Online version of the 2013-14 Department of Health Annual Report

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

Page last updated: 17 July 2019

Major Achievements

  • An additional 91 Primary Care Infrastructure Grant projects were completed in 2013-14, bringing the total to 375. These projects are delivering expanded health care services and additional training for health professionals.
  • Review of Medicare Locals completed and implementation of new arrangements for Primary Health Networks (PHNs) is underway. The smaller number of PHNs will result in a reduction in administrative functions, with further funds available for services.
  • Ceased funding to the Australian Medicare Local Alliance effective 30 June 2014, in response to the Review of Medicare Locals.
  • Continue to support improvements to primary health care delivery through the Practice Incentives Programme with 84.7% of general practice patient care provided by practices participating in the Practice Incentives Programme.

Challenges

  • In 2013-14, nine of the 14 Primary Care Infrastructure Grant projects commenced. The remaining five organisations were not in a position to conclude negotiations in the 2013-14 financial year and will be contracted in 2014-15.

Looking Ahead

In 2014-15, the Department will work to establish Primary Health Networks from 1 July 2015; placing general practice at the centre of primary health care delivery in Australia. A review will be conducted to examine the most appropriate and effective means to support the ongoing delivery of after hours services in Australia, with new funding arrangements to be in place by 1 July 2015. A review will also be conducted of the existing GP Super Clinics programme.

Programmes Contributing to Outcome 5

  • Programme 5.1: Primary care education and training
  • Programme 5.2: Primary care financing, quality and access
  • Programme 5.3: Primary care practice incentives

Division Contributing to Outcome 5

In 2013-14, Outcome 5 was the responsibility of Primary and Mental Health Care Division.

Outcome Strategy

Outcome 5 aims to provide cost-effective, community-based primary health care. In 2013-14, the Department worked to achieve this Outcome by managing initiatives under the programmes outlined below.

Programme 5.1: Primary care education and training

All activities funded through Programme 5.1 are discussed in Outcome 11 – Mental Health.

Programme 5.2: Primary care financing, quality and access

Programme 5.2 aims to improve the infrastructure, coordination and integration of primary health care services across the health system.

Improve coordination of primary health care services

In 2013-14 there were 61 Medicare Locals. From 1 July 2015, a smaller number of Primary Health Networks (PHNs) will replace the Medicare Locals.

Qualitative Deliverable
Implement the Medicare Locals Accreditation Scheme
2013-14 Reference Point
All Medicare Locals are registered for accreditation by August 2013
Result
Not applicable
The Government commissioned a Review of Medicare Locals which was completed in March 2014. Announcements in the 2014-15 Budget included the Government’s response to the review. Commonwealth funding to Medicare Locals will cease on 30 June 2015 with the establishment of PHNs. In line with this decision, the requirement for Medicare Locals to achieve accreditation was withdrawn in May 2014.
Quantitative KPI
Percentage of Medicare Locals with completed needs assessment and strategies for responding to identified service gaps
2013-14 Target
100%
2013-14 Actual
100%
Result
Met
Qualitative Deliverable
Develop bilateral agreements with each state and territory on priority areas for primary health care
2013-14 Reference Point
Bilateral agreements developed by July 2013
Result
Not Met
Finalising bilateral agreements was halted due to the 2013 Federal Election. At that time, negotiated agreements had not been finalised for any jurisdiction. In 2014-15, the Department will work with States and Territories to align the new PHNs more closely with jurisdictional health network arrangements, ensuring effective working relationships, and reducing duplication of effort.

Improve primary health care infrastructure

Primary Care Infrastructure Grant projects are intended to increase the capacity of primary health care providers to meet local health care needs.

Quantitative Deliverable
Number of grants to upgrade or extend existing general practices, primary and community care services or Aboriginal Medical Services
2013-14 Target
14
2013-14 Actual
9
Result
Not met
The number of grants to upgrade or extend existing general practices, primary and community care services or Aboriginal Medical Services: 2010-11 137 grants, 2011-12 332 grants, 2012-13 85 grantsNine organisations received grants during 2013-14. The remaining five organisations were not in a position to conclude negotiations in the 2013-14 financial year and will be contracted in 2014-15.
Quantitative KPI
Number of additional GP Super Clinics that commence delivery of services, including early services
2013-14 Target
10
2013-14 Actual
13
Result
Met
As of 30 June 2014, 16 of the 61 GP Super Clinics were not operational.

