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No firm movement on health funding as national cabinet briefed by ASIO on sovereign citizens — as it happened

Doctors are criticising recommended changes to the healthcare system following national cabinet announcing it will wait until April to decide how to address issues in the sector.

Look back on our live blog as it happened.

Key events

Live updates

That's all for our live blog

By Shiloh Payne

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Here are some photos from today's national cabinet meeting

By Shiloh Payne

Allied health wants My Health Record access

By Andrew Thorpe

Key Event

Annie Guest reports dieticians, physiotherapists, psychologists and other allied health workers are welcoming the report, but say reform will fail without engagement with their sector.

Allied Health Professions Australia points out their practitioners usually operate in small private businesses that are not under the same roof as a general practice.

They're urging the federal government to give allied health workers access to patients' data on My Health Record, saying they cannot otherwise contribute critical information into the system.

"If Minister Butler is serious about improving continuity, quality and safety in healthcare, then bringing allied health into the digital ecosystem must urgently be addressed," chief executive Bronwyn Morris-Donovan says. "As it stands, the Strengthening Medicare Taskforce digital recommendations offer no reassurance that allied health will be prioritised."

Modernising My Health Record to "significantly increase the health information available to individuals and their healthcare professionals" is also one of the report's recommendations to government.

Section four of the Medicare report outlines a cultural change

By Shiloh Payne

The fourth key area outlined in the report is supporting change management and cultural change.

Five recommendations have been included in this section, they are:

  • Put consumers and communities at the centre of primary care policy design and delivery. Allow for flexibility in models of care to deliver on local needs and incentivise innovation to deliver better health outcomes.
  • Learn from both international and local best practice, and invest in research that evaluates and identifies models of high value primary care excellence.
  • Work with providers to help them effectively manage change and transition to new ways of working, including through a strengthened role for PHNs to support the adoption of successful, locally designed models of care.
  • Support the continued development of practice management as a profession, including through an initial training program to help practices transition to new ways of working.
  • Implement a staged approach to reform, supported by an evaluation framework to monitor progress and measure the impact of reforms.

Australian College of Nursing CEO wants to see nurses paid directly

By Jessica Riga

The head of the peak body for Australian nurses has slammed the way the country's health system is funded, saying it's not fit for purpose.

Australian College of Nursing CEO Professor Kylie Ward says she wants to see nurses paid directly.

"It's not fit for purpose, it's not a good use of the funding that's been invested within it. And we're certainly looking to see greater access for the nursing profession to get directly paid," she says.

"It's time to move into the 21st century."

Nothing in report deals with bulk-billing 'crisis', AMA says

By Andrew Thorpe

The main item on doctors' wish lists is more funding for bulk-billing in GP practices, Annie Guest and Mary Lloyd report.

But the federal government has not committed to go beyond the $750 million announced for Medicare reforms in the last budget.

"You'll have to wait for the May budget," Health Minister Mark Butler says.

That's surprised the Australian Medical Association, which says general practics around the country are under enormous financial pressure and are not able to make ends meet.

"There's nothing in the report that will deal with that crisis and make it easier to see a GP," AMA president Steve Robson says. "We need real action now."

Mr Butler says making changes to the healthcare system isn't something that can happen quickly, nor can it be fixed in one budget.

"This report sets a very clear challenge to government about how we start to turn things around in general practice and primary care more broadly," he says.

Section three of the report is about modernising primary care

By Shiloh Payne

let's take a look at the recommendations in part three of the report.

This section is about modernising primary care and improving data and digital technology.

Here are the recommendations:

  •  Modernise My Health Record to significantly increase the health information available to individuals and their health care professionals, including by requiring 'sharing by default' for private and public practitioners and services, and
  • make it easier for people and their health care teams to use at the point of care.
  • Better connect health data across all parts of the health system, underpinned by robust national governance and legislative frameworks, regulation of clinical software and improved technology.
  • Invest in better health data for research and evaluation of models of care and to support health system planning.This includes ensuring patients can give informed consent and withdraw it, and ensuring sensitive health information is protected from breach or misuse.
  • Provide an uplift in primary care IT infrastructure, and education and support to primary care practices including comparative feedback on their practice, so that they can maximise the benefits of data and digital reforms, mitigate risks and undertake continuous quality improvement.
  • Make it easier for all Australians to access, manage, understand and share their own health information and find the right care to keep them healthy for longer through strengthened digital health literacy and navigation.

