Pre-budget Submission

Transcription

1 Health equality in the bush: realising physiotherapists potential to improve health outcomes and reduce preventable hospital admissions

2 Letter from Melissa Locke APA President Physiotherapists are one of the largest groups of primary health care professionals in Australia. They have been!"#$% &'($)&$%*")&$+$+'(,"#%-'"%-'"$.%.,)"#/%)(0%1)2,%)%#+3(+!&)($%"'4,%$'%*4).%+(%5,,$+(3%67#$")4+)8#%1,)4$1%&1)44,(3,#9 Unfortunately there is a dire shortage of these key frontline workers in many areas. :1+#%5,)(#%$1)$%)%#+3(+!&)($%*"'*'"$+'(%'-%$1,%67#$")4+)(%*'*74)$+'(%+#%7();4,%$'%)&&,##%$1,%*1.#+'$1,")*.%#,"2+&,#% they need. :1,%5'#$%&"+$+&)4%)",)%'-%7(0,"#,"2+&+(3%+#%+(%"7")4%)(0%",5'$,%)",)#%'-%67#$")4+)%<1,",%$1,",%)",%#+3(+!&)($4.%5'",% potentially preventable hospitalisations for chronic conditions than in metropolitan areas. Physiotherapists are vital to these communities individually and for the role they play as part of multidisciplinary teams. =--'"$#%$'%)00",##%$1,#,%#1'"$)3,#%1)2,%;,,(%1)5*,",0%;.%)%4)&>%'-%)(.%#+3(+!&)($%3'2,"(5,($%+(&,($+2,#%$'%5'2,% to a rural area or to establish a rural practice. This is in stark contrast to the medical profession where successive Australian Governments have invested vast resources to encourage rural medical practice. There are well documented barriers to rural and remote recruitment and retention in the allied health professions, particularly in physiotherapy. These include such issues as lack of career path, isolation, lack of professional and peer support including networking, access and support to attend continuing professional development activities and postgraduate study, lack of remuneration and recognition, staff shortages, and lack of locum availability. The Australia Government is beginning to address some of these issues, but much more needs to be done to give rural and remote Australians equitable access to health services. The APA urges the government to extend its programs to get more physiotherapists practicing in rural and remote areas. Melissa Locke FACP APA National President 1

3 Executive Summary Physiotherapists play a vital part in health care teams. The skills and training of physiotherapists mean they are capable of working with a wide variety of conditions and disabilities to improve the health status of individuals across the lifespan. Physiotherapists also work with groups to deliver improved population health outcomes within their local areas. Physiotherapists are valuable members of multidisciplinary teams, making an important contribution to health care through their health promotion, prevention, screening, as well as triage, assessment and treatment activities. Apart from the treatment of musculoskeletal conditions, physiotherapists have a well-established role to play in the treatment and maintenance of chronic conditions such as cardiovascular disease, chronic obstructive pulmonary disease, diabetes, osteoporosis, arthritis, obesity, and hypertension. The educative focus they adopt in areas such as chronic disease management, self-management techniques and lifestyle and physical activity counselling aligns well with the primary health care philosophy of consumer and community empowerment. Issue :1,",%+#%)%#+3(+!