Section 2 – Department Outcomes – 5 Primary Care
Outcome 5
Primary Care
Access to comprehensive, community-based health care, including through first point of call services for prevention, diagnosis and treatment of ill-health, and for ongoing management of chronic disease
Outcome Strategy
Through Outcome 5, the Australian Government aims to provide cost-effective, community-based primary health care. Australia’s health care system faces significant challenges due to the growing burden of chronic disease, an ageing population, workforce pressures, and unacceptable inequities in health outcomes and access to services.[1] Chronic diseases place an enormous demand on the health system, with more than 50% of consultations with general practitioners (GPs) attributed to people with a chronic condition such as heart disease, cancer or diabetes.[2]
Under National Health Reform, the Australian Government is shifting thecentre of gravity of the health system towards primary health care. Astrong primary health care system helps prevent disease and assist people to manage their health conditions in the community, freeing up hospitals to look after those who need hospital care.
Under the National Health Reform Agreement, theAustralian Government is working together with state and territory governments on systemwide policy and statewide planning for GP and primary health care services. Together with the Government’s primary health care reforms, this work will help equip the Australian health system to meet future challenges and better respond to the needs and priorities of local communities.
In 2013-14, the Government will continue to strengthen its primary health care reforms includingaccess to after-hours care through Medicare Locals. The national network of Medicare Locals is ensuring primary health care services are more accessible and responsive to local health needs.
The Government will also continue to support integrated, team-based care through significant investment in primary health care infrastructure through the construction of GP Super Clinics and upgrades to primary health care facilities.
Outcome 5 is the responsibility of Primary and Ambulatory Care Division.
Programs Contributing to Outcome 5
Program 5.1:Primary care education and training
Program 5.2:Primary care financing, quality and access
Program 5.3:Primary care practice incentives
Outcome 5 Budgeted Expenses and Resources
Table 5.1 provides an overview of the total expenses for Outcome 5 by program.
Table 5.1: Budgeted Expenses and Resources for Outcome 5
2012-13Estimated
actual
$'000 / 2013-14
Estimated
expenses
$'000
Program 5.1: Primary care education and training
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 6,852 / 7,070
Departmental expenses
Departmental appropriation1 / 1,054 / 926
Expenses not requiring appropriation in the budget year2 / 33 / 44
Total for Program 5.1 / 7,939 / 8,040
Program 5.2: Primary care financing, quality and access3
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 546,167 / 632,045
Departmental expenses
Departmental appropriation1 / 29,057 / 27,637
Expenses not requiring appropriation in the budget year2 / 914 / 1,235
Total for Program 5.2 / 576,138 / 660,917
Program 5.3: Primary care practice incentives
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 280,507 / 208,477
Departmental expenses
Departmental appropriation1 / 1,455 / 1,374
Expenses not requiring appropriation in the budget year2 / 46 / 62
Total for Program 5.3 / 282,008 / 209,913
Outcome 5 totals by appropriation type:
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 833,526 / 847,592
Departmental expenses
Departmental appropriation1 / 31,566 / 29,937
Expenses not requiring appropriation in the budget year2 / 993 / 1,341
Total expenses for Outcome 5 / 866,085 / 878,870
2012-13 / 2013-14
Average staffing level (number) / 215 / 201
1Departmental appropriation combines "Ordinary annual services (Appropriation Bill No 1)" and "Revenue from independent sources (s31)".
2Expenses not requiring appropriation in the Budget year" is made up of depreciation expense, amortisation expense, makegood expense and audit fees.
3This program includes National Partnerships paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. National partnerships are listed in this chapter under each program. For budget estimates relating to the National Partnership component of the program, please refer to Budget Paper 3 or Program 1.10 of the Treasury Portfolio Budget Statements.
Program 5.1: Primary care education and training
All activities currently funded through Program 5.1 are undertaken as part of activities discussed in Outcome 11 – Mental Health, in these Portfolio Budget Statements.
Program 5.1: Expenses
Table 5.2: Program Expenses
2012-13Estimated
actual
$'000 / 2013-14
Budget
$'000 / 2014-15
Forward
year 1
$'000 / 2015-16
Forward
year 2
$'000 / 2016-17
Forward
year 3
$'000
Annual administered expenses
Ordinary annual services / 6,852 / 7,070 / 8,227 / 8,374 / 8,525
Program support / 1,087 / 970 / 961 / 972 / 797
Total Program 5.1 expenses / 7,939 / 8,040 / 9,188 / 9,346 / 9,322
Program 5.2: Primary care financing, quality and access
Program Objectives
Improve coordination of primary health care services
In 2013-14, the Australian Government will continue to support the national network of Medicare Locals. Medicare Locals are delivering and improving the planning and coordination of services at the local level to make it easier for patients to navigate their way through the health system. The overwhelming majority of Medicare Local staff are frontline. Investment in 2013-14 will continue to support these frontline activities in local communities across Australia
In 2013-14 the Government willimplement a new Medicare Locals Accreditation Scheme to support Medicare Locals to meet best practice organisational management and service delivery processes. Accreditation is one aspect of a broader quality framework for Medicare Locals, which will seek to promote transparency, information sharing, and a culture of continuous quality improvement.
