Delivering local health solutions through General Practice

Medicare Locals -Opportunities for the Sector -Working with ACCHOs & Medicare Locals Chris Pickett, Director WAGPN New Decade, New Opportunities Aboriginal Health Council of WA – Annual State Sector Conference 12 th -13 th April 2011

The History Rudd Government came into power – Health Reform was a key election commitment. -National Health and Hospital Reform Commission (NHHRC) established -Interim Report released for consultation -Final NHHRC Report released -A National Preventative Health Strategy was developed: Australia: The Healthiest Country by COAG discussion and agreement in 2010 & 2011

National Health and Hospital Reform Commission - Established by the Rudd Government in February 2008 to develop a long-term health reform plan for a modern Australia. Dr Christine Bennett to Chair the Commission -Interim Report released in February 2009 – Extensive consultation with health sector and community. - Final Report released in June 2009

- Lots of argy bargy between the PM and State Premiers over the details of the package. In reality the WA Government’s concern was not with the content but more regarding the States GST share. - In 2010 WA unwilling to sign off on Health reforms due to concerns over GST and Mining Supertax – they have since agreed at February 2011 COAG Budget announcements - Single funder for primary health care in Australia (Commonwealth) - New National Health and Hospitals Network with LHNs and Medicare Locals - Medicare Locals to develop from the existing General Practice Networks - MLs to be fully established by July 2012 with the first 15 to be in place by July 2011 What's happened over the past 18 months?

What's happened over the past 18 months? Extensive consultations with Government on the roles and function of the Medicare Locals. - Detailed Boundary Mapping exercise conducted to determine the number, size and population coverage of the MLs - Initial Expressions of Interest called in December 2010 – 58 proposals lodged by 113 GPNs across Australia (involves merging of a significant number of GPNs) - Detailed proposals sought from General Practice Networks in March 2011 closing last week on April 5 th. (Important - GPNs will be defunded from July 2012) Announcement of the first 15 expected mid May to commence operation from 1 July 2011

National Health and Hospital Reform Commission What problems are they trying to solve: Australia’s Health System has strengths but There is a declining health workforce - Increasing levels of chronic disease -Continuing inequity of access and outcomes There is divided responsibility for different parts of the health system leading to inefficiencies and the ‘blame game’. The system is complex, hard to navigate and too focused on acute (hospital) care.

- The primary focus of the Australian Government’s reform agenda and the COAG National Health and Hospitals Network Agreement is a new National Health and Hospitals Network (NHHN). - The Network will consist of Local Hospital Networks (LHNs) working closely together with regional Primary Health Care Organisations (PHCOs), now known as ‘Medicare Locals’ which are to built on the existing Divisions of General Practice Networks. National Health and Hospitals Network

The WA ML Boundaries: 23/12/10

What will Medicare Locals do? - MLs will be funded to deliver better access, address inequities and coordinate and integrate services, by: Develop Regional Health Plan and Models of Care for their communities. Allocate Funding and ensuring the delivery of comprehensive health services for their population. Address Service gaps. Support the broad health workforce. Work with the LHNs on patient pathways out of hospital. Support community and provider engagement … In some instances – they will deliver programs that promote health and prevent illness, direct health service provision to communities …

What are the opportunities under the Medicare Locals? - A true population health planning approach which: - involves local communities in the planning process - gets away from the ‘one size fits all’ thinking and recognises differences in access to health services, disease burden, population demographics, remoteness, infrastructure, workforce. Local solutions to Local Problems - provides more focus on primary health care (health promotion and preventative health) - Better coordination of scarce resources avoiding duplication and waste by involving service delivery agencies in the planning and delivery solutions

Specific opportunities for the Aboriginal Health Sector: - Involvement in the governance of Medicare Locals -Opportunity to build on the work of the Regional Aboriginal Health Planning Forums as key contributor to the ML -Opportunity to expand the ACCHO model of primary health care into the broader PHC sector -A better understanding at the local level of the needs and challenges facing communities

Specific Opportunities For the Aboriginal Health Sector -As the DGP funding ceases in July 2012 and the AMS funding continues discussions can be taking place now to maximise the best outcomes for communities in the planning stage of MLs -Establish clear pathways of care from AMS to other services that will be operating within the ML boundaries and beyond. -Work with the ML and other providers to develop skills that best suit the needs of the Aboriginal Community

Thank you Questions?