&)($%5)40+#$"+;7$+'(%'-%$1,%*1.#+'$1,")*.%<'">-'"&,%+(%67#$")4+)9 In metropolitan areas, there are 47 physiotherapists for each head of population, yet in ASGC-RA categories 2 5, there are just 34 physiotherapists per people, despite these practitioners being required to serve a more dispersed population with greater health challenges, higher rates of smoking, alcohol consumption, obesity and lower rates of physical activity. To ensure that Australians are treated in the community rather than in hospitals, it is important to address this imbalance. :1,",%)",%!2,%*")&$+&)4%<).#%+(%<1+&1%$1,%?,0,")4%@'2,"(5,($%&)(%7$+4+#,%,A+#$+(3%+(-")#$"7&$7",%$'%+(&,($+2+#,% physiotherapy practice in rural and remote areas. 1. Expand HECS Reimbursement Scheme!"#$%&'"(#&)*+,-&./%%/"0&"123&412&52$3( 2. Expand General Practice Rural Incentives Program (GRIP)!"#$%&'"(#&)6,+&./%%/"0&"123&412&52$3(& 3. Expand Practice Incentive Payments (PIP) &!"#$%&'"(#&)7,8&./%%/"0&"123&412&52$3(& 4. Establish a pilot to evaluate the effectiveness of Medicare funded Telehealth consultations between medical specialists and physiotherapists in rural areas!"#$%&'"(#&)9,:&./%%/"0&"123&#;"&52$3( 5. Extend Medicare Chronic Disease Management items!"#$%&'"(#&)77,8&./%%/"0&"123&412&52$3( 2

4 Issue: Workforce Maldistribution Australia is currently experiencing a national shortage of physiotherapists, with the situation particularly critical in the public sector, rural and remote areas, and aged care. 1 Demand for physiotherapy services continues to increase due to the ageing population, population growth, and the rising incidence of chronic disease and survival of accidents or illness. 2,3 & 4 While physiotherapist numbers have been increasing, 5,6 & 7 the nature of the workforce means that this growth is unlikely to overcome existing or future shortages. Physiotherapists are an integral part of both private and public systems and work in sync with other health professions. :1+#%5,)(#%$1)$%$1,%#1'"$)3,%'-%*1.#+'$1,")*+#$#%+#%)%#+3(+!&)($%*"';4,5%)&"'##%$1,%#*,&$"75%'-%*"+5)"./%#,&'(0)".% and tertiary health services, particularly in rural and remote areas. According to the annual Bettering the Evaluation and Care of Health (BEACH) Report 8 into General Practice activity in Australia, physiotherapists are the health professional most commonly referred to in general practice. This includes both referrals to medical specialists, and to other health practitioners such as dentists and podiatrists. Data from the survey indicated 9 per cent of all referrals in general practice were to physiotherapists, followed by psychologists, surgeons and orthopaedic surgeons. Such statistics demonstrate the close working relationship between physiotherapists and general practitioners. :'%,(#7",%$1)$%*)$+,($#%<1'%<'740%5'#$%;,(,!$%-"'5%;,+(3%$",)$,0%;.%)%*1.#+'$1,")*+#$%)",%)&$7)44.%$",)$,0%;.% a physiotherapist, it is important to address the maldistribution of this workforce. A health workforce distributed to best suit the needs of the community will help free-up the time of GPs to treat patients with more complex medical needs, thereby reducing the strain on already over-stretched rural and remote doctors. 6()4.#+#%'-%$1,%67#$")4+)(%B1.#+'$1,")*.