NHHRC outlines agenda for primary healthcare overhaul

Funding and delivery of primary health care is destined for a dramatic overhaul, if the government chooses to adopt the new agenda set out yesterday by the National Health and Hospitals Reform Commission (NHHRC) in its much-anticipated interim report.

Voluntary patient registration, more GP super clinics and extended roles for nursing and allied health professionals are all touted in the 400-page report presented by NHHRC chair Dr Christine Bennett.

PATIENT SIGN-UP

The NHHRC recommends that patients be given the option of enrolling with a primary healthcare service of their choice – their “healthcare home” – to ensure continuity of care.

Funding would then be tied to enrolment levels, and used to support multidisciplinary clinical teams in coordinating continuity of care for patients. This funding would not replace, but would instead complement, existing fee-for-service payments.

PAY FOR PERFORMANCE

The NHHRC also proposed incentives within healthcare funding arrangements for improved patient health outcomes and efficiency.

Speaking at the launch of the NHHRC’s interim report in Canberra yesterday, Dr Bennett stated: “This would involve a mix of activity-based funding, payments for a course of care or period of time, and payments to reward good performance in outcomes and timeliness of care.”

ONE STOP SHOPS

The commission also called for the establishment of ‘Comprehensive Primary Health Care Centres’. Though no mention was made of the Rudd government’s controversial GP super clinics strategy, the commission called for the widespread establishment of “one stop shops” with services provided by a multidisciplinary team.

OTHER MEASURES

Also included in the report is a proposal to grant “appropriately credentialled nurse practitioners and other registered health professionals” authority to order diagnostic tests and make specialist referrals covered by Medicare. The same would apply to PBS cover for prescriptions.

Dr Bennett also invited discussion around alternative health governance models in which the Commonwealth would take complete control of health services administered either through local authorities or a social health insurance scheme.

Other measures include:

• Patient controlled e-health records.
• Health literacy included in national school curriculum.
• Introduction of school nurses.
• Universal dental care access scheme.
• National mental healthcare service for young Australians.