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A WAVE of outrage from the general practice community won’t be enough to save either the Bettering the Evaluation and Care of Health (BEACH) program, nor the Primary Health Care Research and Information Service (PHCRIS), unless funding “white knights” can be found before 30 June of this year.
The director of the BEACH program, Professor Helena Britt, and the director of PHCRIS, Professor Ellen McIntyre, were informed last week by the Department of Health and Ageing that there would be no government funding for them beyond the end of the financial year.
“We were told in November that there would be a competitive grant round coming but it never came, and we were never given any reasons for the defunding,” Professor Britt told MJA InSight.
“The uproar [from the general practice community] has just been amazing and I’m so proud of that, but I’m also especially sad.”
BEACH has been running for 18 years, although the data collection system it uses has been developed over 30 years at the University of Sydney. It has involved commitment from over 11 000 GPs and currently holds about 1.7 million GP-patient encounter records.
“BEACH has been the only continuous national study of general practice in the world which relies on random samples of GPs, links management actions to the exact problem being managed, and provides extensive measurement of prevalence of diseases, multimorbidity and adverse medication events,” Professor Britt wrote in an official statement about the closure.
BEACH needs $1.5 million to survive for another year, Professor Britt told MJA InSight.
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The University of Sydney (UoS) is in talks with Professor Britt to explore the chances of the university keeping BEACH afloat, at least in the short term, but no decision has been made at the time of MJA InSight going to press.
Professor Lyndal Trevena, head of the Discipline of General Practice at UoS, said BEACH was “a priceless gem” and that the GP community was “in shock and disbelief” at its defunding.
“[The government] will spend $8.7 billion on general practice, but won’t spend a little over $1 million to evaluate it?” Professor Trevena told MJA InSight.
“We continue to hope that the government will realise its error, but in the meantime we obviously want to try and save what we can, although we can’t fully fund it in the long term.
“If [Professor Britt and her staff] have the energy and stamina to move forward then we want to do what we can to help.
“It’s a tragedy that it’s come to this.”
BEACH isn’t the only program in the firing line.
The Australian Primary Health Care Research Institute, based at the Australian National University, was closed down on 31 March to “enable an orderly transition to APHCRI’s host organisation, the Research School of Population Health (RSPH) at ANU and to ensure that remaining research contract commitments are met”.
PHCRIS will also close at the end of June, unless $1.4 million can be found from other funding sources to cover the loss of government money.
Professor McIntyre told MJA InSight that “it wasn’t a very good place to be”.
“But we haven’t given up,” she said. “We’ve got till the end of June.”
The 2016 PHC Research Conference, scheduled for 8-9 June, would go ahead as planned, Professor McIntyre said.
“We are absolutely committed to that. There is real value in the exchange of information that goes on at the conference.”
The frustrating thing, Professor McIntyre said, was that PHCRIS involvement with the Department of Health had deepened and become very positive over the past 15 years.
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PHCRIS was established in 1995 as the National Information Service (NIS) before the name change in 2001. PHCRIS generates, manages and shares research, information and knowledge about primary health care to accelerate the impact of research and evidence in policy and practice, working with four key stakeholder groups – policy makers, practitioners, researchers and consumer advocates.
The human side of the closures is weighing heavily on both Professor Britt and Professor McIntyre.
BEACH staff have been working on 3-month appointments for the past 18 months, Professor Britt said, and it had been a “year-to-year” proposition since 1993 for her.
“We are devastated,” she said of the 14 staff and student volunteers involved with BEACH. “The five academics involved, most of them came up through the ranks and BEACH has been their whole life.”
The closure of BEACH will mean the loss of 155 years of general practice research experience, she said.
It also means that data collected in the past year by BEACH will go unpublished, along with the annual BEACH report and the “decade of Australian general practice activity” report for this year.
“I know a lot of GPs recognise the value of BEACH,” Professor Britt said. “They know we are independent that we identify things that need to be improved.
“We would have liked to close professionally by having enough time to get the data out, because GPs have put their time and commitment in over the past year, and now there will nothing to show for it.