%6##'&+)$+'(8#%5,5;,"#1+*%0)$)#,$%;.%$1,%C,*)"$5,($%'-%D,)4$1%)(0%63,+(3% shows a decrease in physiotherapists outside metropolitan areas. E(%"7")4%)(0%",5'$,%)",)#%$1,",%)",%#+3(+!&)($4.%5'",%*'$,($+)44.%*",2,($);4,%1'#*+$)4+#)$+'(#%$1)(%+(%5,$"'*'4+$)(%)",)#9 9 To reduce the additional burden on expensive tertiary care in rural and remote areas, the introduction of programs to improve the distribution of the physiotherapy workforce is vital. In metropolitan areas, there are 47 physiotherapists for each head of population, yet in ASGC-RA categories 2 5, there are just 34 physiotherapists per people, despite these practitioners being required to serve a more dispersed population with greater health challenges, higher rates of smoking, alcohol consumption, obesity and lower rates of physical activity. To ensure that Australians are treated in the community rather than in hospitals, it is important to address this imbalance. To help reduce the cost of the chronic disease to the community, the ratio of physiotherapists in rural areas needs to increase to at least the same ratio as that available to people dwelling in metropolitan areas (47 per ). Therefore 900 additional physiotherapists are required in rural and remote Australia. ASGC-RA <=5(/"#=23$>/(#( 988&888&>">?%$#/"0 RA 1 Major cities n/a RA 2 to Additional FTE >=5(/"#=23$>/(#(& needed Considering the fact that there are close to one thousand physiotherapy students graduating every year this target is both reasonable and achievable over the medium term. However it will require a commitment on behalf of the Australian Government to implement policy initiatives which drive this change. 3

5 1: Expand HECS Reimbursement Scheme Problem The HECs reimbursement scheme aims to encourage doctors to move to rural and remote areas. It offers payments based on the ASGCRA category and length of time at the location, seeking to improve access to medical professionals in rural areas. The scheme is administered by Medicare Australia and gives doctors, who have graduated with a substantial debt $'%$1,%F'55'(<,)4$1/%$1,%'**'"$7(+$.%$'%*).%0'<(%$1,+"%'7$#$)(0+(3%)5'7($#%<+$1+(%)%$<'%$'%!2,%.,)"%*,"+'09% Recently graduated physiotherapists have no access to such incentives, thus little incentive to begin a career in rural physiotherapy. This model would be an effective way to incentivise physiotherapists to work in more rural and remote regions '-%67#$")4+)/%)(0%<'740%;,(,!$%*)$+,($#%7$+4+#+(3%;'$1%*"+2)$,%)(0%*7;4+&%#,&$'"#9% Cost Students commencing a typical four year undergraduate course have the potential to incur a HECS-HELP debt of $ by the time they qualify as a physiotherapist. Doctors can potentially incur a HECS-HELP debt of $47 125, around $ more than physiotherapists. Based on the latest available data sorted by remoteness area, the APA estimates that there are approximately 678 physiotherapists who would be eligible for HECS reimbursement currently living in ASGC-RA (Australian by approximately 50 physiotherapists per year. <3"A2'#2B&'"(#(&C"3&43(#&'"="3#&"C&2%/D/E%2&>=5(/"#=23$>/(#(&/0&3?3$%&$32$( RA Category Year 1 Year 2 Year 3 Year 4 Year 5 RA 2 $ $ $ $ $ RA 3 $ $ $ $ Nil RA 4 $ $ $ Nil Nil RA 5 $ $ Nil Nil Nil Total $ $ $ $ $ Based on the current