Thread by @TimRRead

Victoria’s health minister inadvertently stepped on a minefield yesterday by saying she was flabbergasted a GP worked with upper respiratory symptoms, later found to be #COVIDー19, thread. #SpringSt #auspol #coronavirusaus

This highlights a deep flaw in our health system. States and state health ministers have almost nothing to do with primary care. State health departments offer advice and a lot of rules to GPs, but no funding. When a health emergency strikes, the state has limited influence.

GPs are self-employed or, contractors to health care chains (run by sharp financial operators), or to other GPs. GPs and private specialists are paid a fee for service by Medicare (federal), often plus private patient fees.

General practices are responsible for buying their own supplies like masks and gloves. It's a business and costs must be managed.

There's no sick leave for private docs. Public hosp staff feel guilty for taking it. Catching the latest virus is part of healthcare work (& teaching, child care). It’s no surprise doctors work with mild respiratory symptoms, nor that a state health minister doesn’t quite get it.

Responses to large scale health crises must overcome the public/private state/federal gaps in our healthcare systems. There is no one e-mail that all doctors read. A GP in Melton and a hospital doctor in Sunshine hear from different governments, different medical colleges.

Some solutions to consider: 1. National Centre for Disease Control to do much of the work of the many state Chief Health Officers, 2. a federal review of general practice – Medicare is harvested by big companies employing doctors – is this the best way to run primary care?