Name: Assessing the State of Australian General Practice: exploring challenges & future outlook
Uploaded: 2023-06-30T05:14:20.077Z
Duration: 449.37
Description: In this video, Charlotte Hespe, a GP and faculty chair for the Royal Australian College of GPs, discusses the challenges facing general practice in New South Wales. She highlights the workforce crisis, low remuneration, and the need for funding reforms. Join her while she calls for better funding, incentives, and coordination of healthcare data for a sustainable healthcare system.

Professor Charlotte Hespe - Edited.mp4

Professor Charlotte Hespe - Edited.vtt

Subtitles

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Hi, I'm Charlotte Hesby.

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I'm a GP.

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I'm the New South Wales

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and a C T faculty chair

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for the Royal Australian

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College of gps, and I'm also

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head of general practice

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at Notre Dam University.

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Sydney.

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General practice at the

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moment is technically in a

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state of crisis and that's

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because we have problem with

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workforce and the problems

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with workforce are complex.

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One is about

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actually recruitment.

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So attracting medical

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students to come into general

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practice from medical school

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we really need 45 to 50% of

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medical graduates to choose

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general practice, and at this

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point in time, 13.8% are.

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We also know that currently

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we haven't been able to

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have enough GPs ourselves.

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So 52% of our workforce

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has been trained overseas.

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On top of that, we're an

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aging workforce, so there

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is not enough GPs to be able

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to, in 10 years time, we know

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we're gonna have an absolute

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crisis because there's a

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number who are just about to

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retire and leave practice.

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So with the majority of

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workforce being older, that's

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a potential extra prices.

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And then the final one

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is that because the lack

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of remuneration,  and the

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difficulty I think in feeling

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valued within the health

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system, because of the way

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the Medicare rebate system

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is set up, we're actually

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finding a lot of,  GPs who are

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within the right age range are

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also being attracted to jobs

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which really use their

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skills as GP much better

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remunerated and are giving

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them better access to

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leave, maternity leave

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and those sorts of things.

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So if we're gonna look at

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sort of funding reforms

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for general practice,

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there's a couple of things.

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We do need to really

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look at the rebate system

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itself and what it talks

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about, the value of the

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care that's being offered.

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Currently we know that

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the rebates nowhere near

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cover the cost of what

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it cost to provided.

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So it's about 45%, of

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the cost of delivering

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service is the rebate.

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So that needs a body of work.

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But we also, that's,

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Medicare is good for actually

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valuing volume and pushing

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through a fee for service.

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But really if we actually

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want to, actually get general

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practice better funded.

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And actually really look at

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being able to deliver high

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quality, high value care.

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Then we also need to

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be looking at ways

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to incentivize, other

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parts of the system.

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The general practice to

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support the gps,  other

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parts of people who can

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assist, like practice

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nurses, and the practice

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manager to actually help

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fund what those sorts

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of things look like.

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And then we also need to

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be incentivized to actually

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work together as a team with

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all the other parts of the

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allied health system, who can

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really also help decrease the

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cost and the burden of, the

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general practice workload.

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But obviously we need

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to actually address the

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workforce, and that's a really

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big body of work around the

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culture of medicine itself and

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how we value general practice.

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So we actually need to

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understand the value of

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general practice to then be

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able to incentivize it in a

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way that then attracts medical

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graduates to come into it.

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We also need to really

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be able to fund,  GPs to

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be able to go and work

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in the difficult places.

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You know, until we solve rural

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and remote we are not gonna

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really be able to make sure

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that we equitably give good

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healthcare, but if we are not

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solving that in the cities,

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we're never gonna be able

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to solve it in rural remote.

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So we really need to look

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at some innovative models of

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care, ways of being able to

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actually incentivize the gps

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to work across maybe some,

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you know, telehealth and other

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models of virtual healthcare,

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but while providing

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continuity of care that is

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very much patient-centered.

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So it's sort of like, We

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need to actually have some

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funding to enable research

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around what different models

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of care might look like.

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And then finally, we

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really need to address

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the fact that there need

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to be flexible models.

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So there needs to be some ways

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of funding, the provision of

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general practice as a salary.

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That's aligned with the local

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health districts and state

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funding at the same time as

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taking it across into fully

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privatized care and what those

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differences might look like.

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So that we can actually

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really address,  the

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problem of workforce,  and

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the problem of funding.

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I think one of the real

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barriers,  is for being

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able to improve what we

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do is really is funding.

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And the funding, because

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it comes from federal,

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for gps, yet the hospital

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system is funded by states.

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And while that happens,

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there is actually very little

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incentive for the federal

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government to change what

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they're doing for general

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practice because they're

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never gonna reap the benefits.

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The benefits are all going to

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be worn in the state funded

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part of the health system.

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So we need to link them so

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that the benefit for the

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health system in the States

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actually rolls through

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into the federal funded

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part of general practice,

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and gps are rewarded for

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actually improving health

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outcomes and keeping

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people out of hospital.

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I'm a very, very optimistic,

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person and I absolutely

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understand the fundamental

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nature of general practice

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needing to be properly

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funded and supported if

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we really want to have a

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sustainable healthcare system.

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So having that positive lens,

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what we absolutely need to do

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is understand what the, the

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four key roles of the GP are.

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First off though, it's

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all about patient-centered

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care and continuity of care

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and whatever reforms we do

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need to actually have that.

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And we need to make sure

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that we fund appropriately

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acute care, access fund,

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appropriately preventive care,

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chronic disease management,

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and then palliative care

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underneath that framework of

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continuity of care currently,

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because people can go all

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over the place and no one

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is answerable to anything.

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I can access one hospital

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and have $2,000 spent

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on me investigating.

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I can go the next day

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to a hospital just five

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kilometers down the road

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and have the same amount

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of money spent on me.

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We need to actually

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be able to stop that.

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We need to be able to make

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sure that everything is

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all linked together, that

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the data talks to us, and

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then we make sure that that

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patient's journey is both

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optimized in terms of make

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sure the right people and

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the right care is there.

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But at the same time,

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we don't actually, spend

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unnecessary money redoing

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things when the information

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is already being gathered.

Expert Insight

In this video, Charlotte Hespe, a GP and faculty chair for the Royal Australian College of GPs, discusses the challenges facing general practice in New South Wales. She highlights the workforce crisis, low remuneration, and the need for funding reforms. 

Join her while she calls for better funding, incentives, and coordination of healthcare data for a sustainable healthcare system.

Health Insurance

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Charlotte-Hespe.jpg

Charlotte Hespe

Associate Professor RACGP NSW/ACT faculty, Head, General Practice and Primary Care Research, School of Medicine

The current state of Australian General Practice

Necessary funding reforms changes to support and strengthen Australian General Practice

Key barriers and obstacles that hinder the effective functioning of General Practice in Australia

Future outlook of the Australian General Practice

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Fireside Chat (2).png

Assessing the State of Australian General Practice: exploring challenges & future outlook

Funding, Policy & Reform