distribution of physiotherapists, the APA estimates that the additional physiotherapist would cost treasury $7 670 per physiotherapist per year. <3"A2'#2B&'"(#(&C"3&#=2&$BB/#/"0$%&>=5(/"#=23$>/(#(&$##3$'#2B&#"&>3$'#/'/0D&/0&3?3$%&$32$( Physiotherapists Year 1 Year 2 Year 3 Year 4 Year 5 Additional 50 $ $ $ $ $ Additional 100 $ $ $ $ Additional 150 $ $ $ Additional 200 $ $ Additional 250 $ Total $ $ $ $ $ Grand total $ $ $ $ $ Outcome This incentive would attract recently graduated physiotherapists to practice in rural and remote areas, and offset the!()(&+)4%)(0%*,"#'()4%&'#$#%'-%",4'&)$+'(%-'"%*1.#+'$1,")*+#$#9%e$%<'740%&",)$,%)(%+(&,($+2,%-'"%$1'#,%*1.#+'$1,")*+#$#% currently working in those areas to remain in those areas.!"#$%&'"(#&)*+,-&./%%/"0&"123&412&52$3( 4

6 2: Expand General Practice Rural Incentives Program (GRIP) Problem The generous incentives available to doctors working in rural and remote areas are not available to private *1.#+'$1,")*+#$#9%:1+#%+#%0,#*+$,%)(%)&>('<4,03,0%4)&>%'-%*1.#+'$1,")*+#$#%+(%$1,#,%)",)#%)(0%$1,%#+3(+!&)($% need for community based management of chronic diseases. Rural Incentives Program (GRIP) run by Medicare Australia. About 30 per cent of private practices are located outside of Australian capital cities 12 and the APA estimates that $1,",%)",%('<%)"'7(0%M%JNN%*1.#+'$1,")*.%*")&$+&,#%'7$#+0,%'-%67#$")4+)8#%&)*+$)4%&+$+,#9 13 The APA recommends that the GRIP incentives be paid to physiotherapy practices in ASGC-RA Categories 2 5 to encourage further expansion of this workforce. Cost Rural Incentives <=5(/"#=23$>5 14 General Practice Rural Relocation Grant Between $8 000 and $ depending on locations Health Professional Component Between $1 300 and $ depending on period of time and location Between $ and $ depending on locations Between $2 500 and $ depending on period of time and location Outcome :1,%6B6%;,4+,2,#%$1)$%$1,%+5*4,5,($)$+'(%'-%$1,%",4'&)$+'(%+(&,($+2,#%'2,"%$1,%(,A$%!2,%.,)"#%<'740%",#74$%+(% the establishment of at least 150 new physiotherapy practices in rural and remote areas at an average grant cost of $ per new practice established This number of new practices could see an additional 450 private physiotherapists working in outside of metropolitan areas (based on the average of three physiotherapists working in each practice). E(&",)#+(3%$1,%"7")4%*1.#+'$1,")*.%<'">-'"&,%;.%$1+#%5)3(+$70,%1)#%$1,%&)*)&+$.%$'%#+3(+!&)($4.%+5*)&$%'(%$1,%1,)4$1% and wellbeing of rural communities by improving health outcomes. In addition this new workforce will help to decrease the demands on already overstretched rural General Practitioners and allow them to manage more complex medical problems.!"#$%&'"(#&)6,+&./%%/"0&"123&412&52$3( 5

7 3: Expand Practice Incentive Payments (PIP) Problem The APA believes that the provision of culturally safe services to Aboriginal and Torres Strait Islander peoples is vital to closing the gap in life expectancy, and believes that governments at all levels should support health practitioners and their staff to gain and maintain the appropriate understanding of culturally safe practice. The provision of culturally appropriate services to Aboriginal and Torres Strait Islander peoples takes local connections, $+5,%)(0%,07&)$+'(G)44%'-%<1+&1%&'5,%)$%)%!