A new report from the Grattan Institute outlines the potential of physiotherapists, and other allied health professionals, to improve Australia’s outdated primary care system and increase access to the care Australians need.

‘A new Medicare: Strengthening general practice', found that “more GPs, and more funding under the same model, are not the answer.” Instead, deeper structural reform is required, to reform a system that actively discourages team care and rewards speed, not need.”

The Australian Physiotherapy Association (APA) welcomes the report and its emphasis on solutions to support greater levels of integration to meet the needs of a changing population.

“The report contains strong evidence for integrated care models that include allied health services, yet successive health budgets have continued to deliver no or insignificant change from conventional primary care.

“The new Albanese Government sets us back on a reform path, in what now presents as an unprecedented opportunity to transform the health care system,” APA President Scott Willis said.

The APA has put forward evidenced reform solutions, including most recently to the Strengthening Medicare Taskforce, to help drive improvements in health system design, address inequities, and improve efficiencies through advancing team-based care.

“Real reform requires greater investment in publicly funded physiotherapy and improved access to physiotherapists as first contact practitioners, including in urgent care clinics. 

“We must ensure that those who need it the most can access care, Mr Willis said.

The Grattan Institute report found a “very significant gap” between the contribution physiotherapists are able to make and “what funding and policy let them do in Australia” and recommended engaging an “independent commission to remove regulatory barriers that stop primary care workers from safely using all of their skills”. 

“Almost one in six GP visits are for a musculoskeletal issue, which evidence shows physiotherapists can provide expert diagnosis and treatment for without requiring a GP referral, as is now the model in the UK,” the report states.

This model is called Funded First Contact Physiotherapy (FFCP). 

“FFCP trials were initiated in the UK to find more innovative models of care and to reduce the demand on GPs. It’s resulted in tens of thousands of patients avoiding hospital and costly surgery for health problems such as arthritis, back pain and muscle, bone and joint conditions just by seeing a physiotherapist.”
In Australia, FFCP operates in a limited capacity within some emergency departments and to some extent, within the Aboriginal Community Controlled Health Organisations.

“If FFCP already exists, and there is a very obvious need for adjustment to the current system, why are we still resisting better health outcomes and faster access to diagnosis and treatment?” Mr Willis said.

The report identifies the current Medicare Benefits Schedule (MBS) as a ‘key barrier’ to first contact care without a GP referral.

“While there is no limit on the number of GP visits a patient can have, access to MBS-funded allied health services is heavily restricted."

The report states that to be eligible, patients must have a chronic condition and complex care needs. Even then, these patients can have only five allied health services a year.

Federal Health Minister Mark Butler recently said that ‘primary care is in its worst shape since Medicare began.’

“The cost-effectiveness of physiotherapy interventions is proven both in the literature and through cost-benefit analysis.

“To address the inequality and structural challenges outlined in the report, the government needs to fund new and innovative models of care, models that encompass physiotherapy.

“This report shows greater team-based care and funded first contact physiotherapy are a smart place to start,” Mr Willis said.

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Scott Willis is available for comment.

Physiotherapists are the fourth largest group of registered primary healthcare professionals in the country. The APA represents over 31,000 physiotherapists around Australia.