Mapping primary care in Australia
Strong primary care is central to an efficient, equitable and effective health system. Australia has good-quality primary care by international standards, but this report shows that it can and should be better. Too many poorer Australians still can’t afford to go to a GP when they need to, or a dentist when they should. People in rural and remote areas still find it too hard to get to a pharmacist or medical specialist.
Australians’ access to general practice varies according to their means. Two-thirds of Australians are bulk-billed for all their visits to the GP. But for those who are not, the financial barriers can be high. About 4 per cent of Australians say they delay seeing a GP because of the cost.
Individuals or their private health insurer have to pay for the bulk of dental care. As a result, about one in five Australians do not get the recommended level of oral health care. Worse, people on low incomes who can’t afford to pay often wait for years to get public dental services.
Access to allied health services such as physiotherapy and podiatry varies significantly according to the patient’s address. Victorians are nearly four times more likely to use Medicare-funded allied health services than people in the Northern Territory.
More broadly, the funding, organisation and management of primary care has not kept pace with changes to disease patterns, the economic pressure on health services, and technological advances.
In particular, primary care services are not organised well enough to support integrated, comprehensive care for the 20 per cent of Aus- tralians who have complex and chronic conditions. Nor is primary care well organised to prevent or reduce the incidence of conditions such as type 2 diabetes and obesity. Broader community-level functions of primary health care – such as developing self-help groups and promoting healthy environments – are also being neglected.
Primary care in Australia is typically delivered by many thousands of small, private businesses: the local dentist, pharmacist, physiotherapist or GP clinic. Funding and payment arrangements are fragmented and variable. There is insufficient data to properly plan the distribution of services and monitor the quality of care. Governance and account- ability are split between various levels of government and numerous separate agencies, making overall management of the system difficult.
Primary care policy in Australia is under-done. Neither the Common- wealth nor the states have taken the lead.
This report shows new policies are needed: Australia needs a comprehensive national primary care framework to improve patient care and prevention; formal agreements between the Commonwealth, the states and Primary Health Networks to improve system management; and new funding, payment and organisational arrangements to help keep populations healthy and to provide better long-term care for the increasing number of older Australians who live with complex and chronic conditions. Read the full report https://grattan.edu.au/wp-content/uploads/2018/07/906-Mapping-primary-care.pdf