Primary care redesign: patients must come first

Thursday, August 6, 2015

The Australian Healthcare and Hospitals Association (AHHA) welcomes the release this week of the Primary Health Care Advisory Group's discussion paper, Better Outcomes for People with Chronic and Complex Health Conditions through Primary Health Care.

"There is widespread agreement across the health system that a more strategic and sustainable approach to the management of chronic disease is required, and that this work should be undertaken in a context of ensuring better health outcomes.  It is pleasing that the Health Minister is seeking the views of Australians on this important issue and is considering a range of innovative options," says Alison Verhoeven, AHHA Chief Executive.

The proposals outlined in the discussion paper focus on the organisation and funding of primary health services, workforce responsibilities, and technology and data enablers. But the desired outcomes of reform are not clearly defined, and the various proposals are presented in isolation, without reflection on interrelatedness.  It is also unfortunate that the concepts of equity, accessibility and affordability are absent from the paper generally, and from the vision and guiding principles specifically.

"Primary health care needs to be delivered not only in a manner that is sustainable to governments and providers, but that is also affordable and accessible for all Australians, regardless of where we live or how wealthy we are.  If the aim of this paper is to provide options to improve health outcomes for people with chronic and complex health conditions, it has overlooked the economic disadvantage that many people with these conditions experience, and it provides little evidence of any consideration of equity, accessibility and affordability in its system redesign proposals," says Alison Verhoeven.

A patient-centred approach to primary care would place affordability and equity at the centre of proposed changes to health system funding and organisation. Further, patient-centred care models, with funding and technology as enablers, are more likely to achieve the goal of better outcomes for people with chronic and complex health conditions than care models driven by funding decisions. It is unfortunate that there is little discussion in the paper about the consequences for patient care of the various funding mechanisms proposed. More detailed discussion of these consequences in the planned public consultation process would be welcome.

The AHHA urges the Primary Health Care Advisory Group and the Health Minister to look beyond the financial interests of governments and providers, and place consumers and their ability to access affordable, quality, well-integrated healthcare at the centre of any changes.

For more information on the AHHA, visit

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, community and primary healthcare services, and advocates for universal, high quality and affordable healthcare to benefit the whole community.

Media enquiries:

Alison Verhoeven, Chief Executive

0403 282 501