Australia’s national health reforms must improve health equity and prioritise prevention: RACGP

Royal Australian College of GPs

The Royal Australian College of GPs (RACGP) is calling on the Federal Government to use its national health reform agenda to prioritise preventive care to make Australia healthier and ensure no patient is left behind.

In a submission to a key review of practice incentives, which is part of the national health reform agenda, the RACGP said there are significant opportunities to boost prevention and reform the system to meet patient needs in every community.

RACGP President Dr Nicole Higgins said: “We have a once in a lifetime reform opportunity and we need to get it right to meet the health challenges of today, and the future.”

“Just 2% of Australia’s health spending goes to preventive care, which can stop chronic disease in its tracks. The vast majority of funding goes to acute care in hospitals – governments pay more for a single patient hospital admission than what it would cost to send that same patient to their GP twice a week for an entire year.

“We need to refocus our health system to prioritise keeping people healthy and out of hospital, as well as better supporting the growing number of older Australians and people with chronic, complex diseases.

“Chronic disease is exploding. Almost half of all Australians now have a chronic disease, including mental health concerns, and they need complex, ongoing care in the community from their GP and care team.

“If we reform our health system to be proactive about keeping people healthy, it will not only be more cost-effective for health funding, there will also be numerous flow-on benefits for our communities and country. In 2017, the Productivity Commission conservatively estimated that if we can improve the health of people in poor or fair health, it would lift Australia’s GDP by $4 billion a year. It would likely be much more now, given the increasing burden of illness.”

The RACGP President said general practice incentives should be expanded to meet the growing and changing needs of our community and reduce costs for patients.

“The current incentives are a critical part of health funding. While they need to be redesigned, they are key to ensuring disadvantaged patients, including in rural areas, can get the care they need, and the practices serving them stay viable,” she said.

“However, they come with significant administrative burden, and there is a lot of room for improvement and simplification, so GPs have more time to spend with their patients.

“This is a significant opportunity to improve preventive care, right from the start of life, and onwards.

“For example, incentivising four-year-old health checks and optimal development in the first 2,000 days, which sets a child up for life, would make a big difference. And it’s in line with the NDIS review recommendation that these checks are expanded and nationally consistent, so no child misses out.

“Incentives can also help people at-risk of or living with chronic disease by supporting social prescribing, which is used widely by GPs overseas and proven to be effective. This sees GPs prescribe activities to improve their patients’ physical and mental health, such as yoga or social groups, and link workers are employed to connect patients to these groups.

“There are many more opportunities to improve preventive care and health equity in our country, and better support our growing population of older people and those with chronic disease, by reforming our health funding and incentives. Every community in Australia is unique, and we need to ensure they can access the care they need, and that its affordable.”

In its submission to the Effectiveness Review of General Practice Incentives, the RACGP recommended supporting general practices to:

  • employ multidisciplinary teams, including practice nurses and allied health workers, and enable GPs to delegate care to other health professionals in the team, to improve access for patients in a safe environment.

  • prioritise preventive care, including supporting practices to implement social prescribing programs, outreach to hard-to-reach patients, population and community health.

  • provide more after-hours care and expand services to meet the needs of their community and improve access for patients, such as emergency care, skin procedures, or setting fractures in rural communities and deprived urban areas, which face barriers to care.

Other recommendations included:

  • Increasing support for Indigenous health services and practices to provide better care for Aboriginal and Torres Strait Islander patients and

  • Unlocking health data to improve patient care, including for mental health, health promotion and illness prevention, chronic disease, and public health issues.


/Public Release.