National Primary Health Care Strategic Framework

Attachment A Extracts from the National Health Reform Agreement

Page last updated: April 2013

Schedule D – Local Governance – Clauses D29-D43

D29. Medicare Locals will be established by the Commonwealth by 1 July 2012.

D30. The Commonwealth will work with States, primary health care providers and other relevant groups to establish Medicare Locals as primary health care organisations across Australia.

D31. Medicare Locals will be the GP and primary health care partners of Local Hospital Networks, responsible for supporting and enabling better integrated and responsive local GP and primary health care services to meet the needs and priorities of patients and communities.

D32. Medicare Locals and State-funded health and community services will cooperate to achieve these objectives.

D33. The strategic objectives for Medicare Locals are:

  1. improving the patient journey through developing integrated and coordinated services;
  2. providing support to clinicians and service providers to improve patient care;
  3. identifying the health needs of their local areas and development of locally focused and responsive services;
  4. facilitating the implementation of primary health care initiatives and programs; and
  5. being efficient and accountable with strong governance and effective management. Top of page
D34. Medicare Locals will, among other functions, have responsibility for assessing the health needs of the population in their region, for identifying gaps in GP and primary health care services and putting in place strategies to address these gaps.

D35. Medicare Locals will be independent legal entities (not government bodies) with strong links to local communities, health professionals and service providers, including GPs, allied health professionals and Aboriginal Medical Services. Medicare Locals will reflect their local communities and health care services in their governance arrangements.

D36. As set out in Schedule E, the Commonwealth and States will work together on system-wide policy and state-wide planning for GP and primary health care. The Commonwealth will consult with States to ensure that:

  1. Medicare Locals are taken into account in system-wide policy and state-wide planning for primary health care; and
  2. plans required to be developed by Medicare Locals take account of state-wide plans.
D37. Medicare Locals and Local Hospital Networks will be expected to share some common membership of governance bodies where possible. Medicare Locals will be expected to work closely, and establish a formal engagement protocol, with Local Hospital Networks.

D38. Medicare Locals will be subject to the performance monitoring and reporting requirements of the Performance and Accountability Framework outlined in Schedule C. The Commonwealth will be responsible for ensuring Medicare Local performance in accordance with this framework, where it applies. Top of page

D39. The Commonwealth will establish performance management arrangements for Medicare Locals, and will ensure that the States have opportunities to access performance information as part of these arrangements. The NHPA will develop and produce reports on the performance of Medicare Locals and will provide confidential advice to the Commonwealth on poor performing Medicare Locals where ongoing poor performance has been identified. The Commonwealth will decide on the nature and timing of actions to remediate ongoing poor performance. Where the NHPA finds poor performance by a Medicare Local that plans and coordinates primary care services provided by a State, the relevant State will be consulted before the NHPA issues its final performance report.

D40. States will not establish duplicate GP or primary health care planning and integration organisations. To the extent that such organisations already exist, the Commonwealth and the relevant State will work together to agree a transition plan, including timing, for the organisation then to become part of Medicare Local arrangements.

D41. The Commonwealth and States will work together to create linkages and coordination mechanisms, where appropriate, between Medicare Locals and other State services that interact with the health system, for example services for children at risk, people with serious mental illness and homeless Australians.

D42. In establishing Medicare Locals, the Commonwealth will work co-operatively with States to ensure, wherever possible, common geographic boundaries with Local Hospital Networks. These boundaries may be reviewed over time by the Commonwealth in consultation with States.

D43. Medicare Locals will engage with the following stakeholders to enable their views to be considered when making decisions on service delivery at the local level, or service and capital planning at the State level:

  1. other Medicare Locals to collaborate on matters of mutual interest;
  2. Local Hospital Networks; and
  3. the local community and local clinicians, particularly in the area of safety and quality of patient care. Top of page

Schedule E – GP and Primary Health Care

E1. GP and primary health care services are integral to an effective and efficient Australian health system. The Commonwealth will renew its efforts to improve GP and primary health care services in the community in order to improve care for patients. The Commonwealth will take lead responsibility for the system management, funding and policy development of GP and primary health care with the objective of delivering a GP and primary health care system that meets the health care needs of Australians, keeps people healthy, prevents disease and reduces demand for hospital services.

E2. The Commonwealth and the States will work together on system-wide policy and state-wide planning for GP and primary health care given their impact on the efficient use of hospitals and other State funded services, and because of the need for effective integration across Commonwealth and State-funded health care services.

E3. The Commonwealth will develop by December 2012 a national strategic framework to set out agreed future policy directions and priority areas for GP and primary health care, informed by bilateral work on state-specific plans for GP and primary health care, with state-specific plans to be completed by July 2013.

E4. As part of its lead role in the delivery of GP and primary health care reform, the Commonwealth has a range of initiatives and reforms to Australia’s GP and primary health care system under way or in the process of implementation, including Medicare Locals, GP Super Clinics and infrastructure grants, the practice nurse incentive, after hours arrangements, and additional GP and allied health professional training. These programs are currently being implemented and the Commonwealth will release implementation details for these programs, and consult the States in their development, as appropriate.

E5. States will work cooperatively with the Commonwealth in the implementation and ongoing operation of the Commonwealth’s primary health care initiatives.