Medical access missing in aged care reform

The AMA says a new survey of medical professionals in aged care is further evidence of an urgent need to focus on access to quality healthcare for older Australians.

Above: AMA president, Dr Steve Hambleton

By Keryn Curtis

The Australian Medical Association (AMA) has aged care firmly in its sights with a new survey of doctors, its latest line of attack on the lack of policy around medical care in the government’s aged care reform package.

The AMA president, Dr Steve Hambleton, said he was concerned that the aged care reform discussions had become bogged down in debate about refinancing residential aged care at the expense of the broader reform process.

“We’re talking about reforms versus refinancing. What does reform mean? It doesn’t mean refinancing and trying to catch out nursing homes on claiming; it’s about how to get the system working in best possible way.”

Dr Hambleton said the AMA was also concerned that, while the Living Longer, Living Better (LLLB) aged care system reforms would fund home care for nearly 40,000 older people, he was aware of very little discussion around how to improve their access to medical services.

He said the members of the medical workforce who are providing the majority of medical services to older Australians in residential aged care and in their own homes, are themselves ageing and there was too little no policy in place to ensure their replacement. 

According to Dr Hambleton, the July 2012 AMA survey of medical professionals working in the aged care sector is a further demonstration of the urgent need for policies to build and support the provision of medical care in aged care. 

“Our survey shows that the medical workforce in aged care is ageing and they are starting to cut back their visits, and the next generation of younger health professionals are not moving in to fill the gap,” Dr Hambleton said.

“Current aged care policies ignore medical workforce issues and medical workforce planning.

The next generation is not being trained and we need to focus on that before it becomes desperate.”

“This survey shows that governments and aged care advocates must urgently embrace policies to build and support medical care in aged care.  If not, older Australians who lack mobility and cannot travel to the surgery are going to have less and less access to quality medical care in coming years,” Dr Hambleton said.

The AMA recently released a position statement setting out a number of measures it believes will improve access to quality medical care for older people. 

 “We need to turn back and focus on the actual reforms. We have changing workforce models, we need better training, a good aged care nurse workforce, support for telehealth and other technology.

“Aged care is hard and complex and it doesn’t pay well.  The reality of life is these are the sickest people in the stable and the environment isn’t conducive to looking after them properly,” Dr Hambleton said.

Survey findings

The findings of the July 2012 AMA survey – which included general practitioners, consultant physicians, geriatricians, emergency physicians, psychiatrists, and palliative medicine specialists – shows an aged care medical workforce that is itself ageing, with more than 15 per cent of the 845 respondents intending to reduce their aged care visits over the next two years.

Key findings of the survey include:

  • of the medical practitioners providing medical care to older Australians in residential aged care facilities, just 8 per cent are under 40 years of age;
  • the average number of visits by medical practitioners per month to residential aged care facilities is 6.14 – down from 8.36 visits per month in 2008;
  • the average number of patients seen by medical practitioners per visit to residential aged care facilities is 5.36 – up from 4.77 patients in 2008;
  • the average time spent with each patient is 15.71 minutes– up from 13.12 minutes in 2008; 
  • the average time spent for each patient managing the care of the patient with the facility and/or family is 13.67 minutes – up from 13.20 minutes in 2008;
  • 31.39 per cent of survey respondents have decreased their visits to residential aged care facilities over the last five years – up from 21.64 per cent in 2008;
  • 16.03 per cent of survey respondents will increase their visits to residential aged care facilities over the next two years – up from 15.95 per cent in 2008; and
  • 95.27 per cent of survey respondents identified the need to improve the availability of suitably trained and experienced nurses and other health professionals in residential aged care to support the medical workforce.
Tags: ama, steve-hambleton, survey, workforce,

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