GPDV Board Summary
Friday 11th February 2005
1. New funding for positions at GPDV
Hepatitis C
Michelle Wills has been employed in the half-time position for the Hep C project
Palliative Care
DHS has confirmed the funding for the PEPA 2 program of clinical attachments for GPs in Palliative Care. DHS also proposes a project to support the strengthening of linkages between divisions and palliative care agencies.
2. Review of the options for the re-establishment of the SBO in WA
ACIL Tasman is conducting review of options to re-establish the SBO. The DoHA view is unknown but there is a surprising level of concern in WA that if the SBO is re-established as an independent organisation the same problem would re-occur with next CEO. There was no unanimous opinion regarding this issue at the ASBO Coalition meeting.
3. Quarterly ADGP/SBO meeting
The progress of the RIC: DoHA stated that the lack of services from some divisions had been raised as an issue of equity for consumers; the work of the Structural Efficiency Working Group on possible ways to enable some lower-performing divisions to lift their game is seen by DoHA as an important part of RIC's work.
ADGP/SBO relationship: ADGP had tabled a proposal for the definition of roles that clearly stated ADGP's intention to concentrate on its work at the national level and to support SBOs in their work at the state level and with divisions. This is the breakthrough that we have been working for over several years and augurs well for the development of a more effective network.
Primary Care Policy: in discussion of the report that ADGP are working on a draft but that there is a sense the pressure is off, the board agreed that it is important that divisions should drive the development of the policy because they link Commonwealth and State programs. If there is a chance that ADGP will be unable to advocate strongly for the development of a policy because it is nobbled by its contract with DoHA, then GPDV must use our policy paper to keep the pressure up.
4. Review of RWAs
The meeting had agreed to take the position that workforce issues should be dealt with in a more integrated way, rather than fragmented. SBOs supported one agency to manage all workforce issues both rural and urban in each state, with the exact model to be used varying to suit the circumstances in each state.
In discussion Rob & Wendy commented that RWAV is providing valued services to rural divisions and would be reluctant to take on work for urban divisions because that might dilute its focus on rural recruitment and retention. Rural divisions are already losing GPs to the outer metro areas under the Commonwealth's incentives program.
5. Medication Management
The board supported the submission with the inclusion of a comment opposing the de-funding of MediConnect.
6. DHS Discussion
Janet Laverick, Director, Primary & Community Health, DHS, attended
Ambulatory Care: DHS priorities are to move HARP from its project base to mainstream services and to strengthen support for chronic and complex care. The Primary Care Branch is developing an Ambulatory Care Framework through which to roll out changes and initiatives. GPDV will be included in consultations about this development. To increase involvement of local services and divisions, Regional Offices will use PCPs to develop local care pathways;
GPs in CHCs Program: DHS will consult GPDV on the guidelines for the new funding round to ensure that divisions' concerns are recognised. Janet acknowledged the importance of engaging with divisions and GPs and said that. DHS will require submissions to give evidence of consultation with divisions, although this will not give divisions veto power.
Super Clinics: Super Clinics at Lilydale, Melton and Craigieburn are the government's policy statement and are not negotiable. The services to be provided have not been decided, but there is no standard list of services to be provided by Super Clinics. The services will be planned locally after a review of existing services in those areas and local consultation, which will include divisions. The aim is to provide access to necessary specialist (including diagnostics and day surgery) and allied health services locally so that patients do not have to go to the city. DHS is considering governance arrangements for Super Clinics and recognises that these will affect the engagement of GPs and other service providers.
GP clinics & EDs: DHS are considering the options for services to relieve the pressure on EDs and to provide access to medical services where there are no GPs, no after-hours GP services or no bulk-billing GPs. The options include Walk-in/Walk-out clinics, co-located clinics, after-hours services such in Moe, GPs in CHCs, better links between GPs and CHC allied health services, and a review of overseas experience. No decisions have been made and there is much work still to be done. The board commented that many of the models of GP clinics in EDs have been tried without success and offered to collect examples to help in the development of this program. The board also discussed that the choice of model will be completely dependent upon the availability of GPs to do the work at a time when there is a severe shortage of GP workforce.
GPLOs: GPLOs have been successful and are likely to be included in hospital funding. The board suggested that to ensure that the funding is used for effective GPLOs the the employment of a GPLO in full consultation with the local divisions should be a performance indicator for hospital CEOs.
7. Refugee & Asylum Seeker Health Network (RASHN) Victoria
The board agreed to support the approach by RASHN to Minister Pike, seeking funding to provide health services to refugees and asylum seekers who are legally in Australia but are not eligible for Medicare. The board also decided to take the matter up with the Commonwealth Government as the lack of access to Medicare is a national issue
8. Metropolitan Ambulance Service (MAS)
MAS has proposed a service to refer callers in the “sick person” category (who phone for medical advice rather than because they need an emergency service) to a GP rather than take them to ED. The board received Lenora's report on her discussions with Angela Hodgkinson of MAS, and with DHS about the proposal. Lenora said that it is still not clear whether MAS has already recruited a group of clinics to provide the service or whether they want divisions and GPDV to help in recruiting them.
The board noted a number of specific concerns about the operation of the proposed service and expressed some doubt that it will solve the problem. In particular it is not realistic to expect that a problem supposedly caused by a shortage of GPs can be solved by finding GPs with spare time available. The board agreed that MAS needs to do more research into the reasons why people call before deciding on the solution.
9. Displan
The board commented that diaster planning focuses on the immediate needs rather than effects that may only appear years later, which is when GPs pick up the mental health issues. Some longer-term provision must be made in DHS planning.