The Royal Australasian College of Physicians (RACP) says the 2019 Budget contains a number of welcome health measures but did not take the opportunity to significantly invest in prevention and longer term health system reform.

The RACP welcomes:

• $448.5m investment in primary care, particularly measures that enable people over 70 to voluntarily enrol with their GP. We also welcome the opportunity for GP consultations to be provided digitally without necessarily needing a face to face consultation.
• A continuing investment in Indigenous health, including measures to reduce the spread of blood borne viruses and Indigenous youth suicide prevention.
• A further investment of $430m in genomics research.

RACP President-elect John Wilson said while the budget contained a number of welcome initiatives, it has not significantly invested in prevention and more deep seated health reform that will ensure the system is sustainable in the longer term.

We are concerned that public hospitals remain under pressure as clinicians at the coal face treat ever increasing numbers of people who have more complex conditions.

“Australia’s health system is not a collection of band aids – it needs to be a world leading system where prevention is at the core.”

Preventative health

Australia still spends less than 1.5% of its health expenditure on preventative health.

This is considerably less than the UK, Canada and NZ and means there are many missed opportunities in prevention, early detection and quality care, including the needs of Indigenous Australians, people in rural and remote areas, people with mental health issues and the growing cohort of older Australians.

Other measures that should be taken to secure public health include committing to secure, long-term funding for evidence-based prevention measures for overweight and obesity and funding the provision of a minimum schedule of universal preventative health care interventions to be delivered at the time of vaccination to both babies and mothers.

GP chronic disease proposal

The $448 million that the Commonwealth will provide over the next four years for “enrolling” elderly patients with chronic disease is a good start given that an increasing proportion of the community are living with multiple chronic conditions.

However, care for chronic conditions should not be confined to one part of the health sector. Depending on their severity, care and management of these increasingly prevalent conditions requires coordination between the primary, secondary and tertiary sectors. We look forward to the future extension of this model to include consultant physicians and specialists.