AMA Victoria has provided a submission to the independent review of cohealth’s general practice and related services. The submission draws on evidence from affected GPs, alongside external economic analysis, and is directed to the review’s task of identifying options to support the continuation of general practice services for communities with complex needs.
At a high level, the submission makes the case that the current situation cannot be understood through a single lens. It highlights the interaction between two factors.
The first is structural funding misalignment. Community health general practice delivers concentrated clinical complexity, continuity of care and multidisciplinary coordination, particularly for patients with significant medical and social vulnerability. Current Medicare settings do not adequately support this model of care. Complexity, continuity and non-face-to-face clinical work are systematically under-priced, creating financial fragility in services that deliver substantial downstream value to the health system, including reduced ED presentations and avoidable hospital admissions.
The second is governance and organisational capability. The submission raises questions about whether governance processes supported early risk recognition, transparent scenario testing and meaningful clinician engagement.
The submission emphasises that neither factor alone explains the current situation. Structural underfunding does not remove the importance of governance capability, and governance limitations do not negate the impact of systemic funding problems. Both must be considered together in assessing viable options to sustain community health general practice.
Drawing on this analysis, AMA Victoria proposes that options emerging from the review should focus on better alignment between funding and service models, realistic use of existing Commonwealth mechanisms, governance capability matched to clinical and service risk, continuity of care as a threshold safety requirement, and workforce sustainability as a determinant of service viability.
AMA Federal provided a formal letter of support to the review panel, endorsing AMA Victoria’s analysis and noting that similar pressures are being experienced by high-complexity, continuity-based general practices across Australia. The letter encourages the review to consider the implications of this case for longer term Commonwealth primary care policy.
AMA Victoria will continue to engage with the review process and keep members informed as it progresses.