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    Sydney = 1/4 of Australian population, 1/20 of Medicare locals. Curious.

  2. 2


    In fairness the plan was they would always be stepwise, presumably NT and Vic will come along in due course.
    They replace Divisions with the same funding-stream, so permission of the Vic State Government isn’t required. NT can of course be around to comply anyway as it is not sovereign.
    What’s unclear is how they will differ from Divisions apart from how boards are elected, and even that’s not clear either (will pharmacists be able to vote? how about private specialist?).
    GPs will be less involved which I suspect for many will be a relief.

  3. 3


    Private specialists do not appear to be one of the groups that are currently involved in Medicare Locals, in either the governance, service delivery or service coordination components. MLs will be coordinating ‘primary care services’ which by the current Australian Dept of Health definition appears to be GPs and allied health only.

    There does seem to be some confusion over what constitutes primary care services – my reading of Australian Dept of Health documents suggest they actually mean community based services. They don’t appear to be using the nomenclature that state and territory Depts of Health use, where primary care is an unreferred service and secondary care is a referred or specialist service. So, the Australian government definition of primary care does include allied health even though much (most?) of the work they do is specialised and or referred, ie secondary care.

    If we do take ‘primary care’ to mean community care (which is what the Australian government seems to be doing) then we really ought to be involving private specialist in the Medicare Locals – for many of them, particularly the physicians, much of their work is actually community based care, and they work closely with the GPs and allied health providers as part of the community team that keeps patients out of hospital, and out of aged care facilities.

    Medicare Locals would work better if private medical specialists that are part of the community team were specifically included. Currently they are not.


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