Report calls out Australia's disjointed care

By Andrew Thorpe

The Medicare taskforce report says Australia lags behind other countries when it comes to making the most of the healthcare workforce's skills, Leonie Thorne reports.

The report includes a whole section on encouraging multidisciplinary team care — something health experts have been calling for — saying there needs to be more collaboration between different healthcare workers and teams.

"Our primary care system funding mechanisms reward episodic care and fast throughput, creating barriers for many people to get the comprehensive care they need," the report says.

"This has a disproportionate impact on older people, First Nations Australians, people with chronic and complex conditions, people with mental health conditions, people with disability, people from culturally and linguistically diverse backgrounds, and people on low incomes.

"To improve access and achieve better health outcomes for all, we need systems and funding that support comprehensive continuity of care delivered by well-connected teams working together to address people's health needs."

Click here to read the report's five recommendations for encouraging multidisciplinary team-based care.

Nurses don't want to miss historic opportunity

By Andrew Thorpe

The Australian Nursing and Midwifery Federation is calling on the federal and state governments not to waste what it calls a historic opportunity for reform, Annie Guest reports.

"Nurses … have been unable to fully work to their full capacity. Expertise and skill must be central to the reform of Australia's universal healthcare system," ANMF federal secretary Annie Butler says.

The ANMF wants general practice nurses funded to perform chronic disease management checks, wound care, and immunisations, as well as provide sick certificates and deliver health promotion and disease prevention.

"[This] would certainly reduce the number of people having to go to hospital for these everyday care episodes," she says.

Healthcare system needs to be more proactive, expert says

By Shiloh Payne

A former president of the Australian Medical Association NSW says the country's healthcare system needs to be more proactive.

Dr Kean-Seng Lim says the current Medicare system isn't efficient.

"The system of the future and what we should be looking at more is much more proactive, looking at how we prevent illnesses and even how we can identify problems before they become a problem," Dr Lim says.

No specific recommendations on a funding model for primary care

By Andrew Thorpe

Key Event

Leonie Thorne has been looking at the Strengthening Medicare Taskforce report. Here she is with the details:

The Strengthening Medicare Taskforce report has called for a rethink of the way Australia funds primary care and GPs, saying funding arrangements need to be "strengthened and remodelled".

The report didn't recommend any particular funding model, but did say reforms should "focus on mechanisms that support an ongoing relationship between patients and their primary care team".

It also said investments in healthcare should address inequalities in accessing healthcare and outcomes, including for First Nations Australians and people living with disability.

"We need to design new funding models to enable providers to engage the people who are hardest to reach and most at risk of poorer health outcomes," it said.

You can read the six recommendations when it comes to increasing access to primary care below.

SA says the wait to see a GP has increased 50 per cent in three years

By Jessica Riga

Earlier today, SA Health Minister Chris Picton said South Australia can not afford any further deterioration of GP services.

He said the wait for a South Australian to see a GP has increased by more than 50 per cent over the past three years and it's putting more pressure on the state's hospitals.

Mr Picton said there must be improvements to GP wait times and costs and has called for the federal government to increase its contribution to primary healthcare.

"If we continue to see the deterioration of primary healthcare to the extent it's been happening then we won't get to the situation where we can get people the care that they need, because more people are getting sicker and ultimately they've got no choice when they become sicker to go to our hospitals."

Health sector full of 'loud voices and sharp elbows'

By Andrew Thorpe

A reporter asks Mr Butler how the government is going to end the "turf wars" between different health professions and make sure people like pharmacists and nurses are able to work "to the full extent of their abilities".

Mr Butler says anyone who's worked in health for a while knows there are "a lot of loud voices and sharp elbows" in the sector.

