Budget unsettles GP training
In a media released headed Rebuilding General Practice Training, Health Minister Peter Dutton announced the closure of Health Workforce Australia, General Practice Education and Training Ltd (GPET) and Australian National Preventative Health Agency (ANPHA). In WA, WAGPET has been told it programs for GP training and education will continue to the end of 2015 with the exception of the PGPP Program. PGPPP was going to stop at the end of this year but it has been able to secure funding for this program now until the end of 2015. After 2015 GP training will be put out to competitive tender. The state GPET chairs and CEOs were meeting on May 23 after Medical Forum went to press. We will report back in June on the outcome. GPET has raised the number of GP registrars in Australia from 400 to 1200 in 14 years.
Creditors, don’t hold your breath
Some Perth practitioners and providers have been caught up in the collapse of General Practice Support Services (GPSS), which went into liquidation last year owing more than $6m to 100 creditors including wages, superannuation and annual leave to GPs. Recently GPSS was fined $22,176 by the Fair Work Ombudsman for underpaying staff. Medical Forum spoke to one of the administrators, Mr Robert Kite from Cor Cordis, who said it was impossible to single the Western Australian creditors from the list. He added that whoever they were, they would be waiting for a while as ‘recovery was a slow process’.
GP info sharing
Perth Central & East Metro Medicare Local will hold a Workshop for HealthPathways at the UWA Club on June 4-5. Primary Care Health Network co-lead Dr Mike Civil is involved. HealthPathways is developed in New Zealand (http://wsproject.healthpathways.org.au/PathwayProgress.aspx). The idea appears to be centralised information adapted for local use. The idea is good – resource doctors and other health professionals tackling various health problems within a geographical area. GPs can be the main drivers of information that can include CPD and job information, and only accessed by registered health professionals (doctors have to log on). So far, HealthPathways is with two district health boards in NZ and has a consumer Health Information arm (http://healthinfo.org.nz/). Will they become defacto clinical guidelines? Keeping all up-to-date and relevant is important and a big task.
Adverse reactions reporting declines
In the March edition we ran a story of a young woman who had a stroke while taking the oral contraceptive. We could not confirm that any of the doctors involved in her care had reported a possible adverse drug reaction (ADR). Like many others, maybe they were too busy or expected someone else to do the reporting. The NPS looks after the Adverse Medicine Events Line and our Medicines Line, both phone reporting for consumers, and it makes no decision on whether a causal relationship is likely but leaves that to the TGA. Apparently, reporting directly by healthcare professionals to the TGA has declined.
Standards under scrutiny
The RACGP’s task of setting standards for general practice is not easy and will now be scrutinised. Our November 2013 survey of 147 GPs had a slim majority of GPs supporting the idea that accreditation maintained quality of health care (Yes 26%, Maybe 31%), but only a minority agreed that “the majority of things required of general practices undergoing accreditation are appropriately targeted to improve the quality of patient care” (Yes 31%, Uncertain 16%). In fact, 52% said they were being asked to comply with accreditation requirements that did not help. While 75% of general practices undergo accreditation, the Australian National Audit Office found that the ‘carrot’ of PIP payments cast doubt over measures of quality assurance. For this reason, the RACGP and the Australian Commission on Safety and Quality in Health Care has been asked to develop a governance and reporting framework for general practice accreditation in Australia (ends 2015) looking at complaint handling (e.g. duplications, variations in responses), what works and improve coordination (including an appeals mechanism). Current 4th edition standards are unaffected.
Pharm and education
Untied financial sponsorship of medical meetings by pharmaceutical companies has become a key component of medical education funding in Australia with sponsoring companies averaging more than $200,000 each in such grants during the most recent reporting period. See www.medicinesaustralia.com.au