()(&+)4%)(0%$+5,%&'#$%$'%1,)4$1%*")&$+$+'(,"#9%F7"",($4.%$1,",%+#%('%!()(&+)4%+(&,($+2,%-'"%)%*1.#+'$1,")*+#$%+(%)%"7")4%)",)%$'%#*,(0%",#'7"&,#%'(%$1,%0,2,4'*5,($%$1,%&74$7")4%&'5*,$,(&.% needed to work safely and effectively with Aboriginal and Torres Strait Islander clients. Physiotherapists also have an integral role in areas such as rehabilitation after injury, health promotion, child health, 3,(0,"O#*,&+!&%1,)4$1%+##7,#%)(0%)##+#$+(3%'40,"%*,'*4,9%B1.#+'$1,")*+#$#%1,4*%*,'*4,%*",2,($%+(P7"+,#%)(0%5)+($)+(%!$(,##/%)(0%*"'2+0,%#,"2+&,#%+(%)%<+0,%2)"+,$.%'-%&'($,A$#%)(0%#,$$+(3#9%% Despite this, physiotherapy services are often under-utilised by Aboriginal and Torres Strait Islander peoples, particularly in the private sector. Aboriginal Community Controlled Health Services are the preferred and most culturally appropriate organisations to deliver health services to Aboriginal and Torres Strait Islander Australians, but access to physiotherapy in these organisations is very limited and needs to improve. 15 A 2001 survey of the discrete Aboriginal and Torres Strait Islander communities, mainly in remote Australia, found that 60 per cent had no access to a physiotherapist. 16 :1,%6B6%;,4+,2,#%$1)$%*1.#+'$1,")*+#$#%#1'740%;,%,4+3+;4,%-'"%#*,&+!&%*).5,($#%7(0,"%$1,%E(0+3,('7#%D,)4$1% Incentives under the current Practice Incentives Program run by Medicare Australia. About 30 per cent of private practices are located outside of Australian capital cities 17 and the APA estimates $1)$%$1,",%)",%('<%)"'7(0%M%JNN%*1.#+'$1,")*.%*")&$+&,#%'7$#+0,%'-%67#$")4+)8#%&)*+$)4%&+$+,#9 18 A range of Indigenous Health Incentive payments could be established modelled on the current GP Practice E(&,($+2,%B).5,($#9%:1,#,%*).5,($#%)",%'7$4+(,0%;,4'<%)(0%+(&470,%)%#*,&+!&%)((7)4%B1.#+&)4%D,)4$1%6##,##5,($% to be undertaken by the physiotherapist each year with a summary report back to the General Practitioner. Cost Indigenous Health Incentive <=5(/"#=23$>5 19 General Practice Sign-on Payment $550 per practice $1 000 per practice Patient Registration Payment $135 per patient per year $250 per patient Physical Health Assessment $55 per patient per year $100 per patient Outcome :1,%6B6%;,4+,2,#%$1)$%)%#+3(+!&)($%$)"3,$%+#%",Q7+",0%-'"%$1+#%+(+$+)$+2,%$'%1)2,%)%5,)#7");4,%+5*)&$%'(%1,4*+(3% to close the Gap in Indigenous Health and recommends a target of 500 practices. This represents close to half of all physiotherapy practices in ASGC-RA categories 2 5. Assuming this initiative results in those practices registering on average 10 Indigenous patients per practice '2,"%!2,%.,)"#%$1+#%<'740%",#74$%+(%L%NNN%E(0+3,('7#%*,'*4,%",&,+2+(3%*1.#+'$1,")*.%$1)$%$1,.%<'740%*",2+'7#4.% not have received.!"#$%&'"(#&)7,8&./%%/"0&"123&412&52$3( 6

8 4: Establishment of a pilot to evaluate the effectiveness of Medicare funded Telehealth consultations between medical specialists and physiotherapists in rural areas Problem :1,%6B6%)**4)70#%$1,%67#$")4+)(%@'2,"(5,($8#%+5*4,5,($)$+'(%'-%$1,%$,4,1,)4$1%#&1,5,%$'%1,4*%"7")4%*,'*4,%)&&,##% specialist care. Telehealth services have immense potential to overcome such barriers to treatment as physical distance from health facilities, lack of clinicians or specialists in a geographic area and lack of transportation. Medicare funding is vital to make this type of consultation an accepted alternative to face to face services, and the 6B6%;,4+,2,#%5'",%&)(%;,%0'(,%$'%,(#7",%$1)$%$1,%)44%*)$+,($8#%(,,0+(3%#*,&+)4+#$%5,0+&)4%)$$,($+'(%&)(%)&&,##%$1,#,% consultations. C,#*+$,%1)2+(3%)%0+#$+(&$%)-!