The much anticipated Strengthening Medicare Taskforce report was released this afternoon following a national cabinet meeting that put healthcare reform firmly at the top of the political agenda for 2023. Prime Minister Anthony Albanese gave it the report a big thumbs up but very little detail in his press conference before handing over to Health Minister Mark Butler, who actually released the report and took some questions.
The positives? It was great to see an acknowledgement that primary care is on its knees and that the last government’s nonsense on bulk-billing rates is now widely dismissed. Even the fact that primary care is now recognised as front and centre of healthcare provision in Australia is a step forward. Hospitals and emergency care may garner the big bucks and the headlines, but primary care is where it’s at.
Mr Butler spruiked the immediate steps his government is making, such as the introduction of urgent care centres and a new GP registrar training model in Tasmania, but he would not be drawn on any new funding bar the $750 million over three years promised before the May 2022 election and the October 2022 budget. He refused to be drawn on any new funding commitments, including the desperately desired Medicare rebate increase, before the next budget in a few months.
While Mr Butler accepted that reforms to primary care are a long term program, little was said about one of the main aims of the Strengthening Medicare Taskforce, which the report itself makes clear. “The Taskforce’s purpose has been to focus on what can be done immediately to strengthen Medicare, backed by the $750 million Strengthening Medicare Fund, and to lay the foundations for longer-term reform and investment in the primary care system,” the report says.
On first perusal, there is no doubt that the report does the latter but fails on the former. Granted there is little that can be done immediately without a big injection of funds, but the report seems to just rehash already existing policy such as the Department of Health’s beloved voluntary patient enrolment system, increases to workforce and bulk-billing incentives and various commitments to team-based care.
Similarly for digital health. Of the five different themes, data and digital is highlighted as the third, which is great to see. But again, there are no immediate initiatives suggested beyond providing “an uplift in primary care IT infrastructure” – the details of which are not spelled out – and a commitment to modernising the My Health Record.
The latter of course is already underway, although there was an interesting mention of “requiring ‘sharing by default’ for private and public practitioners and services”. Does this mandate uploading data to My Health Record rather than on the whim or time constraints of the practitioner? Again, the report is a bit wishy washy on that.
What is clear is that the dearest desire of the rump of My Health Record naysayers that the system be dumped is yet again going to be dashed. While Mr Butler accepted that the system desperately needs improvements to its functionality as well as ongoing funding, the government is going to stick with it through hell and high water.
“If genuinely it is going to be the centrepiece of a connected digital health system,” Mr Butler opined, “we have to improve its functionality. It’s currently a pretty outdated, clunky PDF format system that needs to be able to underpin a real time fully integrated digital health system.”
“We recognise that the Commonwealth has the first responsibility to move here,” he said, “and to upgrade the nature of the My Health Record”. Money will be found, it will keep going, and who knows, incentives might be on the cards to use it.
We’ll have a full report on the taskforce’s recommendations on Monday, but in the meantime, we were struck by how similar the language Mr Butler used when releasing the report today was to the previous government. Greg Hunt famously was “rock solid” on Medicare and used “strengthening Medicare” as a policy platform, and we fondly remember one of his predecessors, Peter Dutton, opining in 2014 about how the new government was committed to “rebuilding general practice” and fixing the PCEHR, only to turn in one of the worst health policy proposals in history with the $5 GP tax. The 2014 slash and burn budget would be one of its only rivals.
So it was interesting to hear Mr Butler talk today about Medicare as being “one of this country’s shining stars” and “the backbone of our healthcare system”.
“But it’s simply not delivering the sort of care that Australians need in the 2020s,” he said. “Our government has no higher priority than strengthening Medicare and rebuilding general practice to ensure that Australians get the care they need when and where they need it in the community in order to take pressure off our deeply stressed hospital systems.”
That could have been said nine years ago, or 18 or 25. Time for the buzzwords to end and actual change to happen.
That brings us to our poll question for the week:
Do you support the recommendations of the SMT report, including investment in modernising My Health Record?
Vote here or comment below.
Last week, we asked: Do you agree with the recommendation to restrict online scripts?
A big majority said no: 73 per cent were against, and 27 per cent were in favour. We also asked why you thought so. Here’s what you said.
So, do readers support the recommendations of the SMT report, including investment in modernising My Health Record? Pretty much yes: 78 per cent said yes, just 22 per cent saying no. We also asked why you voted that way. Here’s what you said:
– The foundational enablers are present in this report. We do need to take a CQI approach that her than start again. The pace just needs accelerating
– It’s not a question of should we have this, but why it has taken so long.
– Yes modernise the My Health Record to enable FHIR capabilities for increased integration with other industry products and systems.
– The system needs a complete overhaul and modernisation given the impending number of older people and competing demands for limited funding. The concept of priority care centres is poorly conceived and will be poorly delivered. The Federal government has a history of failures in all manner of things. The belief that technology will solve what is principally a people business is poorly conceived at best and you only need to look at aged care to see the reality.