By MAHIA RAHMAN

Dental care and general practice have been identified as key areas of Australia’s primary care policy that require an overhaul, a new report from the Grattan Institute has found.

The Mapping Primary Care report, released in late July, concludes that although the quality of primary care in Australia is above average by international standards, it could improve in terms of accessibility and affordability.

The report found one in 25 Australians delayed seeing their doctor because of the cost, despite mass services such as general practice costs being covered by Medicare and private health insurance.

However, barriers to treating oral health has been an on-going issue for many lower socio-economic Australians and was found to be a major issue in the report.

Part-time La Trobe University student Mitch, who is unemployed, said he had insurance, but dental costs remained expensive.

“I can’t really afford to fix a tooth at the minute, it’s going to cost around $1000 for a root canal,” he said.

The Grattan Institute’s health program director Dr Stephen Duckett said that there was no Medicare-equivalent arrangement for dental care.

“For dental care 56 per cent [of the] costs are met by individuals, with 10 per cent or so by Commonwealth government and 5 per cent by state and local governments,” he said.

“It is a different pattern of funding arrangements and once you have a high proportion met by individuals, almost inevitably you end up with a high proportion of individuals missing out on services due to cost.”

The report called out primary care services in Australia as not being organised enough to support the 20 per cent of Australians who had complex and chronic conditions.

Dr Duckett identified a worrying lack of coordination between primary care services and community care services, which is essential for people with chronic illnesses such as diabetes.

Performance Education student Lubaba, who has type 1 diabetes, said she faced  substantial financial outlays for her condition.

“I monitor my blood sugar and take insulin therapy consistently, keeping in mind that I really can’t afford to go to the hospital now,” she said.

Dr Duckett said there were various levels of government and separate private agencies that had an impact on funding and payment arrangements.

“No one is responsible for the network of services in any region, at the moment, and as a result you end up with gaps and duplications,” he said.

Primary health networks are independent organisations facilitated by the Commonwealth, located across Australia, and these could be used to guide coordination between the various services.

Alongside the issues of coordination, another concerning fact was the growing popularity of general practices using a corporate model of operation.

“The first thing the corporate do is look at the practice and say, can we actually get more money, for example, by consolidating pathology and radiology to the company we own,” Dr Duckett said.

As a result, the report highlighted an increase in the number of non-referred encounters per GP, as well as a decline in their working hours individually.

More generally, the report also suggested that there was room for growth in how general practice services address common risk factors, including obesity, alcohol abuse and smoking.