(+$.%<+$1%)%(75;,"%'-%5,0+&)4%#*,&+)4+#$#/%*1.#+'$1,")*+#$#%)",%('$%,4+3+;4,%7(0,"%R,0+&)",% rules to assist patients in consultations with such specialists as orthopaedic surgeons, or sport and exercise medicine specialists. The APA has already been told by rural members that metropolitan medical specialists have requested $1,.%&'(#74$%2+)%$,4,1,)4$1G#*,&+!&)44.%+(%$1,%!,40#%'-%'"$1'*),0+&%#7"3,".%)(0%*),0+)$"+&#9% E(%'"0,"%$'%,#$);4+#1%$1,%#&+,($+!&%,2+0,(&,%;)#,%-'"%$1,%,--,&$+2,(,##%)(0%(,,0%-'"%#*,&+)4+#$%5,0+&)4%#,"2+&,#%-)&+4+$)$,0 by physiotherapists, the APA proposes the establishment of a pilot program. 25 sentinel physiotherapy practices should be recruited to participate in a pilot. Grant funding should be provided to conduct the research, with a competitive tendering process used to establish the most clinical and cost effective procedure for the pilot. Key features % S% B)$+,($#%)(0%*1.#+'$1,")*+#$#%4'&)$,0%+(%6T@FOH6%F)$,3'"+,#%JKL % S% B)$+,($#%'-%*)"$+&+*)$+(3%*1.#+'$1,")*+#$#%#1'740%;,%,4+3+;4,%$'%&4)+5%-'"%R,0+&)",%+$,5#%JMJU/%JMVW/%)(0%JMXL % S% B)$+,($#%,4+3+;4,%$'%&4)+5%R,0+&)",%)#%(,&,##)".%'(%",-,"")4%-"'5%$1,%*1.#+'$1,")*+#$ % S% :1,%$.*,%'-%5,0+&)4%#*,&+)4+#$#%",-,"",0%$'%;.%*1.#+'$1,")*+#$#%57#$%;,%<+$1+(%$1,+"%#*1,",%'-%,A*,"$+#,9% The APA expects that most commonly this will include but will not necessarily be limited to: - Orthopaedic Surgeons - Pain Specialists - Rehabilitation Physicians - Sports and Exercise Medicine Specialists - Neurologist - Paediatricians Cost To ensure that the data collected is of high quality and is empirically relevant, the APA recommends that a pilot run for two years. Current Medicare data shows the following claiming patterns for Medicare item numbers between 1 July and November 2011: Item Y,(,!$ Services Total cost 2100 Level A $ $ Level B $ $ Level C $ $ Level D $ $ All n/a $ While growing, these costs are relatively low, and the APA estimates that the costs of a physiotherapy pilot to Medicare <'740%;,%5+(+5)4/%('$%,A&,,0+(3%ZJNN%NNN%+(%$1,%!"#$%.,)"9%E(%)00+$+'(%$'%$1,%&'#$%$'%R,0+&)",%-'"%$1,%$,4,1,)4$1%+$,5% numbers the cost to run the evaluation project would be $1 million. Outcome Telehealth consultations save time and money for patients in rural areas, and contribute to improved outcomes through earlier expert medical intervention. The pilot program will provide clear empirical evidence of the safety,,-!&)&.%)(0%(,,0%-'"%*1.#+'$1,")*+#$#%$'%#7**'"$%#*,&+)4+#$%$,4,1,)4$1%&'(#74$)$+'(#9%!"#$%&'"(#&)9,:&./%%/"0&"123&#;"&52$3( 7

