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Nurse policy to disadvantage GPs: AMA

General practitioners are fearful of practice nurse subsidies.

Employment opportunities for practice nurses will come to a halt under proposed funding changes for general practices, claim the AMA.

In the May budget, the government announced an extra $390 million in funding support for general practices to employ practice nurses. This was widely welcomed by both nurses and doctors, but concerns were raised over the way this funding would be provided.

“They propose moving from a mix of fee for service MBS rebates and incentive payments to a system based entirely on block funding grants that go direct to general practices, but the new arrangements are likely to prove problematic for many practices,” Dr Andrew Pesce, AMA president, said.

“The AMA advised the government at the time that many practices would be disadvantaged by the new funding system and we sought changes.”

While the extra funding has the potential to be a huge success, to be most effective consultation with the profession over the design and implementation of proposed arrangements was needed. This was supported in the findings of a recent AMA survey, Pesce said.

During June 2010, the AMA surveyed 257 general practices from across the country to get feedback about the impact of the government's changes.

The results of the survey provide evidence for the need to change the proposed new arrangements to make them work better for general practices and create employment for more practice nurses,” he said.

The survey indicates the main problems with the proposed design of the new funding arrangements were the decision to move entirely to a system of block funding grants; and the decision to cap the number of available grants at five per practice, Pesce said.
Of the general practices that participated, 48 per cent said they were likely to be worse off as a result of the changes - with outer urban, regional and rural practices being hit the hardest.

It also found that 21 per cent of practices that currently employ a practice nurse said under the changes they were likely to cut back on practice nurse employment.

Of the practices that currently employ practice nurses, 56 per cent said individual GPs would be left worse off financially as a result of the decision to abolish MBS GP practice nurse rebates in favour of block funding grants for practices.

“Practice nurses have been a success story in improving patient access to care through general practices, with over 8500 now working with family doctors across the country,” Pesce said.

This number had the potential to grow with the survey also finding 44 per cent of practices that do not currently employ a practice nurse would consider employing one or more practice nurses once the government's budget changes were implemented.

“But the momentum of greater employment opportunities for practice nurses will come to a sudden halt unless the funding system is changed so that no practices are disadvantaged,” Pesce said.

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