Our advocacy priorities for 2024-25 focus on the theme of "Restoring Confidence: Practical Solutions to Address Victoria's Healthcare System Challenges." These priorities build upon the initiatives we have been pursuing since May 2023. AMAV President, Dr Jill Tomlinson, talks us through them.

“Victorians want a healthcare system that provides quality, accessible safe healthcare. We have lived through unprecedented times, and there is much work to be done to restore confidence and improve workforce morale,” says AMA Victoria’s President, Dr Jill Tomlinson.

“The Victorian healthcare system delivers high quality care, but workforce pressures and the impact of the pandemic has left the medical workforce with low morale and extremely stretched resources. The continued expectation that we can do more with less, the increasing complexity of care, increasing cost of living pressures and access issues are contributing to despair and burnout among doctors.

“General practitioners lament the fragmentation of team-based general practice care by initiatives including pharmacy prescribing and priority primary care clinics, and the challenges of accessibility and affordability for their patients. Psychiatrists experienced significant challenges with communication around the implementation of the Mental Health and Wellbeing Act 2022 and are concerned that care delivery is being limited by workforce and bed constraints despite increasing demand for services. “

AMA Victoria is committed to enhancing Victoria's healthcare system by focusing on key areas including—sustaining general practice, improving public hospitals, advancing digital health, supporting mental health, advocating for progressive public health measures, prioritising rural and regional health, lessening the administrative burdens placed on all medical practitioners, and addressing equity and diversity issues.

Restoring Confidence provides AMAV’s advocacy template for the year ahead. It focuses on three key areas or leading themes (general practice, public health services and mental health), and five contributing themes (digital health and technology, equity and diversity, regional and rural healthcare, administrative burden, public health).

“General practice is the most efficient part of our healthcare system and the workforce and funding crisis in general practice heightens the difficulties of managing patients who have increasingly complex care needs. We desperately need to bolster the general practice workforce through improvements in recruitment and retention; improve accessibility and affordability of quality primary care for Victorians; and reduce avoidable hospital presentations and admissions. We need to improve working conditions for public hospital doctors including in psychiatry, and address recruitment and retention factors, particularly in regional and rural areas.”

“Given the straitened state fiscal climate and the reality that much advocacy in 2024 will be directed at preventing cuts rather than proposing new expenditure, we have deliberately not used the term ‘budget submission’ this year. Instead, we’ve created series of priorities that encapsulates the policy and advocacy initiatives AMAV has been pursuing since May 2023. This deliberately presents nothing we haven’t discussed many times with government,” explains Dr Tomlinson.

"The 2024-25 priorities reinforce our messaging and are supported by many tangible, achievable solutions, which we strongly recommend the Victorian Government take up to resolve persistent issues, improve the healthcare system and usher in a more resilient and responsive era – one that advances a Victorian healthcare system that empowers doctors and enriches patient care.”

Leading themes

We are advocating for public health

Improvements to working conditions for public hospital doctors: 

• restructuring health system governance
• job security enhancement
• adequate staffing levels
• improved gender equity
• improved implementation of employment terms and conditions
• fair remuneration for unsocial hours
• streamlined credentialing process
• rural and regional infrastructure investment
• carer support provisions
• support for IMGs
• increased transparency in workforce planning
• oversight of specialist colleges
• doctor to patient ratio standards

Reasonable and swift resolution of Doctor in Training class actions

Providing clarity regarding MBS billing in public health services

Transparency and appropriate consultation in reform of Victorian health services

We are advocating for general practice

General Practice Support and Recovery Strategy interventions:

• Single Employer Model trial in 2025
• extension of GP Registrar Incentive Payments
• payroll tax clarity and certainty
• removal of red tape
• reduced expectation for forms to be completed gratis
• improved transfer of care
• support and recognition for GP reduction of avoidable hospital readmissions
• Continuation of the vital Chief General Practice Advisor position within the Department of Health

Expanding Victorian virtual specialist consults to improve community access to specialist opinions

State-initiated primary care measures (e.g. pharmacy prescribing, Priority Primary Care Centres) to not further fragment GP-led, team-based care

Timely access to vaccines

We are advocating for mental health

Continuation of mental health service funding, given the burden of the Mental Health and Wellbeing Act and noting that mental health services were unable to be delivered at projected levels last financial year due to workforce and bed constraints

Improved communication from the Department of Health about implementation of the Mental Health and Well Being Act, and Restrictive Interventions and Compulsory Assessment and Treatment policies

Solutions to enhance recruitment and retention in the mental health workforce, particularly those that address increasing rates of occupational violence and a lack of senior leadership

Reasserting the importance of the medical model in mental health reform

• co-design of policy
• embedding clinician executive decision-making authority within the Department
• funding for appropriate remuneration to enable experienced clinicians to participate in such processes

Contributing themes

We are advocating for digital health and technology

Improved transfer of care particularly discharge summary content and delivery, and referrals and information sharing

Embedding protected time to perform clinical handover at the point of hospital discharge

Virtual care measures that support emergency care and general practice

Lifting digital maturity in health services across Victoria

Improving health information sharing

Reducing red tape through digital improvements

Equity and diversity

Availability and analysis of gender data within the workforce

Addressing the gender pay gap

Facilitation of participation, cultural safety, and inclusion of doctors from diverse backgrounds

Carer allowances or supports

Needs-based adjustment of medical school and training programs to provide pathways to specialties with shortfalls

Better support for IMGs, especially in rural settings

Recognition of prior learning from College training programs

Inclusion, fair selection and support for medical students with disability

Increase flexible training opportunities, including part time stand-alone positions

Improved racial literacy of healthcare workforce, and Ahpra

All trainees able to sit/apply to sit College and Fellowship exams while on parental leave

Fair and equitable registration fees

Please see AMAV/ASMOF(V)’s Ministieral Review Submission for more information on these initiatives

Regional and rural healthcare

Rural infrastructure investment

Student training and recruitment investment

Increase medical student intake from rural areas

Increase rural exposure for metro students

Increase pay, allowances or subsidise expenses for doctors and students training or practising rurally

Ensure clinical services are adequately equipped

Require colleges to recruit trainees based on rural experience

Provide more rural training opportunities

Please see Please see AMAV/ASMOF(V)’s Ministieral Review Submission for more information on these initiatives

Administrative burden

Reduction in duplication, unnecessary paperwork and streamlined workloads for healthcare workers

Eliminate automatic rejection of unnamed referrals by public hospital outpatient clinics

Substantial reduction in organisational expectations for doctors to provide pro bono services in completing forms and reports without payment

Improvements to Ahpra’s notifications process

Public health

Supervised injecting facility in the Melbourne CBD

Drug checking (pill testing) accessibility

Pharmacotherapy services (opioid replacement therapy)

More accessible chronic pain services for women and men

Progression of the aims of the Victorian Sustainable Healthcare Unit including developing sustainability KPIs, embedding sustainability metrics into procurement contracts and developing a roadmap for net zero healthcare emissions targets

Reduction in vaping related harms

Improved regulation and public safety, and reduced harms around e-Scooters

 

BY VANESSA MURRAY

 

This article first appeared in the 2024 Winter edition of VICDOC. Read the original story here.