NACCHO political alert: Speech to Medicare local Forum Canberra Hon Tanya Plibersek MP


Medicare local forum Canberra

The speech is provided to NACCHO members for information only and is not NACCHO Policy

Please note: NACCHO will be responding next week

As Health Minister, it’s always such a privilege to meet with some of the brightest minds and passionate advocates in the Australian health system. So thank you for the opportunity to do that again today.

And congratulations on playing such an important part in reshaping the Australian health system.

The establishment of Medicare Locals is emblematic of how this Government has acted to shift the gravity in the health system towards primary healthcare.

Medicare Locals are part our Government’s National Health Reform agenda. An agenda that’s changing the landscape of Australian healthcare – from a system focussed on the best treatments for people who are sick in hospital, to one that keeps people well too.

It’s change based on the best evidence about what works to give patients quality healthcare when they need it, where they need it.

As we all know, the evidence is clear. Health systems centred on primary healthcare have better outcomes.

As I’ve said before, but it’s important to reinforce, we just have to look at the findings of the World Health Report in 2008. The Report found that where countries at the

same level of economic development are compared, those that were organised around the tenets of primary healthcare produced better health outcomes for the same investment.

Today I wanted to speak with you about three things:

  • Firstly, how Medicare Locals are transitioning from the establishment to the delivery phase;
  •  Secondly, about engaging with Australians on what their Medicare Local is doing for them; and
  •  Thirdly, why the devolution of decision making and responsibility to Medicare Locals is so important, and how that flexibility supports innovation.

Medicare locals transitioning from establishment to delivery

Since 2009, we have worked to set up the architecture for Medicare Locals, so each organisation can operate with the confidence of strong governance and support.

But as important as that architecture is, we’re now on to the exciting stuff – the transition of Medicare Locals from establishment to the delivery phase.

That is, health professionals on the ground delivering services to people – across the nation.

I find it extremely disappointing to hear some describe Medicare Locals as just another layer of red tape.

I’ve spoken to health professionals and the people they help in Medicare Locals throughout Australia – and nothing could be further from the truth.

You know, as I know, that Medicare Locals are health services, not health bureaucracies. And those who suggest otherwise do so in spite of the facts.

The truth is that around seven out of ten Medicare local staff work directly with patients -More than 1740 workers across Australia

I fail to see which doctor, which nurse, which psychologist, or which patient would be helped by cutting the $1.2 billion for Medicare Locals out of the system.

The word Medicare in the name ‘Medicare Local’ reminds us all what an integral part Medicare Locals play in Australia’s world-class universal health system.

Any assault on Medicare Locals is an assault on Medicare and our system of universal healthcare. And it’s an insult to those health professionals who work so hard to help so many.

Make no mistake – to me, and to this Government, Medicare Locals are no optional extra. Although much newer, Medicare Locals are as important to our healthcare system as the MBS or the PBS.

They are also the vital link between community health and hospitals – the other three out of ten Medicare Local workers are helping to ensure patients are cared for properly whether in their own home, a community setting, or going into or coming out of hospital.

Engaging with australians on what their medicare local is doing for them

Because Medicare Locals are in their infancy, it is critical we work together to engage with Australians about what Medicare Locals mean for them.

As I visit Medicare Locals throughout the country, I see first-hand the incredible work going on – and the difference that work is making to people’s lives.

And they are the stories we must share.

Only last Thursday I visited the Footprints program at Newstead in Brisbane which is supported by Metro North Brisbane Medicare Local through its flexible fund.

Footprints uses the money to provide an active outreach service targeting the homeless community in their region to access primary healthcare services, and to help them with advanced care planning.

Or the new after-hours service that’s just opened at the Nepean Hospital – helping families in Penrith and the Blue Mountains access a GP instead of having to turn up at an emergency room.

And there are many many other examples of fine work happening across Australia.

But for the public and for healthcare professionals to grow confident in Medicare Locals, they must hear about what it is you are doing, and they must be a part of it.

That is why this forum is so important.

I understand the purpose of you all being here together in Canberra is to clearly articulate a shared strategy for Medicare Locals …

…what is your common story and how do you tell it?

…here are you going as a network of Medicare Locals and how are you going to get there?

…ow do you continue building trust and respect amongst the people you serve?

…ow do you not only perform and succeed, but share that performance and success with your communities, and with each other?

…how do you build capacity and capability to take on increasingly sophisticated and complicated roles and responsibilities within the health system?

These are important questions and it is timely for you to be planning together about how you respond to them.

The importance of devolving decision making and responsibility to medicare locals – flexibility to support innovation

As a Government, we have given Medicare Locals the opportunity to play a central leadership role in reform of primary healthcare and consequently of the Australian health system more broadly.

This is both a great privilege and responsibility.

The devolution of decision making to a local level and more flexible funding allows Medicare Locals to be innovative and responsive to the unique health needs of their communities.

But it’s important to remember that the investments you are making in your communities are with the nation’s health dollar. And it’s critical that you get bang for our buck.

Your achievements so far have been impressive.

In recognition of that, I continue to look for other Commonwealth funded programs that can be devolved to the Medicare Local level.

