Unpacking the federal Budget
This year’s was a general practice Budget, no doubt about that. It represented the largest investment in Medicare in a long time and was welcomed by the seemingly unappeasable medical fraternity. It was, in fact, long overdue, writes APA Chief Executive Officer Anja Nikolic.
The lack of incentives to provide bulk-billed access to medical care was hurting all of us, especially our most vulnerable people. As such, we welcome this investment in the Budget, as it addresses at least some of the issues of affordability and accessibility to care.
The rest of the Budget as it relates to health gives cause for optimism.
While it needs a lot more analysis, it sends signals of both strategic intent and financial commitment to reform.
Time will tell if these are short-lived, in immediate response to the public’s demands to rescue our health system, or if they will be continued in subsequent years.
Particularly pleasing is the investment of $79.4 million over four years to strengthen the role of allied health in multidisciplinary teams within Primary Health Networks to improve the management of chronic conditions and reduce avoidable hospitalisations.
We think this paves the way for a trial of Medicare-funded first contact physiotherapy and will advocate hard for this.
Primary Health Networks are the logical vehicle to support such trials but have been unable to in the past due to rigid funding mechanisms.
A commitment to the review of scopes of practice supports Minister for Health and Aged Care Mark Butler’s desire to ensure that all professions operate to the full extent of their scope.
Physiotherapists are frustrated about the inability to refer to specialists, a task they’re well equipped to undertake, and that Medicare rebates for imaging referrals differ from general practice.
Prescribing in physiotherapy—in certain circumstances for certain clinicians—also deserves exploration as an avenue to improving access to care.
We will ensure that all of these issues are fully considered by the government’s scoping review.
Also welcome is the $6 million investment into allied health professionals’ use of My Health Record.
This is necessary to enable better coordinated care in the community and to foster working relationships between health professionals.
Our criticism is that it is a modest investment.
There are things we have reservations about. Take the Workforce Incentive Program, for example.
The program provides incentives to general practice to employ nurses and allied health professionals to extend the range of care offered to the community.
We are pleased that for the purposes of the program, what constitutes ‘employment’ is up to the parties to determine and can include contract work.
This means that a physiotherapist can maintain their own private practice while contracting services to their local GP. It may also work well for sole traders.
While we think that there are better ways to fund access to allied health, the program will no doubt be useful and attractive to many physiotherapists.
We are concerned by the absence of a concrete commitment to veterans’ care and disappointed by the Opposition’s anaemic response.
According to the APA’s member polls, veterans’ access to physiotherapy is in real jeopardy due to the grossly inadequate funding of physiotherapy by the Department of Veterans’ Affairs.
We also expected more support for the embattled aged care sector.
Funding for aged care workers is welcome, but there is every danger that this will be used for low-value supports unless good safeguards and guidelines are established.
All in all, this is a Budget to be welcomed as one that acknowledges the importance of our health system but also gives rise to many questions and opportunities for dialogue with our elected representatives.
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