary health care for Australians?

The primary health care system - including GP and allied health services - is fragmented, making it hard for some patients to get the treatment they need. Access to after hours primary care varies significantly across Australia and in many areas is either very limited or not available. The lack of consistent after hours primary care places pressure on our public hospitals.

The Australian Government is taking action through its National Health and Hospitals Network. The Government will invest $416.8 million to establish a nation-wide network of primary health care organisations (Medicare Locals) to support health professionals, to improve the delivery of primary care services at a local level and to improve access to after hours primary care.

How will the Medicare Locals work?

Medicare Locals will be independent legal entities (not government bodies) that have strong local governance, including broad community and health professional representation, plus business and management expertise. They will have strong links to Local Hospital Networks, local communities, health professionals and service providers including GPs, allied health professionals and Aboriginal Medical Services.

Medicare Locals will be established in two phases.

• A small number of Medicare Locals will start operating by mid-2011.
• The remaining Medicare Locals will start operating by mid-2012.

Medicare Locals will be responsible for providing better integrated care, making it easier for patients to navigate the local health care system. The roles of these organisations could include:

• facilitating allied health care and other support for people with chronic conditions .
• working with local health care professionals to ensure services are integrated and patients can easily access the services they need
• planning to ensure the availability of face-to-face after hours services for their region .
• identifying groups of people missing out on GP and primary health care, or services that a local area needs, and responding to those gaps by targeting services better
• working with Local Hospital Networks to assist with patients’ transition out of hospital, and if required, into aged care, and
• delivering health promotion and preventive health programs to communities with identified risk factors (in cooperation with the Australian National Preventive Health Agency, once it is established).

As part of the Australian Government’s aged-care package, from 2012-13, Medicare Locals will be provided with a flexible funding pool to target gaps in primary health care services for aged
care recipients.

Medicare Locals will also help roll out the Australian Government’s chronic disease package for diabetes patients by coordinating allied health services for those enrolled in the diabetes management program.

Where possible, Medicare Locals will be drawn from the Divisions of General Practice that have the capacity to take on the roles and functions expected of Medicare Locals. They will be expected
to have some common board membership with Local Hospital Networks.

How will the after hours primary care initiative work?

The Government will improve access to after hours care across Australia by establishing a national after hours telephone-based General Practice medical advice and diagnostic service (this will be an add-on to the nurse triage, information and advice services currently provided by the National Health Call Centre Network trading as healthdirect Australia).

People who need to see a GP at night or on the weekend when their usual practice is closed will:

• contact their local general practice and have their call referred as necessary to healthdirect Australia
• have their condition assessed by a nurse, who will determine whether the patient should have their call transferred to an online GP
• be provided with appropriate advice and options by the nurse if the patient is not referred on to a GP
• where patients are referred on to the GP, the GP will provide further medical advice and treatment options.

To ensure appropriate continuity of care, a record of all GP consultations will be sent electronically to the patient’s usual GP the following morning.

This new service will operate from 1 July 2011 and will provide access to GP advice after hours, from 6pm to 8am Monday to Thursday, 6pm Friday to 8am Monday and on national public holidays. It will be a free service.

From 2013-14, each Medicare Local will be provided with funding to plan and ensure the availability of face-to-face after hours services for their region. These services will be integrated with the new telephone-based GP medical advice and diagnostic service and will be ready to see patients referred to them by the on-line GP. Medicare Locals will also be responsible for ensuring that details of local after hours arrangements in the healthdirect Australia service directory are up to date at all times.

Additionally, to improve after hours care, all new GP Super Clinics will be required to provide extended hours coverage as a condition of funding.

Existing after hours grants and Practice Incentive Program payments will be phased out by July 2013. After hours Medicare Benefits Schedule (MBS) items will remain unchanged.

What has the Government done so far to improve primary health care for Australians?

Since 2007, the Government has:

• committed to funding 36 GP Super Clinics that are being built across the country, enhancing GP and primary health care;
• invested in critical areas of need to ensure that more Australians will be able to access GP and primary health care services. In 2008, the Government increased GP training places by 35 per cent;
• continued to provide grants to support the viability of after hours GP services. In the 2008-09 Budget a total of $76.3 million over four years was made available to support after hours services under the General Practice After Hours (GPAH) Program;
• continued to provide practice incentive payments to encourage general practices to provide quality after hours services. In 2008-09, total expenditure was around $56 million; and
• as part of the MBS Review of Primary Care Items, from 1 May 2010 replaced the Transitional Hours items with MBS after hours items that begin from 6pmon weekdays (instead of 8pm) and from midday on Saturdays (instead of 1pm) (except for non-urgent consultations in consulting rooms).

The costs of the initiative reflect the total new program costs to the Government.

Further information on the National Health and Hospitals Network is at www.yourhealth.gov.auback to top