Already, about 30 major health programs are being delivered through Medicare Locals.

And today, another program will be added to that list.

I am very pleased to announce that the Government’s

More Doctors for Outer Metropolitan Areas Relocation Incentive Grants  will be devolved to the Medicare Local level.

As you probably know, this program has been supporting doctors to relocate from inner to outer metropolitan areas.

This is helping even out medical care services in our communities and is reducing some of the geographical inequities that persist.

The transfer means 30 outer-metro Medicare Locals will be funded to administer the grant – which is backed by a $15 million Government investment over the next four years.

Responding to emerging community needs

In recent years, our Government has invested record amounts for more hospital beds, more clinics, more equipment for high-tech procedures and better health infrastructure.

We’ve also opened the door for thousands more doctors, nurses and allied health professionals.

But, at the primary healthcare end of the spectrum, what confronts today’s patients?

Will they share in the full benefits of the health resources of an advanced, developed nation?

Do people, especially the disadvantaged, see a clear pathway to wellbeing?

We know that lower-SES Australians still find it harder to access health services compared to their higher-SES counterparts.

Medicare Locals are instrumental in helping to address that inequality.

A great example – just a few days ago in Perth a new StreetDoctor Truck was launched at the headquarters of the Perth Central and East Metro Medicare Local.

This will provide healthcare services in inner Perth and the surrounding area for homeless and disadvantaged people.

The service provides general health checks, wound dressings, immunisations, harm minimisation and other counselling, and links patients to mainstream services.

This service launches with 2,500 active patients, four in every ten are under-25-year-olds, 30 per cent are Aboriginal and Torres Strait Islander people, and the vast majority have mental health issues.

The service has important partnerships with Passages, Red Cross’ soup kitchens, Pharmacy Ashfield, The Town of Bassendean, Catholic volunteer friendship, and support workers.

Recognising this important community need, the Medicare Local has built the StreetDoctor up so that it now provides 40 hours of service a week – an incredible example of a collaborative response to a local health need.

And Medicare Locals are there in times of crisis.

Like in Queensland after the recent floods, the Sunshine Coast Medicare Local offered free mental health counselling to support the well-being of residents in Sunshine Coast and Gympie. And the Wide Bay Medicare Local was also very active in supporting Aboriginal and Torres Strait Islander people who were hit particularly hard.


It’s examples like those that really do speak volumes about the importance of Medicare Locals.

Local control and local solutions are seeing Medicare Locals delivering for communities across Australia.

Medicare Locals are an essential part of our universal healthcare system.

Our Government stands shoulder to shoulder with you all as you continue your fantastic work delivering healthcare to Australians when they need it, where they need it.

Tailor the health care to Close the Gap: hence Medicare Locals


Australia’s increasing Indigenous population is being urged to sign up for quality chronic disease management in general practice to ensure this cohort of Australian society gets the primary health care services they need.

During NAIDOC week, in which the nation celebrates and acknowledges the achievements of Aboriginal and Torres Strait Islander peoples, AML Alliance Chair, Dr Arn Sprogis says the good news is more individuals are identifying as Aboriginal and/or Torres Strait Islander which is fundamental to how we as a nation work towards closing the gap on health inequities between Indigenous and non-Indigenous Australians.

“According to the latest Australian Bureau of Statistics’ Census data for 2011 there has been a 20 percent increase in the Indigenous population since 2006 – that’s an increase from just over 455,000 to nearly 550,000 people,” Dr Sprogis said.

“While much of this increase is due to the Indigenous birth rate, a sizeable factor to this increase can also be attributed to people increasingly identifying as Indigenous,” he said.

“For the health sector, particularly in general practice, the more GPs and practice nurses and allied health professionals are aware of the Indigenous status of patients the greater the opportunity to ensure Indigenous Australians can be made aware of their health rights locally.

“One of the biggest tasks ahead for Medicare Locals is to ensure health service programs can respond to the particular needs and requirements as well as the clinical needs of Aboriginal and Torres Strait Islanders,” Dr Sprogis said.

“To achieve this, the PIP IHI has been designed to get general practices to register for the incentive program and from there encourage their Aboriginal & Torres Strait Islander patients to register to claim the benefits that can be offered through the program,” he said.

“While there is still room to improve these incentives, since this program started 2,600 general practices across the country have registered which is nearly 45 percent of practices nation-wide.

“Over 100,000 eligible patients are currently benefiting from funding directed towards various Indigenous Health programs and over 1.5 million prescriptions have been dispensed from pharmacies and four of the top five scripts have been for treating cardiovascular disease and diabetes.

“Adding to the efforts to improve access to mainstream health services, Medicare Locals across the country are doing a mix of employing and funding a health workforce which currently consists of more than 260 Indigenous Outreach Workers, Indigenous Health Project Officers and Care Coordinators.

“Supported by their Medicare Locals, this workforce has deep outreach into the community so that the right services can be accessed at the right time.

“As Medicare Locals continue to grow, their integration of Indigenous health services will improve significantly and the right balance for health services for their respective Aboriginal & Torres Strait Islander population will be achieved, helping to make inroads into closing the gap in health inequities ” Dr Sprogis said