Physiotherapy 2022: The Profession’s Priorities in an Election Year

Physiotherapy, The Business of Health, The Health Industry July 29, 2022

With 2022 being a year where there was a federal election in addition to the annual handing down of the federal budget, the Australian Physiotherapy Association (APA) has been advocating for the profession throughout the year.

The APA’s 2022 pre-budget submission incorporated four solutions, which it said would strengthen care for all Australians:

The APA called for a change to the Medicare Benefits Schedule requirement for a GP referral to allow physiotherapists to refer patients directly to the most suitable medical practitioner. They also called for the lifting of barriers to allow physiotherapists to refer patients for musculoskeletal images.

The APA called for expansion of the chronic disease and pain-related MBS items encompassing physiotherapy, for a funded pilot to strengthen access to diagnosis, treatment and care of musculoskeletal pain and conditions in primary care, and for investment in public funded physiotherapy to increase the coverage of preventative health services in Australia. They also called for a leading role for physiotherapists in Long COVID care, rehabilitation for cancer care, as well as for pre-and post-natal physiotherapy.

The APA called for funding and/or better access to physiotherapy services in aged care, the National Disability Insurance Scheme, Department of Veterans’ Affairs card holders, Aboriginal and Torres Strait Islander people, rural services, and patients with mental health conditions.

Following the USA model, the APA called for the establishment of a health ‘czar’ to coordinate the implementation and evaluation of agreed on recommendations and actions from Inquiries, Commissions and Strategies, as a means of ensuring ensure whole-of-government responses.

After the federal budget was handed down, the APA expressed disappointment that it did not provide investment in public funded physiotherapy.

“The APA’s pre-Budget submission provided the Morrison Government with evidence-based initiatives that would improve patient outcomes, reduce costs and enhance health care. We are disappointed the Government chose to ignore our submission,” APA National President Scott Willis said.

“The Budget has failed to set the fair foundations we needed for health equity and access.

APA National President Scott Willis said “it was an opportunity to lay the groundwork for the systemic reform needed to reorientate the health system towards primary care encompassing physiotherapy.

“Instead, the Morrison Government has abandoned health for their own political survival — at this critical time in health care reform we see implementation measures against the Primary Care 10 Year Plan that sets aside just $3.9 million to improve access to allied health services.

“This Budget again overlooks the value and impact that allied health professionals have on communities. Significant investment was needed to strengthen care and reduce disparities and this Budget in no way achieves reform which requires sustained investment towards integrated team-based care.

“The APA provided our most detailed and expansive ever pre-Budget submission, offering solutions and options that we know offer substantial improvements to patient care and improved referral pathways. None of these were adopted.

“We called on the Government to initiate fundamental reform to provide a way forward to overcome the barriers to integrated multidisciplinary team-based care.

“There are many welcome measures in the Budget, however, the Primary Care and Rural Health measures ignore the vital role of physiotherapy in health care. Millions of Australians rely on physiotherapists for diagnosis, treatment and services.

“The Government hasn’t properly delivered on the Royal Commission into Aged Care Quality and Standards, and while we welcome some initiatives, we are disappointed with the lack of aged care measures announced in the Budget.

“Reform isn’t just about pumping money into the health system — it’s about redesigning it so that people can have unencumbered access to the care they need.

“Patients are not funded to access physiotherapy services beyond current and very limited MBS chronic disease items. Physiotherapy provides a path to better health and wellbeing but for too many Australians access is denied or inadequately funded” said Mr Willis.

Physiotherapy in aged care was an area of focus for the APA in the lead up to the federal election. This was following on from what the APA deemed to be a failure of the Morrison Government to se the fair foundations required for health equity and access in the 2022-2023 Federal Budget. The APA noted the intention in then Opposition Leader Anthony Albanese’s budget reply speech to put security, dignity, quality and humanity back into aged care.

