I am sometimes asked what the role of GCPHN is, why does it exist and what does it do with the government funding allocated each year. Frequently GPs will ask why GCPHN does not do what the old Division of General Practice did, assisting GPs in their daily work.
Lets start with a history lesson.
In the beginning, there was the Gold Coast GP Association – a loose group of GPs who wanted to connect and do things together. Then, in 1992, the Commonwealth decided to fund specific activities reflecting the then policy settings of government. The Divisions of General Practice was the mechanism for this and the Association became the Gold Coast Division of General Practice. Funded to support general practice, there was a mandate to provide specific support in things like computerisation of practices, training in mental health, care planning and other GP specific activities. The Division was renamed General Practice Gold Coast (GPGC).
Then, under the Labor government in 2011, Medicare Locals were created, with a much stronger focus on the needs of disadvantaged communities with specific funding applied to service provision outside general practice, but involving GPs by sharing of information. GPGC was successful in winning this tender with the creation of Primary Care Gold Coast Limited. Unlike others around Australia, the constitution provided for only three members (shareholders of a not for profit organisation), namely GPGC who cannot be removed from this role, plus the City of Gold Coast reflecting our population, and one of the NGO’s covering all other primary health care providers – currently Anglicare. In addition, three of the six directors needed to be general practitioners.
In 2015 the Coalition changed the Medicare Local model into the Primary Health Network model, very focused on disadvantaged patients for whom the Medicare Local and State health systems did not provide adequate access.
The two main objectives of the new primary health networks, are “increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time”.
Mental health makes up the lion’s share of this funding – it will be of no surprise to my colleagues to know that this has historically been a challenging area, and of course in the recent past with the significant disasters we have had to navigate, the community need is massive.
Of the funding received by GCPHN, the vast majority is applied directly to service provision for patients, following a needs assessment process and designing of the program with consumers, patients and providers to ensure it meet the intended needs. There has also been some funding reserved for supporting general practice, including but not limited to data extraction, to allow practices to receive Practice Incentives Program Quality Improvement funding, coordination of the COVID-19 response across the whole of health system, and other activities to work with Gold Coast Health to challenge and support changes, to ensure the patient journey is manageable across private and public health.
You may ask, why can’t GCPHN provide more direct support for general practice, like “the old Division days”? While it may feel like there is less GP support than under the Divisions program, the reality is that the support remains, but in a different form. The face-to-face evening meetings enjoyed in the past have been over-run with changes to CPD with the colleges, COVID-19 completely changed the GP experience, and we live in a vastly different world of patient need and expectation that has been approached with the patient in the centre of our work. GCPHN still maintains a practice support team, and has developed Primary Sense, a new data extraction, analytics and risk stratification tool, to support GPs.
We are also very fortunate to still have GPGC and its membership is for GPs, working to provide support to this critical part of our system. The directors are all GP’ and are passionate about improvement to the experience of our colleagues in their increasingly complex work. So, the best of both worlds and unlike most of Australia, GPs are firmly in the drivers seat of these parts of our local system.
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