Report highlights failure in primary health care

The Grattan Institute, a public policy ‘think tank’, has just published a report entitled ‘Chronic failure in primary care’ (see here). It is disappointing there is little reference to nurses in the report but that aside, it does give a good insight into the problems (and some possible solutions) in Australian primary health care.

Some highlights of the report are as follows:

  • Ineffective management of heart disease, asthma, diabetes and other chronic diseases costs the Australian health system more than $320 million a year in avoidable hospital admissions.
  • Only a quarter of the nearly one million Australians diagnosed with type 2 diabetes get the monitoring and treatment recommended for their condition.
  • Each year there are more than a quarter of a million admissions to hospital for health problems that potentially could have been prevented. Yet each year the government spends at least $1 billion on planning, coordinating and reviewing chronic disease management and encouraging good practice in primary care.
  • Three quarters of Australians over the age of 65 have at least one chronic condition that puts them at risk of serious complications and premature death. Social, economic and environmental changes are the best way to prevent these diseases, but there are much better outcomes where good quality primary care services are in place.
  • The focus must move away from GP fee-for-service payments for one-off visits; a broader payment for integrated treatment would help to focus care on patients and long-term outcomes.
  • PHNs should be given more responsibility for local primary care services. The evidence shows that a consistent, coordinated approach to specific diseases helps primary care more effectively prevent and manage chronic conditions. In regional areas, clear targets and well-designed incentives for disease prevention are vital.
  • There needs to be a focus on more flexible services, which might include greater use of nurses and allied health staff for assessment, planning, coordination, review and support of people with chronic disease.
  • Practice and incentive payments are not working.

Do you agree there are fundamental problems with our primary health care system? Are there any easy, or even achievable, solutions? We would love to know what you think.

29 September

Dear members,

There is a lot happening as we move toward the next health reform challenge. As I have reported in past eNews editions, APNA has attended government consultation around what these new Primary Health Networks (PHNs) might look like and do. Those government consultations have finished but the conversation is not over.

In the past week the Public Health Association Australia has commenced a series of roadshows that will visit all capital cities. APNA has secured representation at each of these roadshow workshops and will participate as speakers and in panel sessions, not only to showcase the valuable role of primary health care nurses but to gauge the thoughts of other key players as to how services might be delivered. What we are all hoping for is PHNs find innovative ways to provide services and models of care to effectively provide primary health care to our communities. APNA will also be sure to state our concerns around the make-up of clinical councils and PHN boards to ensure that essential stakeholders such as primary care nurses are involved in all levels of governance and program development. We will be sure to provide you with feedback as these sessions roll out across Australia.

In other news, the National Immunisation Committee has commissioned consultants to review the guidelines for Immunisation Provider Competencies. This exciting piece of work is in the early stages and I am pleased to be involved as APNA’s representative on the working group. The call for tenders for the review of the Immunisation Handbook are also underway. You will see updates in the Therapeutic Goods Administration bulletin regarding MMRVwww.tga.gov.au/hp/msu-2014-08.htm#vaccine.

Whist we watch with great concern as the reported number of deaths from Ebola has moved past 2000 in the past few weeks, the Australian health authorities advise that the risk status has not changed for Australia which remains very low.

“The Australian Government has measures in place to assist with the identification of travellers who may be arriving into Australia from affected countries. The health of people who have originated their travel from affected parts of West Africa and from the Democratic Republic of Congo (DRC) is being checked. In addition the Australian Government has put in place banners and messaging at our major international airports to raise awareness of the symptoms of Ebola. General practice clinicians are encouraged to become familiar with the Ebolavirus Disease Information for GPs sheet which provides valuable information on what to do if they have a suspected case of Ebola. More info can be found at www.health.gov.au/ebola.”

Regards to all,

Karen