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The changing primary health care landscape in Queensland

QDGP Forum, 16 March 2007, Brisbane

The Forum in Brisbane organised by Queensland Divisions of General Practice was an excellent way to continue the dialogue between GPs, Queensland Health and Division officials. As Andrew Wilson (Queensland Health) identified, shared service delivery is more likely with committed effective leaders, clear shared vision, roles and responsibilities, organisational alignment and flexible partnership structures. He listed some barriers to well coordinated care, such as ineffective communication at organisation and professional level, duplication and ambiguous roles, structural barriers such as the commonwealth/state divide, inadequate resources and staff turnover, cultural barriers, turf protection and accountability. The numerous state and national initiatives potentially can lead to further fragmentation unless well coordinated.

Panel members from peak allied health and community bodies illustrated some of these problems. Coordinated care may be best practice, but is not yet easy practice because of multiple funding sources, programs, protocols, and eligibility requirements. For example, Aged Care Queensland has 65 funding sources across three levels of government; the Pharmacy Guild deals with 250 rejection codes for prescriptions.

Workforce problems led to coordination issues through staff turnover, lack of orientation and familiarity with local systems and current practice. Financial issues such as lack of remuneration for allied health workers affected processes such as case conferencing.

Many communication problems are due to health workers being used to their own culture, and not understanding each other's needs – for example to see the care plan for a mutual patient, to contact referring GPs after seeing their patient. The Australian Psychology Association has taken steps to correct the latter problem by recommending that all psychologists contact their referring GPs using a suitable template.

QDGP will continue working with peak allied health and community bodies, to find mutual solutions to the issues raised and make progress towards organisational alignment.

For further information contact:
Libby Kalucy, Director, PHC RIS
E: libby.kalucy@flinders.edu.au