9 5: Extend Medicare Chronic Disease Management Items Problem B,'*4,%+(%"7")4%)(0%",5'$,%)",)#%1)2,%)%#+3(+!&)($4.%1+31,"%")$,%'-%*",2,($);4,%1'#*+$)4%)05+##+'(#%-'"%&1"'(+&% conditions than Australians living in metropolitan areas. The Australian Government has acknowledged that there is )%#+3(+!&)($%(,,0%$'%#1+-$%&)",%'-%$1,#,%*,'*4,%-"'5%",)&$+2,%)(0%,A*,(#+2,%$,"$+)".%&)",/%$'%*",2,($+2,%*"+5)".%&)",9% Such care can help people to self-manage their conditions thus supporting the health of the community and reducing the burden on overstretched hospitals. There are limited rebates available for individuals to access private physiotherapy services. These rebates are available only on referral from a GP. This is problematic for rural patients who endure longer waiting times to see a GP, on top of longer travel times to keep appointments. This is a frustrating and unnecessary barrier to care. The main program under Medicare facilitating access to physiotherapy care is the Chronic Disease Management T&1,5,9%:1+#%*"'3")5%)44'<#%7*%$'%!2,%2+#+$#%*,"%&)4,(0)"%.,)"%-'"%)%*,"#'(%<+$1%)%&'5*4,A%)(0%&1"'(+&%&'(0+$+'(% shared between 13 different allied health providers including physiotherapists, on referral from a GP. One of the main #1'"$&'5+(3#%'-%$1+#%#.#$,5%+#%$1)$%$1,%!2,%2+#+$%4+5+$%+#%+()0,Q7)$,%-'"%*1.#+'$1,")*.%)4'(,%-'"%$1,#,%&'5*4,A%*)$+,($#/% not-withstanding the need to share these visits with other providers. The APA believes that this program should be expanded to a more appropriate number of physiotherapy services. This would allow rural Australians to have much greater access to private physiotherapists through increased opportunities for adequate compensation for services, and reduced GP administrative work. Such action would be )%#+3(+!&)($%#$,*%+(%1,4*+(3%#*",)0%$1,%<'">4')0%;,$<,,(%$1,%*"+2)$,%)(0%*7;4+&%#*1,",%+(%"7")4%)(0%",5'$,%67#$")4+)9% To ensure centralised care, the program should maintain its requirement for allied health providers to provide a progress ",*'"$%$'%$1,%@B%)-$,"%$1,%!"#$%)(0%4)#$%#,##+'(9 Cost :1,%6B6%,#$+5)$,#%$1)$%+(%$1,%JNMNKMM%!()(&+)4%.,)"%R,0+&)",%67#$")4+)%#*,($%ZMM%5+44+'(%'(%*1.#+'$1,")*.%#,"2+&,#% under the Chronic Disease Management Items for people living in ASGC-RA Categories '<+(3%-'"%)(%)00+$+'()4%!2,%*1.#+'$1,")*.%#,##+'(#%7(0,"%$1+#%*"'3")5/%)(0%",5'2+(3%$1,%",Q7+",5,($%-'"%)%@B% referral, would double this cost. Outcome People in rural and remote areas would have access to double the current number of physiotherapy sessions, assisting them with managing chronic diseases, and preventing unnecessary costs to the public hospital system through preventable admissions, and unnecessary waits to see their local GP.!"#$%&'"(#&)77,8&./%%/"0&"123&412&52$3( 8

10 For more information: Jonathon Kruger General Manager, Advocacy and International Relations Division >F (+61 3) F GE"?#&#=2&G?(#3$%/$0&<=5(/"#=23$>5&G(("'/$#/"0 The Australian Physiotherapy Association (APA) is the peak body representing the interests of over physiotherapists and their patients. APA members are registered with the Physiotherapy Board of Australia, have undertaken to meet the APA Code of Conduct, are expected to use the latest research in practice and '-$,(%1)2,%-7"$1,"%)(0i'"%#*,&+)4+#$%Q7)4+!&)$+'(#9% The APA sets a high standard for professional competence and behaviour and advocates best practice care for clients. It is our belief that all Australians should have access to quality physiotherapy, when and where required, to optimise health and wellbeing. Vision To be a focus of excellence for the global physiotherapy community. Belief All Australians should have access to quality physiotherapy, when and where required, to optimise health and wellbeing. Mission To evolve into a more member-centric organisation that gives value to members and to support our belief. References M%% T&1'!,40%C[/%?4,$&1,"%T\/%]JNN^I9%:1,%*1.