Connecting Health Services Fact Sheet

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Connecting health services with the future

CONNECTING HEALTH SERVICES WITH THE FUTURE: MODERNISING MEDICARE BY PROVIDING REBATES FOR ONLINE CONSULTATIONS A re-elected Gillard Labor Government will modernise the health system and deliver better health services by providing Medicare rebates for online consultations across a range of specialties for the first time. This investment will help people who live outside capital cities get the health care they need. In many cases it will save patients the time and expense of travelling long distances to see medical specialists, and will help them to see the right specialist sooner. Federal Labor’s $392.3 million investment will provide: 1. $250.5 million to make Medicare rebates available for online consultations across a range of specialties, providing around 495,000 services over four years to rural, remote and outer metropolitan areas. 2. $56.8 million to provide GPs and specialists with financial incentives to participate in delivering online services. 3. $50 million to expand the GP after hours helpline and include the capacity for the helpline to provide online triage and basic medical advice via videoconferencing. 4. A $35 million fund to support training and supervision for health professionals using online technologies. These initiatives will build on the Government’s historic health reforms that will see more hospital beds, record numbers of doctors and nurses, and shorter waiting times in public hospitals. This investment is the next building block in our health reforms.

Julia Gillard and Labor

Let’s move Australia Forward

Why is Federal Labor making this investment? Specialists are in short supply in remote, rural, regional and outer metropolitan areas People living in remote, rural, regional and some outer metropolitan areas often find it difficult to access medical services – especially specialist medical services. There are more than twice as many specialists per capita in major cities as there are in regional and remote areas. The lack of specialist doctors in remote, rural, regional and outer metropolitan areas is a barrier to Australians living in these areas accessing specialist medical services. Australians from rural and regional areas often face a choice between the considerable inconvenience and cost of travelling significant distances to see a specialist in a capital city, or facing a lengthy wait to see a visiting specialist close to home. People in rural areas have poorer health outcomes than their metropolitan counterparts. Life expectancy in regional areas is one to two years lower than in major cities and for people in remote areas it is up to seven years lower due to higher coronary heart disease, other circulatory diseases and accidents. Poor health status also tends to increase with remoteness. Online medicine can improve access to health services, but has been held back by lack of infrastructure and support Many health professionals and stakeholder groups have long argued that modern technology offers the opportunity to significantly improve access to services in remote, rural, regional and outer metropolitan Australia – by enabling consultations which largely involve exchanges of information (as opposed to a physical examination) to be conducted remotely over the internet. Despite this potential, tele-health or online consultation services have not been widely adopted. A lack of infrastructure – in particular, inadequate bandwidth to support high-speed transmission of images and video-conferencing – has been an obstacle to greater use of tele-health. Health professionals have also cited a lack of Medicare support for consultations delivered online as a barrier to greater use of technology to deliver medical services. In particular, the lack of Medicare funding for a health professional (for example, the GP or practice nurse) to be present at the ‘patient end’ of the consultation has often been cited as a disincentive to greater uptake of online consultation services. How will this work? Modernising Medicare by providing rebates for online consultations From 1 July 2011, a re-elected Gillard Labor Government will provide up to $250.5 million in Medicare rebates for online consultations across a range of specialties.

