AMA VICDOC Summer 2024 - Magazine - Page 66
F E D FACTS — D EC E M B ER 2024
Recommendation 6 is to introduce
activity-based regulation of scope
of practice. This recommendation
demonstrates the review’s continued
failure to understand that scope of
practice is dynamic and contextual —
a qualification is not the sole determinant
of scope. The determination of scope of
practice should remain with the relevant
National Boards. Proposals to expand
scope should continue to proceed through
the consultation process they currently
undertake, with regulation impact
statements conducted.
We continue to be very supportive of
enhancing collaborative multidisciplinary
care and ensuring all health professionals
can work to their full breadth of scope
in primary care, but this requires better
funding models and improvements to
the many reforms currently underway in
general practice, such as MyMedicare.
We need strong clinical governance to
ensure that full scope is safe scope,
and that we are truly working together.
Recommendation 12 is to introduce
direct referrals from non-medical health
professionals to non-GP specialists. We
never understood where the suggestions
in this list came from (for example,
osteopaths referring to orthopaedic
surgeons), but the AMA was not consulted.
As I highlighted directly to the reviewer,
there have been many instances where an
allied health professional has referred a
patient to me with the expectation that I
would then refer on to a non-GP specialist,
only for the issue to be one I can easily
manage as a GP. The issue is that our
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allied health colleagues do not understand
the scope of a GP. This recommendation
risks both the MBS budget and creating
backlogs to non-GP specialists through
unnecessary referrals.
This recommendation is frustrating
because our health system already has
the Medical Services Advisory Committee
(MSAC), which can consider the value of
this recommendation. The same goes for
recommendation 11 to introduce bundled
payments for maternity care. MSAC is an
independent, expert body that appraises
proposals for public funding for new
medical services and provides advice
to government based on an assessment
of its comparative safety, clinical
effectiveness and cost-effectiveness.
We need to support and use the
mechanisms that exist — not reinvent
the wheel.
It's not entirely bad news — there are
a couple of recommendations that we do
like in the review, such as recommendation
7, the harmonisation of existing legislation
and regulation, and recommendation
9, the establishment of an Independent
Mechanism to provide evidence-based
advice and recommendations on workforce
models and scope of practice, provided it
includes economic assessment.
It is important to note this is just a
review. The government is yet to announce
any actions in response to the report, and
we are working to ensure any actions do
not further fragment care or undermine
our GPs. All our public submissions are
available on the AMA website including
our response to the final report.