"I will say, though, that the task force deliberations were all respectul, and were, I think, very clearly focused on the reality that people can't operate in silos any more," he says.

"We can't continue to have people who have been trained at vast taxpayer expense, and made big contributions to their training as well … operating below their scope of practice."

'Absolutely nothing' in report to provide immediate resolutions, AMA President says

By Shiloh Payne

Key Event

AMA President Steve Robson says there is "absolutely nothing" in the report that will provide anything immediate.

"And that is what we need," Professor Robson says.

"We know that the Budget is coming in May, and Australians expect that this is going to be a health Budget.

"That's what they need, what they want to see, and we have seen the Prime Minister and the premiers and Chief Ministers acknowledge that health is one of the highest priorities of the National Cabinet, we're just a little surprised not to see that today."

Watch: 'Medicare not delivering the care Australians need'

By Shiloh Payne

Health Minister Mark Butler has pledged to fix Medicare, saying it is not delivering the care Australians need.

'Medicare not delivering the care Australians need': Mark Butler

Will the government rule out an increase to the Medicare levy?

By Shiloh Payne

Mr Butler says he won't rule anything out.

He says the medicare levy was discussed in the task force.

"All I have said is my very clear view - and frankly, I think it's shared in big parts of the healthcare sector -it's simply adding more money in and of itself to the existing structures, which isn't going to deliver better care to Australian patients," he says.

Will anything change before the budget in May?

By Shiloh Payne

Mark Butler has given some examples of what can be done in the lead-up to the budget.

"We've said we're delivering on those Urgent Care clinics this year," he says.

"I think the Prime Minister said that when we were in Perth a couple of days ago, we indicated the first three of them would be rolled out before June 30 — so, fast-track the other four in the second half of the year. That's one example.

"Another example is to improve the ability for connection between state hospital systems and the Medicare system to train general practice registrars, particularly in rural and regional Australia.

"There are some very concrete measures here that now will be considered in the budget process leading into May."

Health minister pressed on specifics

By Jessica Riga

Reporter: A lot of these recommendations, as good as they are, are broad and fairly self-evident. It all hinges on having an adequate workforce. Can you give us specifics?

"What I've said very clearly is perhaps the most terrifying statistic in the area of primary care is that now less than 14% of medical graduates are choosing general practice as their career," Mr Butler starts.

"If you think it's hard to see a GP now, look 5-10 years down the track when the current generation of GPs are increasingly retiring and there's no pipeline coming through — it will be even harder.

"But you don't turn that around in 12 months. To grow a cohort of general practitioners takes time."

What does today's report mean for people who can't afford to see a GP?

By Shiloh Payne

Mark Butler has been asked about today's national cabinet meeting and the release of the medicare report.

"The task force is very clear on the need to address affordability," he says.

"There is a range of options there. There are still stakeholders in the public debate, as is proper, advocating different approaches to ways in which to try and turn around the clear slide in bulk-billing.

"If [Australians are] not able to get a bulk-billed service, they're having to go to a hospital — clearly an issue that state premiers and chief ministers talk about today as well."

Is the health minister ruling out an increase to the Medicare rebate?

By Jessica Riga

That's the first question that's been thrown Mark Butler's way.

"No, I'm not ruling anything out," he says.

"There was a very clear discussion in the task force about affordability. What I have said — and frankly a key message from the health sector more broadly — is we can't just add more money to existing systems, particularly where those systems aren't performing against the range of indicators.

"Most commentators — and frankly, most stakeholders in the health sector — are very clear that the current system does not fit the needs of Australians. An older population with a much, much higher incidence of complex chronic care.

"As I think the national cabinet said, it's not just about more money — it's about getting the settings right, about getting the policy right. Those are the clear messages in this report. There needs to be reform. But clearly, affordability is a major challenge. 

"I talked about the fact that that gap fee has increased above the Medicare rebate for the first time in the history of Medicare. Affordability is a clear challenge and, of course, as a Labor government, we're considering a whole range of options about the Medicare rebate as well as all of these reforms."

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