GP Task Force Final Report

On 15 September 2009, the ACT Minister for Health, tabled the final report of the GP Taskforce in the ACT Legislative Assembly. The report is entitled General Practice and Sustainable Primary Health Care: The Way Forward and is available online (454kb Pdf)

The report presents the outcome of the ACT GP Taskforce’s debate and deliberation following consultation with a broad range of people and organisations

The final report provides the ACT Government with a range of recommendations that supports the provision of general practice and contribute to building a system of sustainable primary
health care for Canberra.

The Report covers issues including

• Workforce Challenges such as workforce supply and better support for General Practice
• Development of the non-medical workforce
• Short and long term sustainability
• Evolving service models
• Access to primary care for Residential Aged Care Facilities
• linking with Government's sustainable transport plan
• Health Literacy and e-Health
• Develop easy to read guidelines for the community and the profession on how to access health records
  

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National Primary Health Care Strategy

The Primary Health Care Strategy has been released.


The Key Priority Areas are:

1. improving access and reducing inequity;
2. better management of chronic conditions;
3. increasing the focus on prevention;
4. improving quality, safety, performance and accountability.

Central to achieving this are:

• patient-centred focus
• eHealth system and
• well educated and distributed workforce

The issues for consumers in accessing primary care have been identified and summarised in the document:

For individuals, the primary health care
services they access and the quality of
care that results can depend on where
they live, their particular condition, and
the particular service providers involved,
as much as their clinical needs and
circumstances. Many patients, particularly
those with complex needs, can either be
left to navigate a complex system on their
own or, even when supported by their
general practitioner (GP), be affected by
gaps in information flows and limited
ability to influence care decisions in other
services. (p.9 Strategy)

we will be very interested in following how this reform is implemented and how the community will be involved.
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Building Relationships - broadening our representation

In August HCCA was delighted to conduct training for the Canberra Multicultural Community Forum. The training sessions focused on the health rights, consumer participation and how consumers and advocates can participate in decision making in the ACT health system.
The workshops were valuable and HCCA staff gained important insights from the CMCF participants which we will use to frame responses to health policy. we would like to thank CMCF for their time, enthusiasm and willingness to build a relationship with HCCA.


HCCA President, Dr Adele Stevens, and Vice President, Marion Reilly, attended the first session and shared their experiences and insights as consumer representatives and being involved in an advocacy organisation. Russell McGowan, HCCA Secretary, attended the second session and we engaged in a lively discussion on health reform.

One thing HCCA does for all our training sessions ask consumers what they would like to change about the health system. The responses to this question are below.

What would you like to change about the health system?

Consumer Feedback
Increased representation from inclusive community
Better consultation process with all stakeholders
More efficient uses of resources from a diverse workforce
Overcome the top HEAVY administration in hospitals

Workforce
Better understanding by health professionals about cultural attitudes to health and their expectations for behaviour of clients
Doctors in hospitals who know as much as nurses about wound recovery etc. (they are often unaware of the long term effects of their treatment and they don’t know their patients.

Research
More funding for research into areas affecting consumers such as gluten intolerance

Home and Improve Aged Care support service – have community representative on the HACC committee. Not just restricted to service providers.
Better primary health care – subsidised fees for gym membership?

Navigating the System
More accessible information about services that are available especially for aged people.
More information about assistance for elderly people to let them stay in their own homes

Access
Access to dentists for all
Valet parking for Canberra Hospital!
Better transport to parking at Canberra Hospital
Reduce waiting at Emergency Department

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Sick Around the Word

Frontline is an online and on air journalism program that looks at critical issues we all face. Last year they worked with a senior reporter from the Washington Post to look at the delivery of health care. The program can be viewed online.

This program, Sick Around the World, looks at how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures.

• UK - there is the government funded National Health Service (NHS)
• Japan - everyone must buy health insurance, either through an employer or a community plan
• Germany - offers universal health care, including medical, dental, mental health, and homeopathy
• Taiwan - the government collects the money and pays providers but the delivery of health care is left to the market.
• Switzerland - health reform saw the establishment of a universal health care system that restricted insurance companies from making a profit on basic medical care

This is of particular interest given the current moves to reform the US health system. The Wall Street Journal has been critical of Obama's move to nationalise the health system and has given attention to what they see as the failures of the NHS. Frontline has posted a 10 minute clip from Sick Around the World that profiles the NHS. This is available online.

HCCA Submission to the GP Task Force

HCCA has made a submission to the GP Task Force. It is available online (290 kb Pdf)

Our community needs primary health care that is accessible, clinically and culturally appropriate, timely and affordable. We based our submission on our research and analysis of consumer experiences and expectations of general practice in the ACT.

We would like thank the hundreds of people who took the time to complete the GP Snapshot online survey and share their experiences and expectations of general practice in the ACT. There is a strong level of interest in the community about access to quality health services.

We would also like to thank the many people in our membership and wider networks who shared their experiences and perspectives with us.

A quick summary:

In our consultations we found that consumers’ experiences of primary health care were varied. Some consumers are very well placed with a regular GP who they can see when the need arises. Other consumers reported that the inadequate supply of GPs presents them with significant difficulties in accessing satisfactory care, including for urgent appointments, referrals, scripts or renewals of prescriptions.

Consumers also reported a level of disruption to their health care with the closure of general practices and move to larger corporate medical centres. The impact of closures of practices on consumers is amplified as many existing GP practices have closed their books to new patients.

One of the strategies consumers have developed to deal with the GP shortage is to have a number of general practices they access. A respondent to the GP Snapshot 2009 said that they had “2-3 GPs because we cannot always get to see the same GP due to difficulties getting an appointment” (Respondent 130).

The extension of “corporate” GP practices with a strong profit emphasis is a cause of dissatisfaction for many health consumers in the ACT; reasons given are reduced geographic access, especially if relying on public transport, no doctor of choice and a ‘production line’ consultation process – a particular concern for consumers with chronic and complex conditions.

The majority (81.2%) of respondents have a regular GP. Respondents were asked to provide reasons for not having a GP. The main reasons given for not having a GP were that the consumers can never get into their preferred GP (17.5%) and that GP Clinics are not taking new patients (16.7%).

The GP Snapshot 2009 was designed to capture a snapshot consumer experiences and expectations of general practice in the ACT.

The survey was developed based on discussions with consumer representatives and members of HCCA. Secretariat to the GP Task Force had seen a draft of the survey before publication. The survey was piloted with a group of HCCA members. It included issues such as whether consumers have regular GPs, waiting times, the quality of the interaction and demographic material and included a number of questions that the GP Task Force had asked practicing GPs.

The survey ran from 15 June - 3 July 2009 and was publicised through HCCA members and networks, and media coverage in The Canberra Times, ABC Canberra and 2CC. There were 635 responses. We think that the number of responses demonstrated a strong interest in the community around this issue.

Our preliminary analysis is included throughout the submission to the GP Task Force. A summary of findings is available online (151kb Pdf). HCCA will continue to analyse the results of the survey and post this to the HCCA blog over time.