Work will continue on the National Evaluation of Medicare Locals to assess the extent to which Medicare Locals are progressing toward the five strategic objectives of the program.
A National Primary Health Care Strategic Framework has been agreed and the Department will work with the states and territories to develop bilateral plans for primary health care by July2013.
Tasmanian Health Assistance Package – Tasmania Medicare Local
In June 2012, the Australian Government, announced a $325 million assistance package for Tasmania’s health system, outlining a number of significant investments to ease pressures and equip Tasmania’s health system to meet future challenges. Under the Package, the Tasmania Medicare Local (TML) has been tasked to improve primary health care services through three key elements. These elements are best delivered through the TML due to its intimate knowledge of the Tasmanian primary health care sector, and will fit in with the long term role of the Medicare Local to improve the health outcomes for all Tasmanians.
Improve access to afterhours primary health care
Medicare Locals have responsibility for the planning delivery and funding of face-to-face after-hours services for their local community.Each Medicare Local will work with their local GPs and other stakeholders to support region wide comprehensive after-hours primary health care services.
The Government will also continue to support the 24 hour nurse-based triage telephone service provided by healthdirect Australia andthe afterhours GP helpline.
Improve primary health care infrastructure
The Government’s investment in improved infrastructure is delivering increased primary health care capacity to meetlocal health care needs, with a particular focus on supporting those with, or at risk of, chronic disease.
In 2013-14, the Department will continue work on implementing more than 60GPSuper Clinics and around 425Primary Care Infrastructure Grant projects across Australia. The Department will continue to monitor completed GP Super Clinics to ensure improved access to integrated, multidisciplinary, team-based primary health care services.
Program 5.2 is linked as follows:
- The Department of Human Services (Services to the Community – Program1.1) to administer access to afterhours primary care.
Program 5.2: Expenses
Table 5.3: Program Expenses
2012-13Estimated
actual
$'000 / 2013-14
Budget
$'000 / 2014-15
Forward
year 1
$'000 / 2015-16
Forward
year 2
$'000 / 2016-17
Forward
year 3
$'000
Annual administered expenses
Ordinary annual services / 546,167 / 632,045 / 598,053 / 584,874 / 561,157
Program support / 29,971 / 28,872 / 28,068 / 28,298 / 28,474
Total Program 5.2 expenses / 576,138 / 660,917 / 626,121 / 613,172 / 589,631
Program 5.2: Deliverables
Qualitative Deliverables for Program 5.2
Improve coordination of primary health care services
Qualitative Deliverable / 2013-14 Reference Point or TargetImplement the Medicare Locals Accreditation Scheme / All Medicare Locals are registered for accreditation by August 2013
Develop bilateral agreements with each state and territory on priority areas for primary health care / Bilateral agreements developed by July 2013
Quantitative Deliverables for Program 5.2
Improve primary health care infrastructure
Quantitative Deliverable / 2012-13 Revised Budget / 2013-14 BudgetTarget / 2014-15 Forward
Year1 / 2015-16 Forward
Year2 / 2016-17 Forward
Year3
Number of grants to upgrade or extend existing general practices, primary and community care services or Aboriginal Medical Services[3] / 70 / 29 / N/A / N/A / N/A
Program 5.2: Key Performance Indicators
Quantitative Key Performance Indicators for Program 5.2
Improve coordination of primary health care services
QuantitativeIndicator / 2012-13 Revised Budget / 2013-14 Budget
Target / 2014-15 Forward
Year 1 / 2015-16 Forward
Year 2 / 2016-17 Forward
Year 3
Percentage of Medicare Locals with completed needs assessment and strategies for responding to identified service gaps[4] / 100% / 100% / 100% / 100% / 100%
Improve access to after-hours primary health care
QuantitativeIndicator / 2012-13 Revised Budget / 2013-14 Budget
Target / 2014-15 Forward
Year 1 / 2015-16 Forward
Year 2 / 2016-17 Forward
Year 3
Number of calls to the afterhours GP helpline / 195,000 / 220,000 / 240,000 / 260,000 / 280,000
Improve primary health care infrastructure
QuantitativeIndicator / 2012-13 Revised Budget / 2013-14 Budget
Target / 2014-15 Forward
Year 1 / 2015-16 Forward
Year 2 / 2016-17 Forward
Year 3
Number of additional GP Super Clinics that commence delivery of services, including early services / 6[5] / 10 / 10 / 4 / N/A
Program 5.3: Primary care practice incentives
Program Objectives
Provide general practice incentive payments
In 2013-14, the Australian Government will continue to provide incentive payments to general practices and GPs to support activities that encourage continuing improvements, increase quality of care, enhance capacity, and improve access and health outcomes for patients.
