2 February 2023

The Royal Australasian College of Physicians says that without including specialist care in Medicare and health system reform, patients will not get the timely care they need to deal with complex and chronic conditions.

RACP President Dr Jacqueline Small says “We need to make sure that any reform to Australia’s primary care system addresses the importance of integrated models of health care for patients that includes physicians and paediatricians.

“With the Strengthening Medicare Taskforce report due within weeks, we want to see a commitment to including specialist care in future health system reform.

“There is now broad recognition that our health system, especially that covered by Medicare, is struggling to keep up with increasing demands from people with chronic health conditions, an ageing population, and who experience disadvantage.

“Almost half of Australians now have one or more chronic condition¹ and many are faced with increasing waiting times and out-of-pocket costs to see GPs and specialist physicians which lead to preventable complications and hospital admissions.

“We are concerned that the Strengthening Medicare Taskforce has left medical specialist care out of the conversation in addressing these issues, and that this could result in an outcome that means patients can’t access the care they need.

We are calling on the Federal Government to:

• Involve medical specialists (physicians and paediatricians) in the design/operation of urgent care clinics to expand their outreach into community-based care services
• Implement the RACP Model of Chronic Care Management or a variation that integrates and streamlines patient-centred GP, medical specialist and allied care for patients with chronic comorbid conditions and disabilities
• Appropriately index Medicare rebates so they are sustainably aligned with inflation and support equitable access
• Fund a care pathway for medical specialists to be included in the voluntary patient registration scheme to support team-based routine care for chronic patients
• Integrate medical specialists into innovative blended funding models to be implemented as part of the upcoming reforms.

“We know that primary and community health will be at the centre of these reforms, but also that the system cannot be reformed without direct participation from specialists.

“That is because multidisciplinary care takes a team to deliver the types of care patients need, and medical specialists play a key role in delivering effective and cost-effective team-based care across the health system.

“At a first step, we seek a commitment from the Government that any reform of the Medicare system following the Taskforce Report includes a way to integrate medical specialists into primary care.” Dr Small said.