Medicare Locals to be sliced into 30 Primary Health Networks
The Department of Health (DoH) has released the long-awaited boundaries for the new Primary Health Networks (PHNs) that are set to replace Medicare Locals.
Thirty PHNs have been established – more than the expected 20 or 24 – which DoH says will align with state-based Local Hospital Network (LHN) boundaries.
The alignment is apparent for the PHN boundaries in NSW, Queensland, South Australia and Western Australia, which mirror those states' LHNs.
Victoria has close to 90 LHNs centred on individual hospitals and health services rather than geographical areas, but it will have only six PHNs. As is currently the case with Medicare Locals, Tasmania, the Northern Territory and the ACT will be covered by one PHN.
Much of the reduction in ML numbers has occurred in the capital cities: the greater Sydney region will have five, Melbourne will have three, Brisbane two, Perth two and Adelaide one.
It is probable that regional sub-offices will need to be established for rural areas in WA, SA, Queensland and western NSW considering the vast distances the PHN will be responsible for. The whole of WA and SA outside of the capitals will have one PHN each, covering the same areas as Country Health SA and the WA Country Health Service.
In an overview of the proposed timeline for establishing PHNs, DoH says that an approach to market (ATM) process will take place late this year for organisations to bid to operate the PHNs. The successful applicants will be announced next year, with PHNs given about three months to begin establishing themselves before the end of the financial year.
A strong emphasis on the role of PHNs in predominantly assisting general practice is apparent in the overview, with no mention of community pharmacy or aged care.
One of the roles for PHNs highlighted in the overview is to assist GPs in understanding and making meaningful use of eHealth systems. In the May budget, specific funding for Medicare Locals to carry out this role was cut.
PHNs will have five primary roles, including analysing and planning for the health needs of their local communities; helping general practices to assist patients in avoiding hospital admissions; supporting general practices in safety and quality measures; assisting GPs to use eHealth systems; and purchasing or commissioning clinical services for population health issues such as chronic disease and mental illness.
Metro North Brisbane Medicare Local CEO Abbe Anderson welcomed the decision not to increase the size of her ML, which already has a population of near 900,000.
“The news that the boundaries for the Metro North Brisbane region will remain as they currently are will be a relief to many GPs and allied health professionals,” Ms Anderson said.
“A recent survey carried out by the Medicare Local revealed that many health professionals were concerned that the increased geographical size of PHNs would mean a loss of connection with local health professionals and providers."
Northern Sydney Medicare Local CEO Ramon del Carmen said the move to align PHN boundaries with LHN boundaries was a logical one.
“Aligning to district boundaries is an effective way of reducing service duplication and concentrating funding and effort on keeping people healthy,” Mr del Carmen said.
As Medicare Locals operate as independent companies, they are all eligible to bid to run one of the new PHNs. Pulse+IT understands that a number of the larger Medicare Locals that transferred directly from previous Divisions of General Practice are set to bid individually, while smaller, neighbouring MLs will put in a consolidated bid.
The chief executives of the Grampians, Great South Coast and Barwon Medicare Locals issued a joint statement welcoming the new boundaries. The three Victorian MLs fall within the new Grampians and Barwon South West PHN.
“We are pleased that the government values the primary health coordination role – to provide better, more sustainable, more efficient access to local health services,” they said.
“The new boundaries make sense as they align with existing Local Hospital Network boundaries, contributing to well-connected health systems in our community.”
Country North SA Medicare Local (CNSAML) CEO Kim Hosking said his organisation would be bidding to provide the new country SA network.
Mr Hosking said the decision to allocate two networks to SA was recognition of the fundamental differences in the provision of health services between the city and in the country.
“For example, country GPs are expected to provide services in local hospitals, as most country hospitals do not have salaried medical officers,” he said.
“As an organisation that covers a vast and diverse area … we are strongly positioned to tender to join the new network, in partnership with other rural stakeholders, as we have a proven track record of working with regional health providers and communities.”
Mr Hosking said CNSAML had set up six local health clusters comprising local health providers, community leaders and health consumers that could become the basis for the community advisory committees and clinical councils that the Horvath review into Medicare Locals had recommended.
“We would seek to include existing groups and partners in other parts of the state that could fulfil these roles should we be successful in our bid to provide the new country SA network,” he said.
The PHN boundaries are:
New South Wales (nine PHNs)
- Central and Eastern Sydney
- Northern Sydney
- Western Sydney
- Nepean Blue Mountains
- South Western Sydney
- South Eastern NSW
- Western NSW
- Hunter New England and Central Coast
- North Coast
- North Western Melbourne
- Eastern Melbourne
- South Eastern Melbourne
- Grampians and Barwon South West
- Brisbane North
- Brisbane South
- Gold Coast
- Darling Downs and West Moreton
- Western Queensland
- Central Queensland and Sunshine Coast
- Northern Queensland
- Country SA
- Perth North
- Perth South
- Country WA
- Northern Territory
- Australian Capital Territory
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