Australia’s universal healthcare system, Medicare, started in 1984. Much has changed in the four decades since, but the government’s approach to general practice – the backbone of our health system – hasn’t kept up.

The complexity of GP work has grown immensely, as the population has grown older and rates of mental ill-health and complex chronic disease have climbed. But the model for general practice has changed little. GPs are struggling to fit more and more care into appointments that still average 15 minutes, and lack the support of a broader team.

Other countries have reformed general practice, and their rates of avoidable hospital visits for chronic disease are falling. Australia has spent 25 years on a merry-go-round of tests and trials that have not changed the system, and our rates are holding steady. We are spending more and more on hospitals, while neglecting general practice - the best place to tackle chronic disease.

Reform is overdue, but an opportunity has arrived. The system is in crisis and the federal government has set aside $250 million a year to respond. That money can fund the recommendations in this report; repairing the foundation of our health system and creating a new Medicare that is ready for the decades ahead.

Key recommendations:

• Expand access by making general practice a team sport, with more clinicians using all their skills to share the load with GPs.
• Change funding to support team-based chronic disease care, match funding with need, and close access gaps.
• Set a clear direction and support improvement.
• Avoid another dead-end trial by committing to a long-term plan.