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Primary Source, December 2011

The Gold Coast’s population profile on the Yourhealth website indicates the challenges ahead for managing health in the region. Over 10% of the population is considered to be among the most disadvantaged in QLD, with homelessness a growing issue. Fourteen percent of the population is over 65 years of age and yet the region has the second largest youth population in QLD. Youth unemployment is at 13.2 per cent. Gaps exist in some crucial services such as mental health and public mental health services are particularly under-resourced to manage mental health and the co-occurrence of drug and alcohol issues. Medicare Local Gold Coast CEO Matt Carrodus is confident about tackling this local primary health care agenda.  Matt tells Primary Source that the GCML will build on existing partnerships and further engage the community and health and well being service providers to jointly identify planning, service development and implementation needs, to improve health and well being outcomes for the Gold Coast community.    

What’s your strong point for your Medicare Local?
We’ve created a model based on our four years as a part of the Gold Coast Primary Care Partnership Council (PCPC). We have been able to develop partnerships with a broad range of primary care organisations and trial new ways of working together, which I think has also helped build trust in our organisation. Our strong cross-sector relationships address a range of issues outside the traditional general practice domain and this gives us vital experience in engaging and working with non traditional partners such as the City Council and private allied health providers. I'd like to think that our model is evidence based and well supported by our sector which contributed to its development. I feel confident explaining to people why we have chosen to create a new company as a population health planning, service development, and commissioning organisation based on our experiences with the PCPC. 

"I’d like to think that our model is evidence based and well supported by our sector which contributed to its development".

What will a Medicare Local mean for your area?
We are very fortunate that our ML boundary aligns very closely with those of the LHN and the Gold Coast City Council. We now have an excellent opportunity to collaboratively develop a health and wellbeing plan that will have a positive impact on the Gold Coast Community.  We aim to complete a comprehensive community engagement and planning process by April 2012 and identify the particular  health and wellbeing needs of our community. Our great opportunity is to then determine with our partners how  the health and community services sector addresses these identified needs using the combined knowledge, skills, and resources of the whole region.  So it’s not a case of the ML being all things to all people. We’ll collectively decide where each organisation can make the most valuable contribution to achieving the stated aim. We need to be making the most efficient use of existing resources by all working together - that’s the value add.  

What will be that penny-dropping moment for communities with regard to ML?
That’s an interesting question. Parts of the community who found it very challenging to access care and services should notice better access to services that meet their special needs.  Patients with chronic conditions should find it easier to navigate the local health system and transition between primary and acute services but will they associate this with a ML?  Perhaps communities will experience the Medicare Local and what it does most directly through their involvement in community consultations, community development activities, and health promotion and prevention activities conducted by ML staff and their partners.  We intend to develop the health and wellbeing plan as described earlier through significant community involvement in consultation and decision making, but we’ll also make sure this is not one-off engagement.  We’ll continue to involve interested people and commit to reporting back to the community at least annually on our progress towards improving the health and wellbeing of the community.

How will your Medicare Local change what is being done today, to what will be done under the new primary health care regime?
We really need to change our paradigms and start to think far more strategically around a whole range of issues. To take just one issue – we need to invest in health promotion and prevention much more than we ever have before.  We can do this by dovetailing into national and state initiatives to implement local activities that contribute towards increasing health literacy, encouraging and enabling people to take greater responsibility for their own health, and assisting service providers to reorientate themselves toward positive health and wellbeing.  It’s a huge challenge and needs considerable investment for coordinated, evidenced-based initiatives from national, state, and local governments working together.

What’s your best example of a program you are running now that exemplifies your ML?
I think the gr8 start early years project best exemplifies what the ML should be doing. This project involves partnerships of public, private, non government organisations, and the City Council working together to ensure good health and wellbeing and positive educational and developmental outcomes for kids aged 0-8. It will also help lay pathways between providers and offer opportunities for practitioners to identify and implement early intervention for developmental delays in young children. Over the past three years the partnership has developed preventative activities such as:
• promoting literacy and language skills-boosting, greater family bonding and closer connections between families and their local children’s programs and services through a book pack strategy
• supporting engagement with caregivers and health and community service providers about child development milestones including strategies to help general practices more easily identify developmental delays in children and to increase immunisations. A local Gold Coast information booklet outlines key developmental milestones, and offers advice and information about services, programs, and activities that caregivers can use to enhance their child’s positive development. 
• Clearer referral pathways to improve the client journey between early years’ service providers and families access to them.

How important is it to have an overarching body to manage and monitor primary health care services for your region?
Having that over-arching body is absolutely essential for a better integrated and co-ordinated service system.  Nothing happens by itself.  Systems need to be developed and it takes resources to implement and maintain them.  We need to become competent systems managers in order to build a single integrated health and wellbeing system that puts people at the centre of health care. We also need to be information managers to achieve universal access to the right service at the right time. The effective use of data and information will help us to inform decisions and ensure connectivity between providers to increase co-ordination of services around the needs of individuals. We also need to be competent knowledge managers to share information, identify best practice, and to develop systems for integration, performance feedback and quality improvement. Having one body to bring all of these skills and services together will help us to achieve our community’s health goals.