Improve access to after hours primary health care

Medicare Locals After Hours Programme

In 2013-14, the Medicare Locals After Hours Programme was funded to address gaps in after hours primary health care services. Consistent with the recommendations of the Review of Medicare Locals conducted in 2013-14, a review of the Medicare Locals After Hours Programme will be conducted during 2014.

after hours GP helpline

In 2013-14, the Department continued to support access to primary care through the 24 hour nurse-based triage telephone service, healthdirect Australia, and the after hours GP helpline. Work to enable the after hours GP helpline and the Pregnancy, Birth and Baby service to allow video functionality has been ongoing. This video consultation feature will be accessible to consumers online from the service’s website and will improve the ability of the services to effectively assess a caller’s medical condition. The introduction of video facilities to these services will provide data which can be assessed with a view to supporting possible future options for the delivery of primary health care more broadly.

Quantitative KPI
Number of calls to the after hours GP helpline
2013-14 Target
220,000
2013-14 Actual
208,333
Result
Substantially met
The number of calls to the after hours GP helpline: 2011-12 154,543 calls, 2012-13 169,218 calls.The after hours GP helpline is a demand driven service with forecasts, rather than targets. healthdirect Australia, 13HEALTH and Nurse-ON-CALL transferred 208,333 calls to the after hours GP helpline in 2013-14.
Residents in Tasmania continued to access after hours GP services through the GP Assist service.

Programme 5.3: Primary care practice incentives

Programme 5.3 aims 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.

Provide general practice incentive payments

In 2013-14, the Department worked with the Department of Human Services to make Practice Incentives Programme (PIP) payments to around 5,400 general practices and 19,000 GPs. Payments were provided to:

  • encourage practices to implement and use electronic health systems;
  • encourage practices to teach medical students;
  • encourage the provision of cervical cancer screening;
  • encourage best practice management of patients with diabetes and asthma;
  • encourage GPs to provide services in residential aged care facilities;
  • support rural practices;
  • encourage rural GPs to provide procedural services;
  • support participation in educational activities to improve prescribing behaviour; and
  • encourage comprehensive and consistent care for Aboriginal and Torres Strait Islander patients with chronic disease.
Qualitative Deliverable
Monitor new eligibility requirements and uptake for the PIP eHealth Incentive
2013-14 Reference Point
Maintain close consultation with the National eHealth Transition Authority, the PIP Advisory Group and the Department of Human Services
Result
Met
Quantitative KPI
Percentage of GP patient care provided by PIP practices
2013-14 Target
83.7%
2013-14 Actual
84.7%
Result
MetThe percentage of GP patient care provided by Practice Incentive Programme practices:  2010-11 82.8 per cent, 2011-12 84.0 per cent, 2012-13 84.4 per cent.
Quantitative KPI
Number of general practices signed on to the Indigenous Health Incentive
2013-14 Target
3,000
2013-14 Actual
3,530
Result
MetThe number of general practices signed on to the Indigenous Health Incentive: 2010-11 2,100 practices, 2011-12 2,900 practices, 2012-13 3,333 practices.
Quantitative KPI
Percentage of PIP practices receiving the eHealth incentive under new eligibility requirements
2013-14 Target
82%
2013-14 Actual
86%
Result
MetThe percentage of Practice Incentive Programme practices receiving the eHealth incentive under new eligibility requirements: 2012-13 80 per cent

Outcome 5 – Financial Resource Summary

(A) Budget Estimate 1
2013-14
$’000
(B) Actual 2013-14
$’000
Variation (Column B minus Column A)
$’000
Programme 5.1: Primary Care Education and Training
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
3,617
3,617
Departmental Expenses
Departmental Appropriation 2
207
493
286
Expenses not requiring appropriation in the current year 3
23
24
1
Total for Programme 5.1
3,847
4,134
287
Programme 5.2: Primary Care Financing, Quality and Access
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
632,045
620,020
( 12,025)
Departmental Expenses
Departmental Appropriation 2
28,096
28,822
726
Expenses not requiring appropriation in the current year 3
1,388
1,395
7
Total for Programme 5.2
661,529
650,237
( 11,292)
Programme 5.3: Primary Care Practices Incentives
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
208,477
212,312
3,835
Departmental Expenses
Departmental Appropriation 2
5,008
4,597
( 411)
Expenses not requiring appropriation in the current year 3
242
219
( 23)
Total for Programme 5.3
213,727
217,128
3,401
Outcome 5 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)
844,139
835,949
( 8,190)
Departmental Expenses
Departmental Appropriation 2
33,311
33,912
601
Expenses not requiring appropriation in the current year 3
1,653
1,638
( 15)
Total Expenses for Outcome 5
879,103
871,499
( 7,604)
Average Staffing Level (Number)
213
213

1 Budgeted appropriations taken from the 2014-15 Health Portfolio Budget Statements and re-aligned to the 2013-14 programme group structure.

2 Departmental appropriation combines ‘Ordinary annual services (Appropriation Bill 1)’ and ‘Revenue from independent sources (s31)’.

3 ‘Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses – please refer to the departmental financial statements for further information. Some reclassifications have been made to the Budget estimates to more accurately reflect the allocation of departmental depreciation by outcome.

In this section