Julia Gillard and Labor

Let’s move Australia Forward

Currently, there are a limited number of Medicare items for tele-health services for psychiatry and radiology. These items enable only the medical specialist to bill Medicare for the consultation. For the first time, Federal Labor’s policy will provide a Medicare rebate for a GP or practice nurse to host a specialist tele-health consultation with the patient – removing one of the major disincentives for the use of tele-health Medicare items. Rebate levels across different services and specialties will be set in consultation with the medical profession. Generous rebates will be provided for each consultation, both for the GP or practice nurse where the service is accessed, and for the specialist conducting the consultation. Federal Labor’s policy will also provide $56.8 million for financial incentives to providers to participate in delivering online services. These incentive payments could support the purchase of infrastructure, including hardware, software and support, to enable tele-health consultations. These investments will support half a million internet-based consultations with GPs and specialists, saving many patients the time and expense of travelling long distances to see specialists, and help them see the right specialist sooner. This is likely to be of particular benefit (though is not limited to) patients of:  Consultant physicians.  Endocrinologists (hormones), dermatologists (skin) and ophthalmologists (eyes) – benefiting those with chronic diseases, such as diabetes.  Psychiatrists – benefitting those with mental health issues.  Surgeons – who may be able to utilise tele-health for post-operative follow up. There will always be medical services which will only ever be able to be delivered in person and which online services cannot replace. Cutting edge health technology services are already being used in our rural and regional towns. For example, a broadband based telemedicine system has been used to link patients in intensive care at the North West Regional Hospital in Tasmania with specialist services available at the Royal Hobart Hospital. Previously, patients at the intensive care unit at the North West Regional Hospital who required specialist services (like an ultrasound of the heart) were frequently transferred to larger centres. By using video technology, specialists in Hobart can interact with a team of health professionals in the North West Regional Hospital – saving patients the need to travel while they are critically ill. While some hospitals have led the way in these services, utilisation of tele-health services outside of hospitals has been held back by lack of infrastructure, poor bandwidth and lack of Medicare rebates for consultations delivered online.

Julia Gillard and Labor

Let’s move Australia Forward

Building on our investments in improving access to after hours services From 1 July 2012, the GP after hours helpline will be equipped for videoconferencing – so that as high speed broadband becomes more readily available in people’s homes, patients will benefit from nurse triage and basic medical advice from a GP via videoconferencing. Funding of $50 million to ‘add on’ this service to the GP after hours helpline will be provided from 1 July 2011. Nurses and GPs staffing the helpline will be able to diagnose problems more quickly and effectively, with the aid of a new dimension of information. For example, a parent whose child comes down with a rash in the middle of the night will be able to videoconference with a nurse or doctor at the GP after hours helpline over the internet from home. The nurse or GP would be able to look at the rash via weblink, and provide advice on treatment and next steps. This investment builds on the Gillard Government’s commitment to establish the GP after hours helpline from 1 July 2011. Harnessing technology to support high quality training for health professionals In addition to providing more services to patients now, starting in January 2011 Federal Labor will provide $35 million to support innovative clinical teaching and training projects which harness the benefits of new technologies including broadband in training the health professionals of the future – so that more health professionals enter the health workforce having experience in providing services using new technologies. Support will also be provided to peak organisations and consumer organisations to assist in the coordination and rollout of these services across rural and regional Australia. A re-elected Gillard Government will consult closely with the medical profession and other stakeholders on the detailed design of these investments. The National Broadband Network The National Broadband Network will enable all Australians to benefit from even better health services as high speed broadband becomes more widely available around the country. As the NBN is rolled out, it will provide greater reliability and internet speeds that are up to 1,000 times faster than now.

Julia Gillard and Labor

Let’s move Australia Forward

The NBN will significantly expand the range and sophistication of services that can be delivered online. For example:  Services will be improved by dramatically reducing the download time for medical data like x-rays to a split second. It will also allow higher bandwidth 3D medical imaging services.  Patients will be able to case conference with multiple health professionals at the same time from their doctor’s surgery.  Health professionals will also be able to use higher speed broadband connections to share medical information and access more training opportunities.  Health services will be able to receive faster access to electronic health records – including high resolution medical images linked to these records. The measures contained in this policy will be enhanced by the NBN, but they are not totally dependent on it. Some surgeries will already be equipped for online consultations and be able to start delivering these services straight away. As the NBN rolls out over the next eight years, surgeries around the country will be supported with the bandwidth to deliver both the services of today, as well as the services of tomorrow that have not even been thought of yet. What will this mean for Australians These services will enable Australians all over the country to get better health services – whether in rural and remote areas, or in our outer metropolitan areas like Campbelltown in Sydney and Beenleigh south of Brisbane. They will save patients the time and expense of travelling long distances to see specialists, and help them see the right specialist sooner. For example:  A patient with breast cancer who would usually need to travel to a regional centre or capital city to see an oncologist to discuss a treatment plan, will be able to have this consultation, with her GP, via a weblink from her local GP surgery. A patient with diabetes and heart disease who usually needs to travel to see an endocrinologist and cardiologist every three or six months will be able to videoconference, potentially with a nurse, at their usual GP practice instead. A parent whose child comes down with a rash in the middle of the night will be able to videoconference with a nurse or doctor using the GP after hours helpline over the internet from home. The nurse or GP would be able to look at the rash via weblink, and provide advice on treatment and next steps.