“We have 10 papers under review, and another four ready for submission, but they won’t get out now, because we can’t respond to reviewers.
“We’re in mourning.”
PHCRIS has a staff of 13, Professor McIntyre said.
“I’m feeling very distressed for them. As a team we’ve worked very well together. They’re remaining very professional and are working very hard on the conference. We’re helping them through Flinders University to find other jobs.
“But we’re also actively looking for support and we welcome any suggestions.
“We can’t do what we do without people being involved.”
The Department of Health was contacted for comment for this story but had not responded by deadline.
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To Geoff Sims,
As stated at the bottom of the story, the Department of Health was contacted for comment but did not respond prior to deadline, and in fact, still have not.
Cate
I was involved with early days of the BEACH program when it was established as a collaboration between the University of Sydney and the Australian Institute of Health and Welfare. It is surprising that the data that it has continued to produce are not a Commonwealth funding prority, given the light that these data shine on what happens in a health services area that costs government (i.e. us) billions of dollars annually through Medcare. BEACH data make a major contribtuion to accountabilty for this expenditure. The government’s relationship with general practice has undegone structural changes since BEACH was established, including in recent years. It may have other plans. Regardless, a comment from the Department of Health would have been appropriate.
I am very saddened to hear that BEACH is likely to fold after providing the only national primary health care data for many years.
We hear constant talk about the need for evidence-based medcine and evidence-based health services. The closure of BEACH effectively closes off an important source of evidence to support decision-making. Without BEACH we may get “Head-in-the-sand” policy making.
We should be strengthening such valuable assets which have provided important data to support clinical practice and policy for many years despite ongoing financial instability aher than destroying them!
It is easier for Ley and Turnbull to destroy Medicare by keeping their head in the sand by scrapping BEACH.
The Government love claiming GPs are greedy and just do six minute medicine, but BEACH studies have shown most GP visits deal with 4 seperate health issues including chronic disease management and opportunistic health checks.
It is much easier to justify freezing GP payments for 4 years when you ignore the work that they do, and that the complexity of consultations and issues addressed increases year by year.
The Federal Government is destroying the best health system on the planet, embracing ideas from the far more expensive and inefficient USA and UK systems. As a result GP moral is sliding almost as fast as Malcolm Turnbull’s popularity.
WE really need BEACH to provide us with data about what is happening in general practice. It gives us demographics (GPS and patients), the length of consultations, the reasons for encounters, diagnoses, management referral and answers to some specific substudies (eg when I did it I had to measure 20 patients’ BMIs).
We can look at this and get an idea of what is happening Australia wide, and then if we are a PHN or a registrar organisation, we can compare that with our own particular area and look at the comparison (eg patient age and sex, GP age and sex) and use that for planning. If we are a GP or a GP practice we can use that data to plan for the future, knowing that we are about average in our demographics or not, and what to expect as time goes on..
WE can also look at it over time – BEACH has provided 10 year reviews. For example, as an aged care researcher, I can see that the number of consults with people over the age of 65 is steadily increasing. This may be contributing to the increased time per consultation, and also the increase in the number or problems dealt with in each consutlation. Without BEACH we would not have this data to work with. I use this sort of data in talks to GPs in teaching medical students and in planning interventions that might imporve general practice. AS a GP I can see that my consultation length is increasing not because I am “slow” but just in line with changing demographics in the practice, and I can adjust for that.
I think it is amazing that it is being defunded.
Just another example of the hopeless substandard ability of our Minoister for Health. SHe should go and go soon.
The BEACH programme is such an important ongoing study that, if worse came to worst, the RACGP could fund it, linking it to CME or accreditation (I know, this ultimately means we GPs ourselves would pay for it). Most GPs would be happy and proud to participate every couple of years, notwithstanding the time pressures involved. The forms wouldn’t cost much to reprint, the main expense being the analysis of data.
I’m surprised some health department apparatchik hasn’t suggested that participation be linked to PIP payment- maybe this is not a bad idea?