‘Worst shape it has been in 40 years’: Huge Medicare shake up to offer after-hours GPs

A huge overhaul is coming to Medicare, with the Albanese government promising a spate of new measures to strengthen the crippled health care system.

The biggest shake-up of Medicare in decades is set to deliver after-hours GP clinics to take the pressure off emergency departments and teams of doctors, nurses and physiotherapists offering longer consults.

Declaring the health system is in “the worst shape it has been in 40 years”, the Albanese Government has vowed to take action but claims simply paying GPs more alone isn’t the answer.

Instead, it is proposing big changes including reforms outlined in the Strengthening Medicare Taskforce report released on Friday.

The issue was also discussed at national cabinet, although state premiers emerged without any clear outcomes.

Minister for Health Mark Butler says it’s time for a Medicare reform. Picture: NCA NewsWire /Philip Gostelow

“It has never been harder to see a doctor, particularly a GP, than it is right now,‘’ Health Minister Mark Butler said.

“And it’s never been more expensive. As I’ve pointed out now on a number of occasions, for the first time in the 40-year history of Medicare, the average gap fee for a standard GP consult is now more than the Medicare rebate itself.“

“Medicare has been the crowning achievement of our health system for 40 years, but it is time for reform.”

Longer consults is also another key recommendation to stop GPs rushing patients through under the fee for service model.

“We need to improve access after usual office hours,” Mr Butler said.

“The former government did not allocate a single dollar to support general practice operating beyond 6pm after June 30. All of the after-hours programs that for many, many years have allowed general practice to offer patients care after 6pm into the night all finish on June 30.

Mr Butler said Medicare is the “crowning achievement of our health system” but it’s in dire need of a shake up. Picture: Supplied

“Their last budget before the election contained not an additional dollar. So we will obviously have to respond to that. The report also recommends better access for Urgent Care. It recommends the ability for GPs to be able to bill for longer consults – particularly reflecting the more complex, chronic nature of so many presentations from their patients. Sometimes in the area of mental health.”

The report recommendations include:

• Improve access to primary care in the after hours period and reduce pressure on emergency departments by increasing the availability of primary care services for urgent care needs.
• Support general practice in management of complex chronic disease through blended funding models integrated with fee-for-service, with funding for longer consultations.
• Support better continuity of care, a strengthened relationship between the patient and their care team, and more integrated, person-centred care through introduction of voluntary patient registration.
• Develop new funding models that are locally relevant for sustainable rural and remote practice in collaboration with people, providers and communities. Ensure new funding models do not disadvantage people who live in communities with little or no access to regular GP care, and whose care is led by other healthcare providers.
• Strengthen funding to support more affordable care, ensuring Australians on low incomes can access primary care at no or low cost.

Mr Butler said chronic diseases including diabetes, high blood pressure and obesity required a different approach.

“The needs of patients today are very different to the needs of the 1980s,” he said.

“Back then, most presentations to a GP were episodic, relatively short, and were to deal with a point in time or a short period in time need from a person‘s healthcare perspective.

“Now we‘re dealing with much more chronic disease, ongoing need, and older Australians who tend to have more than one healthcare condition.

“The recommendations from this report are firstly the critical need to use our health workforce more fully, and to allow all of our healthcare professionals who are trained at vast community expense to operate at the full scope of their practice, to use all of their skills and all of their training rather than being restricted by outdated regulations and, frankly, too often, turf wars between different groups within the healthcare system.”

The shake up could see more after-hour GP clinics. Picture: News Regional Media

An expansion of the MyHealth record is also being proposed to improve the provision of e-health in the system.

“So, time and time again, a patient goes to their doctor, talks about their conditions, and their tests are not available for the GP to look at and use as part of their diagnosis and treatment decisions,” he said.

“We’ve got to do better there. Our government has no higher priority than strengthening Medicare and rebuilding general practice to ensure that Australians get the care.”

However, he also warned the problems were too big to fix overnight.

“I want to tell Australians it‘s not going to be quick and it’s not going to be easy, and it’s not going to be fixed in one budget,’’ he said.

“But this report sets a very clear challenge to government about how we start to turn things around in general practice and primary care more broadly. And this government is up for that challenge.”

Originally published as ‘Worst shape it has been in 40 years’: Huge Medicare shake up to offer after-hours GPs