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Primary healthcare
Marcus Dripps

Thanks to the many members who have sent through their congratulations on my appointment to the Primary Health Care Advisory Group. Health Minister Sussan Ley has appointed the committee, which is chaired by former AMA president and Brisbane based GP Dr Steve Hambleton. The committee will be focusing on the management of patients with complex and chronic conditions, and will provide advice about Medicare funding in particular.

This review presents an opportunity to have a broad discussion about the principles underpinning health funding in primary care in Australia. There are a number of key features that are likely to be explored.

Having a system that is patient-centred and allows Australians with chronic, and complex, conditions to be at the centre of their care is an important starting point. The recent passing of Professor David Sackett, the Canadian physician who championed evidence based healthcare, brings an opportunity to reflect on one of the three pillars of his initial theory that is sometimes overlooked. That is, that the preferences of our patients are taken into account in treatment. Recent changes in the Australian health standards, led by work from the Australian Commission on Safety and Quality in Health Care, have brought new approaches to ‘patient centeredness’ to discussions in many care settings. The current review is an opportunity to further embed this principle in primary healthcare. Funding data currently suggest that many Australians choose physiotherapy as part of their treatment, without necessarily attracting direct government funding for these services.

Another critical consideration is that initiatives, care and programs funded in primary healthcare in Australia are based on the changing burden of disease in our communities. It is critical that the system wide focus is particularly targeted at conditions which broadly impact Australians, such as musculoskeletal disorders. The impact of these conditions is often not as high when measured by health expenditure, and it is often a natural focus of health funders to look at conditions which are expensive to manage, rather than those that affect productivity. Musculoskeletal conditions are not only ranked second in the country for burden of disease, but also have an enormous impact on reducing the ability of those suffering from them to engage in the workforce. There are more than 275 000 Australians who report being out of the workforce due to back pain and arthritis.

Obviously physiotherapists are well-positioned to play a key role in managing these conditions. Our natural focus on maximising function and participation in all activities (including workforce participation) is of key importance.

Over the coming months, I look forward to having many conversations about changes in funding models in primary healthcare in Australia. I encourage you all to share your thoughts with APA representatives in your groups and branches, and I look forward to a good outcome that benefits our patients, and the Australian community as a whole.

APA National President

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