The Strength is in the Network
Annual State Divisions Conference
 17 May 2006, Adelaide
Attended by Libby Kalucy, Anne Magarey, Ann-Louise Hordacre, Miriam Keane
SADI ran a very successful primary mental health care conference on 16 May with more than 200 people, followed by a two day Forum on 17-18 May. As usual, this was an excellent opportunity for PHC RIS to see what Divisions were doing, and put faces to familiar names, especially for new
PHC RIS staff.
Some highlights from the program:
 State Health places great value on easy productive working relationship with SADI, Divisions and general practice. The Chief Medical Officer in SA identified that during his first year in the job it had been remarkably easy to link with general practice processes on many issues, due to the existence of the effective network of Divisions and SADI. - Minister of Health John Hill announced that the Department of Health plans to invest $3.5 million in ten GP Plus centres for Adelaide. These centres will have community health and ambulatory hospital services, and take a population approach to the care of people in the catchment area. The concept is to support the work of GPs and foster collaboration with state funded health services. There will also be GP Plus practice nurses to complement general practice and overcome government boundaries.
- Brian Richards, principal medical advisor on e-Health in the Australian Government, has been closely involved with Divisions from their inception. He outlined the roles for governments, industry and clinicians in information and communication technology (ICT) and discussed how ICT underpins productivity growth as well as empowering its citizens and improving its quality of life. Through ICT Divisions will be able to measure population benefits while keeping the system focused on the needs of individuals.
- After long experience with government policy, Brian Richards and Kate Carnell (ADGP) considered the Council on Australian Governments (COAG) buy-in to significant PHC initiatives in this country, across parties and states, showed an unparalleled alignment between Australian and State governments paying serious attention to health care. This creates many opportunities for progress in primary health care.
What works for mental health service delivery?
National Forum
13 June 2006, Canberra
Attended by Eleanor Jackson Bowers, PHC RIS
I recently attended a National Forum, conducted by ADGP and ANU, to view the presentation of the preliminary results of their systematic review of What works for mental health service delivery? funded under an APHCRI Stream 4 Grant. At the Forum, Professor Ian Hickie spoke passionately about the danger that the $1.8 billion to be invested by the Australian Government in mental health will be absorbed into the same old mental health system and provide the same outcomes. He called for us to build a new system and not reinforce one based on nineteenth century disease models.
I am reminded of the quote by Eric Hoffer:
"In times of change learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists." (Eric Hoffer in Reflections on the human condition 1973)
In building this new mental health system we need to learn. ANU and ADGP have sifted through a plethora of reports, evaluations and research studies to find the evidence base for models of primary mental health care which work in that they produce the best consumer outcomes. Their findings will be released later this year.
To build a new mental health system we need to be learners but we also need to ensure that the learnings are incorporated into the design of a system which works for consumers.
At the Forum, the Honourable Christopher Pyne stressed the importance of bringing together the research evidence to assist policy makers to design programs that work. Similarly, Kate Carnell emphasised the importance she places on ADGP building partnerships with the research community and bringing together all the players in order to make a difference.
Those who were at the 2005 GP & PHC Research Conference will remember Jonathan Lomas' presentation where he said that the best predictor of research use is the involvement of potential users at the earliest stage of the research, through its conduct and interpretation, and on to its dissemination.
In linking policy makers, practitioners, representatives of key organisations and researchers, the forum was an excellent example of this process at work. ADGP and ANU are to be congratulated their involvement of a wide range of stakeholders at all stages of their project. As learners, we may, yet, inherit the earth.
Vital Links State Forum
26-28 May 2006, Sydney
Attended by Dr Ann-Louise Hordacre, Simon Patterson, PHC RIS
 The 8th Vital Links State Forum presented by the Alliance of NSW Divisions of General Practice, was held in conjunction with the Sydney General Practitioners Conference and Exhibition (GPCE) and the Australian Practice Nurse Association Conference. This large event, held in the Sydney Showground at Olympic Park, provided an excellent opportunity for all delegates to be challenged, informed, share and network.
Uncle Greg Simms from the Western Sydney Council of Elders, welcomed delegates to country and presented a valuable framework for the rest of the Forum: "If you don't know where you're going you could end up anywhere". Indicating the importance of the Forum, it was opened by an address from the Honourable Tony Abbott, Australian Government Minister for Health and Ageing, outlining some of the key initiatives in the recently announced Australian Budget. The Honourable John Hatzistergos, NSW State Minister for Health, highlighted state government initiatives to curb the growing health budget and to reduce a fragmented system.
The Research Stream of the Forum raised issues about the ways that research can contribute and influence Divisions. These sessions provided some recipes for success in research, with a focus on collaboration, partnerships and data management - all viable businesses and enterprises need to incorporate research and development in their activities in order to keep moving forward. Discussions highlighted the need for evaluation of Division programs, in order to produce evidence that these activities 'make a difference'. It was recognised that good evidence was required to make good policy, and was powerful in convincing policy makers to continue or change funding - information is more powerful than passion! Speakers acknowledged barriers to be addressed such as the lack of time, capacity or resources to engage in research projects, and that it isn't seen as 'core business'.
GP involvement in research projects was encouraged and promoted, with incentives and remuneration for GPs a recurring theme. However, this was balanced by the acknowledgment that GPs are 'over surveyed', and adding further to this burden was a delicate matter.
A number of speakers were invited to contribute to a lively debate: "GPs are THE obvious choice to lead the primary care team. or are they?". Claims were that GPs were the 'natural leader' due to their generalist training, skills, and natural abilities. Additional discussion focused on whether a team approach was indeed needed, whether GPs were the centre or a cornerstone of good health management, and whether GPs wanted the additional responsibility. This debate is set to continue.
It's time! Harnessing the combined strength of Queensland Divisions
Queensland Division of General Practice (QDGP) Forum
16-17 June 2006, Hervey Bay
Attended by Dr Ann-Louise Hordacre & Simon Patterson, PHC RIS
 The Queensland Divisions of General Practice (QDGP) Forum commenced with the announcement that Queensland Health and QDGP will work together to combat chronic disease with $2.8 million provided to fund 18 project officers throughout the state. This commitment of Divisions and state government to work together was mirrored at a local level in the first presentation, which discussed how Wide Bay Division of General Practice and Fraser Coast Health Services worked collaboratively to avert a local crisis (this story is elaborated in Effective Links on page 7).
Professor Gavin Mooney presented two thought promoting papers on Citizens' Juries and the use of health economics. He challenged the labelling of people as 'consumers' rather than 'citizens', equating it to the difference between retail therapy and community. Asking the question Whose health service is it? , Mooney discussed the values of Citizens' Juries providing a legitimate voice for the values of citizens. When juries are presented with the appropriate information, they act appropriately and independently, and inform processes and values, rather than act as decision-makers.
A session on disaster management, planning and impact provided a valuable opportunity to learn from the experiences of other Divisions. Alison Geijsen, from the ACT Division of General Practice discussed their role in the January 2003 ACT bushfires. GPs provided crucial and timely services in addition to those available though the local hospitals, with Divisions playing a role in communicating needs and coordinating services.
Dr Rod Catton described his experiences as a GP after Cyclone Larry struck the North Queensland town of Innisfail in March this year. Devastation was widespread, impacting on the infrastructure of the entire community. Buildings strong enough to withstand the force of the wind, often sustained damage from flying debris and flooding from torrential rain. He reported that the most valuable resources in re-establishing health care services in the community included staff commitment and ability to work independently, along with community support networks. Support and financial aid from the wider Australian community gave hope and meant that people could meet their immediate basic needs.
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