Julia Gillard and Labor

Let’s move Australia Forward

Federal Labor’s record Federal Labor has delivered the most significant reforms to the health and hospitals system since the introduction of Medicare – to repair the neglect of the previous decade and design an Australian health care system that will better meet the challenges of the future. These reforms include:    Making the Commonwealth the majority funder of health and hospitals – funding 60 per cent of public hospital services, capital, teaching and research costs into the future. Giving local doctors and nurses more of a say in the way in which their hospitals are run, through Local Hospital Networks. Training a record number of doctors and nurses – doubling the number of GP training places to 1,200 a year by 2014 and funding an additional 1,000 training places for nurses every year. Building 1,300 new sub-acute hospital beds across the country. Rolling out a new four hour cap on emergency department waiting times. Rolling out a target of 95 per cent of elective surgeries to be delivered within clinically recommended times. Delivering a GP after hours helpline that provides access to a GP or nurse 24 hours a day – which can also help organize follow up care in the community. Rolling out a personally controlled electronic health record for every Australian that wants one.

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In its first term, Labor has also delivered significant reforms to improve access to health and hospital services in rural and regional Australia, including:     Delivering increased incentives of up to $120,000 a year to move and work in rural and remote and areas for around 500 communities and more than 2,400 doctors. Training 6,000 new GPs and specialists over the next decade – around 50 per cent of these training places will be provided in the bush. Building 20 regional cancer centers in communities across Australia. Supporting up to 7,500 rural nurses and 1,000 rural allied health professionals over the next decade take leave and continue their professional development.

Julia Gillard and Labor

Let’s move Australia Forward

THE COALITION’S RECORD As Minister for Health under the former Coalition Government, Tony Abbott:  Saw $1 billion cut from public hospitals around the country.  Capped GP training places at 600 per year since 2004 – while a shortage of GPs placed additional pressure on emergency departments. If he is elected Prime Minister, Mr Abbott has already made clear that he would further cut health and hospital services:  He would cut electronic health records, taking our health system backwards.  He would cut GP Super Clinics, meaning that 23 communities would miss out on one stop shops and up to 425 communities would miss out on upgrades to their GP practices.  He would cut the 24 hour GP After Hours Helpline that is linked to follow up services in the community: this helpline is expected to provide around 760,000 services across the country over the next four years.  He would cut emergency department funding to roll out a four hour national access target across the country – when some 600,000 Australians currently wait for more than eight hours in an emergency department before they are admitted into hospital.  He would cut elective surgery funding to raise the number of people seen within clinically recommended times to 95 per cent – up from 84 per cent today.

COSTINGS ($m)
2010-11 $m Medicare rebates for online consultations Financial incentives to GPs and Specialists Expansion of GP Helpline to provide online services Supporting training and supervision Total 2011-12 $m 23 5 10 10 48 2012-13 $m 74 17 20 10 121 2013-14 $m 154 35 20 10 218 Total $m 251 57 50 35 392

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Funding for these investments will be fully offset over the forward estimates, consistent with the Gillard Labor Government’s commitment to return the budget to surplus in three years. AUTHORISED N.MARTIN for the ALP, 5/9 Sydney Ave. Barton ACT.

Julia Gillard and Labor

Let’s move Australia Forward

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