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The Grattan Institute has called for a major overhaul of national primary care policy in a new report that shows many vulnerable Australians are foregoing essential healthcare because they cannot afford it.

Mapping primary care in Australia paints a bleak picture of a primary health system that is poorly organised, lacks integration and can be difficult to access.

The report revealed Australians’ access to healthcare varies according to their wealth, with about 4% delaying seeing a GP because of the cost and one in five Australians not receiving the recommended level of dental care due to financial barriers.

It also found people living in rural and remote areas often struggle to access a pharmacist or medical specialist.

For example, people in the Northern Territory are about four times less likely to use Medicare-funded allied health services such as physiotherapy and podiatry than those in Victoria.

Similarly, primary care services are not organised adequately enough to support integrated, comprehensive care for the 20% of Australians living with complex and chronic conditions.

The report argues strong primary care is central to an efficient, equitable and effective health system.

However, it determined that the current funding, organisation and management of primary care has not kept pace with changes to disease patterns, the economic pressures on health services and technological advances.

“Primary care services and organisation in Australia need to be re-formed,” the report says.

“The Commonwealth and the states have made some progress through the National Health Reform Agreement. But these reforms are limited and piecemeal compared with the major reforms introduced in areas such as home care and support and disability services.”

The report’s findings have triggered a call to establish a comprehensive national primary care policy framework in order to improve prevention and patient care.

The move must include increased synergy between federal and state governments and Primary Health Networks to strengthen their delivery of care services, as well as better data and information on patient characteristics.

The report also suggests new funding, payment and organisational arrangements can lead to providing better long-term care for the increasing number of older Australians who live with complex and chronic conditions.

The wide-ranging system reforms flagged aim to reduce barriers to accessing services, including out-of-pocket costs and the geographic misdistribution of services.

“Primary care policy in Australia is underdone,” Grattan Institute Health Program Director and the report’s co-author Stephen Duckett said.

“Australia has good quality primary care by international standards but it can be better.”

ANMF Federal Secretary Annie Butler said the report underlined the importance of access to healthcare for all Australians, especially the vulnerable.

A global campaign launched earlier this year titled Nursing Now is striving to improve health and lift the profile of nursing, with one of Australia’s main contributions focussing on pushing for greater access to healthcare.

“While Australia has Medicare which underpins a great health system overall, some of the country’s most vulnerable residents still miss out on essential healthcare due to a range of barriers,” Ms Butler said.

“For example, way too many Indigenous people don’t have access to suitable healthcare and people living in rural and remote areas don’t have t the same access as other Australians. This means there is significant inequity in health outcomes.

“We welcome improvements to national primary care policy. Especially policy that empowers nurses to use their knowledge, skills and expertise and practise to their full scope so they can play a bigger role in driving better health outcomes.”