#+'$1,")*.%<'">-'"&,%+#%)3,+(3/%;,&'5+(3%5'",%5)#&74+(+#,0/%)(0%+#%<'">+(3%longer hours: a demographic study, Australian Journal of Physiotherapy, Vol 53: Australian Institute of Health and Welfare (2000). Physiotherapy labour force AIHW Cat. No. HWL 22. Canberra: AIHW 3 Johansson S (1999). Gendered physiotherapy in transition the Swedish case. Advances in Physiotherapy 1: Smith S, Roberts P, Balmer S (2000). Role overlap and professional boundaries: future implications for physiotherapy and occupational therapy in the NHS. Physiotherapy 86: Australian Health Workforce Advisory Committee, (2006). The Australian allied health workforce: an overview of workforce planning issues Sydney: AHWAC. U%%% 6(0,"#'(%@/%=44+#%=/%_+44+)5#%`/%@)$,#%@%]JNNLI%B"'!4,%'-%$1,%*1.#+'$1,")*.%*"'-,##+'(%+(%a,<%T'7$1%_)4,#%]MX^LKJNNJI%67#$")4+)(%['7"()4%'-%B1.#+'$1,")*.%LMb% Australian Institute of Health and Welfare (2000). Physiotherapy labour force AIHW Cat. No. HWL 22. Canberra: AIHW c%% Y"+$$%D/%R+44,"%@F/%F1)"4,#%[/%D,(0,"#'(%[/%Y).")5%F/%B)(%d/%`)4,($+%\/%D)""+#'(%F/%e8D)44'")(%[/%f1)(3%F/%?)1"+0+(%T9%@,(,")4%*")&$+&,%)&$+2+$.%+(%67#$")4+)%JNMNKMM9% General practice series no.29. Sydney: Sydney University Press, 2011.Press, Sydney X%% 67#$")4+)(%E(#$+$7$,%'-%D,)4$1%)(0%_,4-)",/%]JNMNI9%67#$")4+)8#%D,)4$1%JNMN9%67#$")4+)8#%1,)4$1%#,"+,#%('9MJ9F)$9('9%6gT%MJJ9%F)(;,"")b%6ED_ MN%%67#$")4+)(%E(#$+$7$,%'-%D,)4$1%)(0%_,4-)",/%]JNMNI9%67#$")4+)8#%D,)4$1%JNMN9%67#$")4+)8#%1,)4$1%#,"+,#%('9MJ9F)$9('9%6gT%MJJ9%F)(;,"")b%6ED_ MM%%:1+#%!37",%+#%;)#,0%'(%$1,%&)*%-'"%*1.#+'$1,")*.%&'7"#,#%+(%JNMJ/%)#%*,"%-7(0+(3%&47#$,"%!2,%7(0,"%$1,%F'55'(<,)4$1%@")($%T&1,5,9 12 Australian Bureau of Statistic, (1999). Physiotherapy Services, Australia, , Cat. no Canberra: ABS 13 Ibisworld, (2011). Physiotherapy Services in Australia, Cat. No , Melbourne: IbisWorld 14 These recommendation payments are proportional to the relative average salaries of physiotherapists and GPs. Based on data from Seek, the APA calculates that on average, physiotherapists earn about 45% less than average medical practitioners. 15 Australian Physiotherapy Association (2005): Physiotherapy for Indigenous Australians in rural and remote areas: A survey report, APA, Melbourne. MU%%67#$")4+)(%Y7",)7%'-%T$)$+#$+&#%h%67#$")4+)(%E(#$+$7$,%'-%D,)4$1%)(0%_,4-)",%]JNNWIb%:1,%D,)4$1%)(0%_,4-)",%'-%67#$")4+)8#%6;'"+3+()4%)(0%:'"",#%T$")+$%E#4)(0,"%B,'*4,#9% ABS cat. no , ABS, Canberra. Australian Physiotherapy Association (2005): Physiotherapy for Indigenous Australians in rural and remote areas: A survey report, APA, Melbourne. 17 Australian Bureau of Statistic, (1999). Physiotherapy Services, Australia, , Cat. no Canberra: ABS 18 Ibisworld, (2011). Physiotherapy Services in Australia, Cat. No , Melbourne: IbisWorld 19 These recommendation payments are proportional to the relative average salaries of physiotherapists and GPs. Based on data from Seek, the APA calculates that on average, physiotherapists earn about 45% less than average medical practitioners.