Join Us, for Patients' Sake
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ISSUE 27.05A - JUNE 2 2015 Join us, for patients’ sake AMA’s bold plan to recruit pharmacists to primary health team, pp4-5 6 Medical school call curtains to good policy 8 Govt forces cut-price health checks for kids 9 Open all hours: incentive to boost after hours care 10 Pharmacy handed extra $3bn in five-year deal 11 Medibank abandons controversial GP Access trial INSIDE 12 Winners, losers in GP rural incentive overhaul Budget 2015 Special Report – pp17-29AUSTRALIAN MEDICINE - 27.05A JUNE 2 2015 1 In this issue Managing Editor: John Flannery National news 4-14 Editor: Adrian Rollins Production Coordinator: Kirsty Waterford Special Report Contributors: Sanja Novakovic Odette Visser Graphic Design: Streamline Creative, Canberra BUDGET 2015-16 17-29 Advertising enquiries Columns Streamline Creative Tel: (02) 6260 5100 15 AMA IN THE NEWS Australian Medicine is the na tion al news publication of the 30 RESEARCH Australian Medical Association Limited. (ACN 008426793) 42 Macquarie St, Barton ACT 2600 31 AMA MEMBER BENEFITS Telephone: (02) 6270 5400 Facsimile: (02) 6270 5499 Web: www.ama.com.au Email: [email protected] Australian Medicine welcomes diversity of opinion on national health issues. For this reason, published articles reflect the views of the authors and do not represent the official policy of the AMA unless stated. Contributions may be edited for clarity and length. Acceptance of advertising material is at the absolute discretion of the Editor and does not imply endorsement by the magazine or the AMA. All material in Australian Medicine remains the copyright of the AMA or the author and may not be reproduced without permission. The material in Australian Medicine is for general information and guidance only and is not intended as advice. No warranty is made as to the accuracy or currency of the information. The AMA, its servants and agents will not be liable for any claim, loss or damage arising out of reliance on the information in Australian Medicine. AMA LEADERSHIP TEAM President Vice President Associate Professor Dr Stephen Parnis Brian Owler NEWS AMAAMA wantswants toto recruitrecruit pharmacistspharmacists toto primaryprimary healthhealth teamteam Patients would suffer fewer adverse reactions to medicine available medications,” A/Professor Owler said. “Evidence shows and be almost $50 million better off while governments would that the AMA plan would reduce fragmentation of patient care, save more than $500 million under an AMA plan to integrate improve prescribing and use of medicines, reduce hospital pharmacists into general practice. admissions from adverse drug events, and deliver better health outcomes for patients.” In a major pitch to improve patient care, reduce unnecessary hospitalisations, and boost cost-effective GP-led primary care, The proposal, developed in consultation with the Pharmaceutical the AMA has developed a proposal to employ non-dispensing Society of Australia, could prove a game-changer in fostering pharmacists in medical practices. closer collaboration between GPs and pharmacists. It is estimated that a quarter of a million hospital admissions It has come amid a concerted push by some in the each year are related to the use of prescription drugs, costing the pharmaceutical sector to encroach upon areas of medical country $1.2 billion, while around a third of patients fail to comply practice in an effort to offset declining revenues from dispensing with directions for taking their medicines, undermining their medicines, including authorising pharmacists to administer health, causing adverse reactions and wasting taxpayer dollars. vaccines and conduct health checks. AMA President Associate Professor Brian Owler said that The AMA has warned governments that allowing pharmacists to integrating non-dispensing pharmacists within general practices practise outside their field of expertise could put patients at risk, as part of a GP-led multidisciplinary health team could go a long undermine continuity of care and increase health costs. way to addressing these problems, improving patient health and The AMA stressed that under its new proposal, pharmacists cutting costs. working within general practices would not dispense or prescribe “Under this program, pharmacists within general practice would drugs, nor issue repeat prescriptions, and would instead focus assist with things such as medication management, providing solely on medication management, including advising GPs on patient education on their medications, and supporting GP prescribing, drug interaction and new medicines, reviewing prescribing with advice on medication interactions and newly patient medications and monitoring compliance, improving Continued on 5 ... 