“The position and priorities offered by Labor, in unveiling a package of major aged care reforms, as the centrepiece of his pre-election Budget reply, and commitment to the NDIS and strengthening Medicare, sets us back on a reform pathway that would make a real difference for so many Australians unable to access the care they need.” APA National President Scott Willis said.

“Health inequity is a longstanding challenge, and one that certainly didn’t arrive with the pandemic. A worsening of inequality is now evident and this is deeply embedded in our structural and health system failures.

“We need to move beyond traditional structures and conventional primary care towards more integrated care models that include allied health services such as physiotherapy.

“Real primary care reform and a properly funded public health system would see a significant expansion of Medicare.

“Real reform would allow for stronger investment in publicly funded physiotherapy to allow access to physiotherapy as first contact practitioners.

“Our health system fails to facilitate this essential care and patients are not funded to access physiotherapy services beyond current and very limited MBS chronic disease items,” Mr Willis said.

“Labor’s commitment to mandate that every Australian living in aged care receives a minimum of 215 minutes of care per day, as recommended by the Royal Commission, is welcomed. However, we await the detail to see the role of physiotherapy and allied health in this care.

“The APA also welcomes Labor’s commitments on integrity and accountability, and new funding, to better support the aged care sector.

“Neither the LNP or Labor used their Budget speeches to address easy reform fixes that would significantly improve the patient journey and provide savings to the health system.

“A key shift would be to allow physiotherapists to directly refer to the most suitable medical practitioner and to request imaging for musculoskeletal conditions.

“Similarly, in enabling more multidisciplinary team-based care, there is a need for stronger measures to deliver structural transformations by funding the full team.

“But nationally we still await fundamental reform to provide a way forward to overcome the barriers to integrated multidisciplinary team-based care.

“Labor has provided a solid start towards advancing health equity in outlining a plan that would set some solid foundations for the future and we look forward to seeing the detail in the coming weeks,” he said.

In the days prior to the federal election, the APA expressed the concern that a long-term vision for health was nowhere to be found in the election campaign.

“With the first federal election since the start of the COVID-19 pandemic, there was an expectation that commitment to funding healthcare reform would be a stronger focus from all parties,” Mr Willis said.

“The APA welcomed the commitments made by Labor, Coalition and Greens, especially to include mental and dental in Medicare, the commitment to fund greater access to allied health and multidisciplinary care in primary care, and to implement the 10-Year Primary Care Plan.

“Where is the long-term vision for health and clear commitment to fund and implement the reform plans developed during the last term of government?”

“We believe in a policy vision that values and recognises the whole health workforce; a vision that values the full benefits of physiotherapy for better health outcomes for patients and a more cost-effective health system.

“For the 1 in 3 Australians experiencing musculoskeletal pain and conditions, the 1 in 2 Australians that will be diagnosed with cancer by the age of 85, and the 1 in 3 older Australians living at home who fall each year funded access to physiotherapy could be life changing, not to mention saving up to $9.2 billion in direct health costs and reduced productivity.

“As physiotherapists, we have the solutions to strengthen the patient journey and deliver great health outcomes for all. We are looking forward to working with the incoming government to ensure everyone has greater access to the health care they need, when they need it,” Mr Willis said.

In the two months following on from the federal election, the APA called for:

By late July, the APA was urging the Albanese government to prioritise allied health care involving the inclusion of physiotherapy for aged care residents with chronic pain.

APA National President Scott Willis said “it is critical for aged care residents to receive pain management therapy as an effective alternative to medication use.

“The vast majority of older people living in residential aged care live with debilitating pain and rely on expert healthcare such as physiotherapy to maintain their quality of life.

“For example, many older Australians live with crippling arthritis that affects their ability to participate in everyday activities and enjoy life. Aged care residents living with dementia depend on their physiotherapists to identify and treat the causes of pain,” Mr Willis said.

“It is critical to maintain access to high-quality care such as physiotherapy that improves sleep and function and reduces the number of falls in older people living with chronic pain.”