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Improving the delivery of care

Health groups call on AMA to support the government’s planned diabetes reforms.

Nurses, general practitioners and healthcare consumers are keeping an open-mind about the federal government's batch of reforms around diabetes management.

Labor has said it will spend $449.2 million on encouraging diabetics to sign up with a “home” GP practice for ongoing care.

The practice would be paid $1200 per patient to create personalised care plans, coordinating access to other health providers such as dieticians, physiotherapists and podiatrists.

Clinics would also be eligible for around $10,800 a year in performance payments if diabetics stayed healthy.

The Australian Medical Association (AMA) wants the plan scrapped but other health groups have welcomed the changes.

Australian General Practice Network chair Emil Djakic said it would be a mistake for the profession to dismiss the proposal.

“What we need to do is work with government and consumers to design a workable system that will ensure its investment achieves the outcomes it desires,” he said.

Australian Nursing Federation federal secretary Lee Thomas said block funding would allow GP nurses to better manage and improve the health of people with diabetes.

“Patients will have better access to a range of health professionals - including nurses, diabetes educators, dieticians and podiatrists just to name a few,” she said.

The initiative has the potential to reduce hospital admissions, said Australian Practice Nurses Association president Julianne Badenoch.

“The combination of increased and a more flexible model of funding will enable practices to provide care more tailored to the needs of their patients, be that more structured nurse-led diabetes clinics, group diabetes education, or telephone counselling,” she said.

“It is about time Australia caught up to other developed countries in providing patients with access to best practice in multidisciplinary chronic disease management.”

But a survey of almost 500 GPs by the AMA found just four per cent of respondents would definitely participate in the scheme.

Two per cent said the scheme would result in GPs being able to spend more time with their diabetes patients.

AMA vice-president Steve Hambleton said the survey reinforced the association's opposition to the scheme.

Hambleton warned the scheme would rob patients of their Medicare rebate entitlements, interfere with doctor-patient relationships and limit choice.

"It is a scheme that imposes arbitrary limits on funding for patient care," he said.

Consumers Health Forum of Australia executive director Carol Bennett said the survey was too small to accurately reflect doctors' views.

"The proposed reforms might not have the approval of a small sample of doctors, but anyone who has had to experience the health system from a user perspective knows that the current arrangements for managing chronic illness like diabetes fall well short of what is needed," she said.

Diabetes Australia’s Victorian branch head Greg Johnson, said Diabetes Australia had recently met with the Royal Australian College of General Practitioners and the Australian General Practice Network and they identified some issues with the program's design.

“But we've jointly agreed that we want to work with the government to now make a good program and a workable program design,” he said.

“We noted that the program doesn't start until 2012 so we believe there's plenty of time for us to get the design right.”

With AAP

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