4 4 AUSTRALIAN MEDICINE - 27.05A JUNE 2 2015 NEWS AMA wants to recruit pharmacists to primary health team ... from p4 coordination of care for patients being discharged from hospital “The policy will likely to lead to improved compliance and with complex medication regimes, and ensuring the safe use persistence with medication regimens, which will result in and handling of drugs. improved health outcomes for patients,” the Deloitte report said. “This will result in significant avoided financial and economic The proposal calls for medical practices to be awarded costs for both the patient and the health system, as well as Pharmacist in General Practice Incentive Program (PGPIP) avoided broader economic costs such as lost productivity that payments similar to those provided to support the employment arise when a health condition is treated and managed sub- of practice nurses. optimally.” The AMA has proposed that practices receive an incentive payment of $25,000 a year for each pharmacist employed for ADRIAN ROLLINS at least 12 hours 40 minutes a week, capped at no more than five pharmacists, meaning practices can receive no more than $125,000 a year – except those in rural and remote areas, which would be eligible for a loading of up to 50 per cent. An independent analysis of the proposal commissioned by the INFORMATION FOR MEMBERS AMA and conducted by consultancy Deloitte Access Economics estimated that if 3100 general practices joined the PGPIP program it would cost the Federal Government $969.5 million Mental health survey for GPs over four years. General practitioners are being invited to take part in a brief The consultancy said that the average annual pharmacist survey to identify current practices when working with families salary was $67,000 plus on-costs, meaning only clinics treating where a parent has a mental illness. 3000 or more standardised whole patient equivalents (an GPs are often the first point of call for a person seeking help for age-weighted measure based on GP and other non-referred a mental health problem, and it has been estimated that more consultation items in the MBS) would be likely to participate. than 12 per cent of all GP visits in a year are mental health- But the Deloitte report said the outlay would be more than related. offset by substantial savings in other areas of the health system, The Children of Parents with a Mental Illness (COPMI) national calculating that for every $1 invested in the PGPIP, taxpayers initiative – funded by the Federal Government to benefit children would save $1.56 in other areas of the health system. and families where a parent experience mental illness – is In particular, Deloitte estimated that, as a result of the program: collating information on the process a GP follows when a parent with a mental illness seeks help. • a drop in the number of patients hospitalised because of adverse reactions to medications would save $1.266 Participating GPs are asked to fill out an anonymous and billion; confidential questionnaire which takes about 20 minutes to complete. • fewer prescriptions subsidised through the PBS because of better use of medicines would save $180.6 million; It can be found at: http://monasheducation.az1.qualtrics.com/ SE/?SID=SV_29uecngqheOp3Xn • patients would save $49.8 million because of fewer prescriptions and the attached co-payments; and Once completed, GPs will also be invited to take part in a 30 minute telephone interview. If you are involved in the interviews • Medicare would save $18.1 million because fewer patients you will receive a $75 Coles/Myer gift voucher for your time. would see their GP as a result of an adverse reaction to their medicine. If you want any further information about the study, please contact Dr Caroline Williamson at COPMI – In all, Deloitte said the initiative would deliver a net saving of [email protected] $544.8 million over four years for the health system, and the benefit-cost ratio improves with each year the scheme is in operation. AUSTRALIAN MEDICINE - 27.05A JUNE 2 2015 5 NEWS ‘Captain’s call’ medical school won’t fix doctor shortage Western Australia’s medical workforce is growing faster than Adding another medical school doesn’t make any sense without almost any other in the country, underlining concerns that putting the resources in to make sure that we have the training the resources-rich state’s medical training pipeline is already positions available.” running at capacity even before the establishment of a A/Professor Owler this was particularly problematic because controversial new medical school at Curtin University. most post-graduate medical training was provided in public Data compiled by the Australian Institute of Health and Welfare hospitals, whose Commonwealth funding was to be slashed by show that although WA has fewer doctors