Policy Issues Paper No.20 on Consumer & Community Engagement

GPDV Conference 2003

CDM funding

Medical Indemnity

The board noted the importance of providing orientation for consumer representatives to divisions, but agreed that it is not divisions� role to train community and consumer representatives.

The board approved the recommendations from the report:

• That ADGP, GPPAC and DoHA develop consistent policies that focus on promotion by divisions of consumer engagement at the general practice level. This is likely to be of interest to GPs, who can see the relevance of enhancements at the general practice level, and has been repeatedly identified by consumer advocates as a central area of concern (most by Kathy Mott at the 2002 ADGP Forum).
• That ADGP, GPPAC and DoHA resist the development of policies that seek to improve particular organisational structures (such as consumer "representatives" on boards), which are likely to alienate divisions, require considerable time and effort, and run the risk of being ineffective and tokenistic.
• The ADGP work with RACGP, AGPAL and NRCCH on a nationally consistent set of tools and incentives to be used through the accreditation process, drawing on the work done in the UK by Michael Greco and others; and to work to further the incorporation of patient feedback into a CQI cycle in general practices.
• That all players recognise that the central task for divisions of engagement with their communities is challenging and complex; and that DoHA support divisions in that task by investing in evaluation.
• That the development of skills training for community representatives to nationally agreed competencies be supported. Representatives of Commonwealth and State health departments would need to work together with consumer groups to develop these opportunities. Provision of training by a provider external to the Division Program (eg. TAFE) would facilitate the participation of consumer/community representatives on equal terms. Provision of such training by divisions would not fulfil the same function.

The board congratulated Louise and Susan on Paper No 20, saying that it�s possibly the only clear statement on the subject

The board received Susan�s report on the conference evaluation, noting that the conference was a striking success and has drawn compliments from all sides. The numbers were down compared with 2001, which may be connected with a general lack of funds in divisions, anxiety about the future and also because the ADGP forum is now held in November.

The board discussion included:

• The appropriate hostility to the presentation by Brian Johnston, which raised accreditation of divisions as a possibility;
• The role of divisions in data collection;
• A possible larger role for divisions in service delivery;
• The possibility of formal contracts between divisions and practices for the delivery of services by practices (on the IPA model);
• The need for Southern Health Department to join in any effective strategy reforms to general practice; and

The difficultly of holding effective strategic debates in the absence of a Primary Health policy in Australia.

A copy of the Shipman session will be sent to the minister and the Commonwealth Department of Health and Ageing. The board noted that a number of issues were raised in the Shipman session and it is important to communicate these to the appropriate people. The board noted their disappointment at the minister pulling out of the conference on such short notice.

The board�s comments will be included in the final report on the conference when the accounts are all in.

CDM funding

Julie reported that West Gippsland Division have successfully negotiated for some funds from the Gippsland DHS Regional Office. The Gippsland Regional Office has recognised the work that the division is doing around CDM and will fill part of the gap in funding when the cuts take place. The board agreed that an approach to other regional offices would be a worthwhile strategy for divisions.

The board received Bill�s update on the new legislation that will change medical indemnity into an insurance policy. Medical defence organisations are presenting information and advice sessions to GPs and other doctors in preparation for the introduction of the changed system. GPDV has advised divisions wishing to provide support and information to their members to ask MDAV and MIPS to make joint presentations to the division�s GPs. No information is available on the details of premiums or limitations of cover.

The Victorian government has announced some changes to state legislation which may change following the meeting last week of state and commonwealth ministers responsible for insurance. The board agreed that it is appropriate for the AMA to take the lead role and that GPDV should provide information to divisions and encourage them to provide information sessions with MDDs for their GPs, Divisions and GPs in search of advice on indemnity/insurance should be referred to the AMA and their current insurer.