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Make Medicare Fair: A new deal for rural and remote Australians

Updated: Nov 2, 2023

The Healthy Communities Foundation Australia Ltd has welcomed the announcement by the Federal Government of plans to reform Medicare.


“Australians can rightly be proud of Medicare, and the goal of universal access to healthcare and health equity for all" said Mark Burdack, CEO of the Healthy Communities Foundation Australia Ltd.


“However, history has shown us that a 'one-size-fits-all' Medicare model is ill-equipped to address the diverse needs of all Australians, particularly those living in rural and remote communities.


“Over the years governments have acknowledged the problem by providing a mix of block and activity based funding for primary health care services to vulnerable communities and groups that were not receiving equitable access to appropriate services under Medicare.


"The Foundation is of the view that rural and remote people need the same type of support including a blended funding model to support locally integrated people-centred care.


"While the detail of the governments plan is still to be announced, we are encouraged by the proposed focus on GP-led team-based care which is a model closely aligned with how rural and remote primary health care has worked for decades.


“There is much that the government can learn from rural and remote communities and how they have innovated to strengthen primary health care systems in very difficult circumstances over many years.


"We will be talking to the Federal and State Governments about the need for a targeted approach to the health of rural and remote communities that better reflects their needs and ensures fairer access to health care for some of the most vulnerable Australians.


"We are looking forward to the opportunity to ensure rural and remote people are heard in this reform debate and that we get the balance right so we can strengthen Medicare for all Australians" said Mr Burdack.


About Us

The Healthy Communities Foundation Australia Ltd was established 20 years ago as a charity to work with rural and remote communities to create healthier futures. Over that period we have helped 17 rural and remote towns to create their own community-led models of primary health care, and established internationally recognised innovative models of care that better meet the needs of disadvantaged communities and groups.


Background

The National Rural Health Alliance has reported that the Federal Government saves upwards of $4 billion annually on Medicare and related services because rural and remote people cannot access a local GP. That is a significant number of rural and remote people not getting access to the healthcare they need, and a large amount of money that no longer flows into jobs and economic activity in rural and remote towns.


Medicare is an activity-based funding model that pays doctors more money to deliver a short consultation, rather than to take time to work with patients with complex health needs (the more patients a doctor is able to see in a day, the more Medicare rebates are generated).


The design of Medicare has contributed to doctors and health professionals leaving rural and remote communities to work in major cities where there are larger populations, and lower rates of complex illness, enabling health professionals to generate higher levels of activity and Medicare income. Over time, small rural and remote towns were unable to compete with major cities contributing to the decline of the medical and health workforce in these communities, and taking health services, jobs and economic activity with them.


Blended funding and multi-disciplinary team care models have been proven to be more appropriate when addressing the needs of small communities and groups.


At the same time, the outsourcing of the bulk of our rural medical workforce programs and funding to major city organisations has contributed to a steep decline in the number of medical graduates wanting to work in general practice from a high of 40% to around 13% today. By comparison, universities such as James Cook in northern Queensland have proven that rurally designed and based programs that target rural and remote students are significantly more successful in attracting and retaining GPs in rural practice.


What we are doing

The Foundation has developed a proposal for the establishment of Community Hubs in rural and remote towns across Australia, based on our innovative community hub program and remote integrated and collaborative care model, that bring together State and Federal health, social assistance and community development functions, jobs and funding to address the health needs of communities holistically and sustainably. The Community Hubs would be a single co-located facility offering a wide range of human and health care services governed by a community board which is able to contract services to non-government organisations to ensure that service design reflects local priorities and needs.


The Foundation has also developed a proposal for the establishment of Rural Integrated Health and Medical Training Centres, built on our more than 20 years of success in attracting and retaining doctors and health professionals in rural and remote towns. It is proposed that State and Federal governments work together to create rural and regional community-run primary health training network organisations with a strategic focus on multidisciplinary care, ensuring that our rural medical and health workforce programs support the aspirations of rural and regional people to 'grow their own' medical and health workforce.


For more information contact Mark Burdack on 0418974988.

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