Priorities beyond this term of government must maximise the promised Medicare funding and ensure it is targeted towards improving health outcomes for all Australians.
Victoria’s community health services are at the forefront of providing accessible and equitable care that improves the health and wellbeing of communities. They are well placed to deliver on policies that seek to strengthen primary care, now and beyond this term of government.
Community health services use a multidisciplinary model to deliver a range of cost-effective services spanning primary care, allied health, health prevention and promotion.
Tomorrow’s federal budget is expected to deliver more funding to implement the work of the federal government’s Strengthening Medicare Taskforce. This is a key platform of this term of government, showing serious efforts to improve health equity for all Australians through added investment in Medicare initiatives that keep people out of hospital.
Recent announcements to extend Medicare bulk-billing arrangements, enabling more people to access a GP without an out-of-pocket expense – have been welcomed across the community. This will have a meaningful impact on the care communities can access, ensuring people have care when they need it.
The recent bipartisan pledge of $8.5 billion to boost bulk billing shows commitment from the major parties to deliver a primary care system that supports improved preventative health outcomes for all Australians.
The Victorian Healthcare Association – which represents more than 90% of the state’s $26.8 billion public healthcare sector – has been focused on understanding what is needed to future-proof system-wide primary care.
Equitable access to primary care has worsened in recent years due to cost-of-living challenges.
The proportion of Australians delaying care due to cost is increasing, particularly in areas where socio-economic disadvantage is more pronounced. Health inflation is one of the highest indicators of household inflation, while rising costs are causing almost 70% of general practices to reduce bulk billing.
We know that cost is a significant barrier to people accessing primary and preventative health.
Community health services are a known and trusted part of the community, which enables better connection and access to health services when, and where, people need it.
These services provide wraparound supports that link in with the broader health system to ensure communities can receive integrated care and treatment – ensuring there is no wrong door to access healthcare.
Community health services sit alongside and complement private general practices. They often deliver care above and beyond what they are funded for – including GP services. They provide a trusted and accessible pathway which communities would not otherwise have.
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Community health services often prioritise bulk billing for their community to ensure equitable access to care. Yet, this can have a financial impact for the service.
As I wrote last year, the current shortage of GPs is expected to become a significant challenge over the coming decade.
Community health services deliver a multidisciplinary workforce that leverages a mix of skills and capabilities to treat people with chronic care needs and address the social determinants of health. Yet they face similar sustainability challenges to private general practice and need reliable and purposeful funding to deliver affordable and equitable care.
Additional funding for bulk billing through the recent bipartisan announcements will have a significant impact for community health services. It will allow greater GP access, improving the sustainability of services and enabling providers to better service the collective needs of their community.
Boosting the funding for bulk-billing practices will have tangible benefits for community health services, both in maintaining the sustainability of vital services and addressing workforce supply.
For cohealth, a not-for-profit community health service operating across Victoria and the east coast of Tasmania, this bulk-billing boost will go some way to bridging the gap between the funding it receives and the actual cost of GP care, supporting cohealth to deliver the best possible care for the communities it serves.
This funding will provide support to those who face unfair societal barriers to good health, with integrated and holistic care that connects to other parts of the health and social services system.
For other services across the state, Medicare reform will improve access to care.
The federal government recently reclassified regional and rural locations as more remote. This will benefit a small number of Victorian locations and is supported by a broader suite of initiatives that aim to better distribute the health workforce, including increasing training placements.
Ballarat Community Health welcomes the recent updates to classification systems and supporting initiatives to strengthen Medicare.
The proposed changes will improve attraction and retention of skilled healthcare workforces in regional and rural communities through fast tracked recognition of qualifications for overseas GPs.
Ballarat and other regional and rural towns will benefit from a stronger, more diverse workforce, which will help them to meet rising demand for care closer to home.
The service has also noted increased bulk billing will benefit more people across the state and highlights a commitment to supporting regional communities with more GPs and care, when and where they need it.
The federal government has yet to respond to a series of independent reviews to improve the system of primary care, including into workforce distribution and scope of practice.
As government responds to these reviews, there is further opportunity for community health services to leverage workforce incentive programs and blended funding payments based on areas of community need. Blended funding should give services the flexibility to employ different professionals that can work to their full scope of practice, while supporting primary care planning and coordination.
Community health services are a vital part of our primary care system in supporting communities experiencing disadvantage and at higher risk of complex health issues. Priorities beyond this term of government must maximise the promised Medicare funding and ensure it is targeted towards improving health outcomes for all Australians.
Leigh Clarke is CEO of the Victorian Healthcare Association.