Webinar highlights opportunities for primary health reforms
Proposals for big changes to primary health care have recently been presented to the Government so this week’s #CHF Talks webinar on the subject was timely.
The 20 recommendations in the discussion paper of the Ministerial Primary Health Reform Steering Group include extensive options for reform, ranging from effective integration of what are now fragmented primary health care arrangements, a greater focus on patient-centred care, stronger supports for preventive health and for allied health services, and support for changes to the current Medicare fee for service system.
The webinar brought together health leaders with four different perspectives and experiences with primary health care. Their conversation served to highlight not only the variety of issues in primary care but also the great potential for improvement.
Alongside cautious Federal Government steps towards reform, health enterprises around Australia are introducing innovations in primary health care that could be more widely implemented.
The Steering Group states that while it has significant strengths, Australia’s primary health care system has “significant weaknesses in its current structure and funding. The current health system was designed to respond well to individual presentations but given the growing burden of chronic disease and the need to focus on population health, system integration and prevention, it is no longer fit for purpose.
“Without attention, the primary health care system will have limited ability to respond to challenges in caring for Australian people over the next ten years and beyond. This particularly applies to care continuity for the growing number of Australians with chronic disease, mental health needs and frailty; workforce development; resourcing; regional service integration; and futuristic models of care,” the report states.
At the webinar we were fortunate to have on the panel the Steering Group co-chair, former AMA President and long-time advocate of primary health reform Dr Steve Hambleton.
He was joined by Dr Dawn Casey, Deputy CEO, National Aboriginal Community Controlled Health Organisation (NACCHO), Mr Ray Messom, CEO, Western Sydney Primary Health Network and Dr Gabrielle O’Kane, CEO, National Rural Health Alliance.
Dr Casey spoke about the success of NACCHO organisations in curbing the spread of COVID in communities. An important part of the success of ACCHOs was that all the staff of local organisation know their patients and all the patients know the staff, she said.
What has contributed to the ongoing success of the ACCHOs was the community-controlled aspect which fostered not only people’s self-determination in health care but also promoted community care — a factor that has been vital in countering COVID, she said.
Central to primary health reform will also be enabling community-based integrated care. Ray Messom described his network’s drive to develop a one system health care in Western Sydney so that the variety of services collaborate with the aim of patient-centred care through integrated, coordinated, comprehensive and accessible services.
An example of this focus has been a cardiology in the community program in Western Sydney which enables continuity of care through from early intervention for patients with heart conditions, through treatment to support for the patient’s return to the community.
The National Rural Health Alliance is proposing a copy of the NACCHO model. Dr O’Kane introduced a new concept to counter the paucity of health services in the bush — RACCHOs, or Rural Areas Community Controlled Health Organisations. These would support integrated, multidisciplinary, pool-funded structures that would serve patients better and make it more attractive for health professionals to move to the bush.
Dr Hambleton said a central point to make about the need for primary health reform was that the focus needed to be on “the person not the patient”.
Our health care needed to move away from an illness to a wellness focus, embracing such factors as the social determinants of health. It was no good fixing somebody’s diabetes if they had not home to go to, he said.
A new funding model was needed to free up GPs to work in team settings for better patient-centred care.
Change is a big challenge, but Dr Hambleton emphasised the opportunity to act is now, with a supportive Health Minister who had established the primary reform process and health professions who supported change.
CHF has for years campaigned to promote the consumer interest in primary health reform. The webinar has further strengthened the case that strong primary health strengthens all Australians.