Is it time to try a new healthcare model? 

by Stephen Alexander

In Australia the federal and state governments have been struggling to manage the growing gap between the ever-increasing demand for health services, and the decreasing ability to fund them at the level which voters expect. Stephen Alexander looks at one attractive solution. 

There are two main areas of contention focusing government minds right now. First, the increasing demand for hospital beds which some commentators have suggested amounts to three new beds a week in Queensland to simply keep up with the influx of new people to the state. 

The second and even bigger problem is the pressure on primary health services in our communities due in part to the increase of chronic disease. The UK National Health Service catorgorises this as people who are drug dependent – now 33% of the population across all age groups and heading towards 50%.

Governments are currently testing a range of measures from hospital avoidance schemes, that try to reduce the cost whilst maintaining, or even increasing, the level of service, to more contentious measures where GPs may be restricted in their activities like ordering blood tests. 

But a more hopeful sign from the federal government is an initiative called GP Super Clinics. The idea, supported by Kevin Rudd, is to fund 31 communities over the four years to establish a more coordinated aproach to primary health delivery at a cost of $223 million.

Interestingly, the application for funding processes will be tailored for the locality, taking account of the specific circumstances of that community. This has provided an unusual degree of flexibility in who can apply for the funding, resulting in a mix of winning consortias so far ranging from a few GPs to a more corporate approach.

GP Super Clinics will have a greater focus on health promotion and illness prevention, and better coordination between privately provided GP services, community health and other state and territory government-funded services.  

They  have been identified as a priority by the Council of Australian Governments (COAG) as a way of achieving a range of cost savings whilst increasing the health and well-being at a community level.

Significant cost savings would be made by reducing the need to go to hospital, reduce unnecessary duplications and through working with those people who not only want to take greater responsibility for their own health but want to improve the general wellness of the community.

It is intended that each GP Super Clinic will bring together general practitioners, practice nurses, visiting medical specialists and allied health professionals, and other health care providers. 

One of the first communities to receive a $5m grant to establish a super-clinic is the Blue Mountains in NSW which is remarkably similar to our own Hinterland in terms of geographic spread and needs.

Kate Gun is the CEO of Balance Healthcare which is running the Blue Mountains super clinic. They will develop an existing practice as the hub, says Kate, and then link up a wide range of existing local services ranging from GP, physiotherapy, exercise physiology, psychology, pharmacy, pathology, radiology and counselling, plus a wide range of other allied services that foster wellbeing. 

Kate Gun says that they want the success of their clinic to be measured by the community. The bench mark would be  better health outcomes and more wellness in the community. Balance Healthcare will also harvest evidence of clinical outcomes to work out what actually works from a patient perspective.

Compared with the Blue Mountains, the Sunshine Coast Hinterland is already ahead of the game in meeting the criteria for a super clinic grant. 

We have a very strong group of primary health service providers which collaborate better than most urban communities through a degree of trust between the parties.

We also have a hospital in Maleny which advocates of the super clinic would like to see developing simple procedures that only require an overnight stay.

The federal government is clearly eager to assess the GP super clinic as a new model for achieving economy in health care as well as delivering desired patient outcomes. The Sunshine Coast Hinterland is well placed to have a super clinic trialled here. It will be up to those responsible for health care to present a convincing case for a $5 million grant from the federal government.