Under the Practice Incentives Program (PIP), incentive payments are made to general practices and GPs for cervical cancer screening, diabetes management, asthma management, and provision of procedural services in rural and remote areas.
Other incentives are provided to GPs to ensure that older people receive appropriate and timely access to primary health care services, thereby improving their health outcomes and reducing avoidable hospital admissions and readmissions. To receive the incentives, GPs must provide a minimum specified number of services to residents of aged care facilities.
The Government continues to provide financial incentives to participating general practices and Indigenous health servicesto provide better health care for Aboriginal and TorresStrait Islander patients, including best practice management of chronic disease. The uptake of the incentive has been strong since its implementation in 2010. In201314, the Department will continue to closely monitor its effectiveness in delivering best practice chronic disease care.
This year the Australian Government will monitor new eligibility requirements for the PIP eHealth Incentive, introduced during 201213, which were designed to encourage general practices to safely and securely share accurate electronic patient records to enhance the quality of care provided to patients and undertake activities such as electronic prescribing and use of the Personally Controlled Electronic Health Record (PCEHR)[6] system.
Program 5.3 is linked as follows:
- The Department of Human Services (Services to the Community –Program1.1) to administer incentives payments to general practices, general practitioners and Indigenous health services.
Program 5.3: Expenses
Table 5.4: Program Expenses
2012-13Estimated
Actual
$'000 / 2013-14
Budget
$'000 / 2014-15
Forward
year 1
$'000 / 2015-16
Forward
year 2
$'000 / 2016-17
Forward
year 3
$'000
Annual administered expenses
Ordinary annual services / 280,507 / 208,477 / 223,316 / 228,619 / 234,203
Program support / 1,501 / 1,436 / 1,314 / 1,325 / 1,356
Total Program 5.3 expenses / 282,008 / 209,913 / 224,630 / 229,944 / 235,559
Program 5.3: Deliverable
Qualitative Deliverable for Program 5.3
Provide general practice incentive payments
Qualitative Deliverable / 2013-14 Reference Point or TargetMonitor new eligibility requirements and uptake for the PIP eHealth Incentive / Maintain close consultation with the National eHealth Transition Authority, the PIP Advisory Group and the Department of Human Services
Program 5.3: Key Performance Indicators
Quantitative Key Performance Indicators for Program 5.3
Provide general practice incentive payments
Quantitative Indicators / 2012-13 Revised Budget / 2013-14 BudgetTarget / 2014-15 Forward
Year1 / 2015-16 Forward
Year2 / 2016-17 Forward
Year3
Percentage of GP patient care provided by PIP practices / 83.4% / 83.7% / 84.0% / 84.1% / 84.2%
Number of general practices signed on to the Indigenous Health Incentive[7] / 2,800 / 3,000 / 3,100 / 3,200 / 3,200
Percentage of PIP practices receiving the eHealth incentive under new eligibility requirements / 78% / 82% / 86% / 88% / 89%
Outcome I05
1
[1]National Health and Hospitals Reform Commission, 2009.A Healthier Future for All Australians – Final Report of the National Health and Hospitals Reform Commission.
[2]Australian Institute of Health and Welfare, 2006.Chronic diseases and associated risk factors in Australia, AIHW: Canberra. Available at:
[3]The Primary Care Infrastructure Grants program is a non-ongoing program. Funding rounds were only available in 2010 and 2011, however payments on some grants funded under these rounds will continue until 2013-14.
[4]The previous indicator reported on the percentage of Medicare Locals meeting reporting requirements, which has consistently been 100% as it is a requirement of funding. The new indicator will more accurately capture Medicare Locals performance in improving the planning and coordinating of services at the local level. The comprehensive needs assessment is due to be completed in May 2014, and will be reviewed on an annual basis to identify and address service gaps in each Medicare Local catchment.
[5]Revised to factor in additional time for extended Council development application processes, land acquisition processes and state government approvals and associated processes outside of the Commonwealth’s control.
[6]For further information on Personally Controlled Electronic Health Records, refer to the Outcome 10 chapter in these Portfolio Budget Statements.
[7]The wording of this indicator has been revised to better reflect the intent of the measure and the data collected for reporting purposes.