At an appropriate point the Department of Health will pick up the threads of their consultations on the 10-year Primary Health Care Plan.  As part of Australia’s “Long Term National Health Plan”, the Primary Health Care plan promises to provide better support to manage conditions like cancer, diabetes, heart disease and mental ill health, and better support to stay healthy and avoid illness.  So I guess we can check telehealth off the list as “delivered”, and also the 7^th Community Pharmacy Agreement that commenced in July 2020.   In health workforce, considerable work is being done to improve rural workforce distribution, as SARRAH is working with our allied health colleagues and stakeholders to implement the Allied Health Rural Generalist Pathway in non-government settings.  This strategy is one way by which rural and remote Australians living with chronic disease might have better access to services to help them manage their condition, by addressing the severe shortage of allied health professionals in rural and remote Australia and making a rural career a real and viable option for early career allied health professionals.
 
There remains the thorny issue of the medical benefits schedule, pivotal because it is the means by which chronic disease management is funded in Australia.  Under a GP Management Plan, Medicare offers part-payment for up to 5 allied health services per patient each calendar year. Somewhat pointedly, the government website adds that “…Additional services are not possible in any circumstances.”  Is this adequate to the task of helping people manage their health condition?
 
The research suggests that people with good self-management skills make better health and lifestyle decisions and use health professionals’ time more effectively than people without these skills (see much of the work of Karen Grimmer among many for further details).   In November 2019 the Consumer Health Forum released a report that suggest that investing in measures to assist patients to exercise more choice and control in their healthcare would deliver high-value returns for those living with chronic illness. The findings indicated that people with low levels of activation may need one-on-one support to understand their condition and to gradually see the way forward to taking control and managing it. 
 
Policy makers are aware of this, according to the Report on the Inquiry into Chronic Disease Prevention and Management in Primary Health Care (May 2016).  Importantly, the report raises the issue that we are not all the same in terms of support for self-care, and some tailoring is required.  Where patients are not highly engaged in their own health care, the report describes many beautiful examples of effective models of care, all of which require more intensive intervention (eg 2 hours per week over 6 weeks) to achieve program outcomes.    In the end, the standing committee recommended (among others) “…that the Australian Government investigate expanding the number of allied health treatments that can attract a Medicare Benefits Schedule rebate … within a year, on the proviso that the patient has the relevant General Practitioner Management Plan in place and Team Care Arrangements in place” (recommendation 3).  Similarly, in 2018 the Medical Benefits Schedule Review Taskforce (Allied Health reference group) recommended among other things to increase the number of allied health treatments under team care arrangements “…by stratifying patients to identify those with more complex care requirements”.
 
It is disappointing, therefore to see no mention of this in the consultation paper on the 10-year Primary Health Care Plan.  Perhaps as the world grapples with a pandemic and people living with chronic illness avoid accessing the healthcare they need over a prolonged period of time, the government will act on the evidence and advice at their fingertips to ensure that all Australians can access an appropriate level of care to achieve their health goals, no matter where they live.

Upcoming Events and conferences 

	OT Exchange 2020 22-23 June 2020 Online Conference
	HIC 2020 19-21 October 2020 Brisbane, QLD
	21st International Mental Health Conference 12-14 November 2020 RACV Royal Pines Resort, Gold Coast, QLD
	Child & Adolescent Mental Health Conference 25 - 27 November 2020 Mantra Legends, Gold Coast
	Associations Forum National Conference 30 November - 1 December 2020 Royal International Convention Centre, Brisbane
	The 2020 Workplace Mental Health Symposium TBC Hilton, Brisbane, QLD1
	7th Rural and Remote Health Scientific Symposium: Shaping the future TBC Alice Springs Convention Centre, NT