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Waiting for evidence

Roxon shelves $450m diabetes care plan.

The federal government has shelved its controversial diabetes reform plan that was meant to allow patients to sign up with a "home" GP practice for continuing care from mid-2012.

Just four months ago, Health Minister Nicola Roxon said it would be "foolish" to walk away from the $450 million overhaul due to opposition from some doctors.

But on Friday she did just that.

Roxon said the government had decided to "pilot" the reform for three or four years before rolling it out nationally.

"To allow for the pilot, the government will defer the full roll-out of coordinated care for diabetes until after its results are known," the health minister said in a statement.

"As a government we are always prepared to listen and respond to views put by the community."

Under the original proposal, practices would have been paid an average of $1200 per year for each diabetic who signed up to the scheme.

Clinics, rather than individual GPs, would then create "personalised care plans" for patients, coordinating access to other health providers such as dieticians, physiotherapists and podiatrists.

They'd be eligible for around $10,800 a year in performance payments if diabetics stayed healthy and out of hospital.

But some doctors - led by the Australian Medical Association - opposed the reform on the basis it would rob patients of Medicare entitlements, interfere with doctor-patient relationships and limit choice.

They saw the plan as the first step towards replacing the fee-for-service model with block grants for a range of treatments.

Announcing the reform in March, Roxon said the change "marks the beginning of a new way of treating Australians with long-term illness".

In July, she insisted that "to walk away from such a big investment, and trying to test it (to) see if this delivers better outcomes for patients, I think is a little bit foolish".

The health minister now says shelving the plan in order to wait for "robust data on patient and clinical outcomes" will save $418 million over four years.

The pilot is expected to cost $30.2 million.

AMA president Andrew Pesce says the association never believed there was proper evidence to support the reform.

"A reliable and valid trial will take the politics out of the debate and ensure that decisions on health service delivery are made based on evidence to support good patient outcomes," Dr Pesce said in a statement.

The AMA has now agreed to be part of the government's Diabetes Advisory Group which will design and implement the pilot.

The Australian General Practice Network says Ms Roxon was right to respond to concerns among professionals "that the proposed plan for treating and managing diabetes had flaws".

Network chief executive David Butt said the pilot could result in Australia eventually becoming a world leader in managing chronic disease.


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