The Royal Australian College of General Practitioners (RACGP) is urging the government to develop a national plan to deal with potential pandemics after the coronavirus (COVID-19) outbreak revealed failures in the public health response.

RACGP President Dr Harry Nespolon warned that the problems with the health response must not be ignored.

“Australia needs to implement a national plan for dealing with potential pandemics. This isn’t the first and won’t be the last – if we don’t address these problems now, we’re risking people’s health.”

“While we have a national plan for pandemic influenza, it has not been implemented. Not implementing a plan is as good as not having a plan.”

Dr Nespolon said that across Australia GPs and patients had battled with a range of problems, including inconsistent advice from state and federal health agencies and unpredictable availability of protective equipment, such as face masks.

“To take one example, there has been confusion about the type of face masks that GPs need to wear – this protective equipment is vital to keep GPs and their patients safe and stop the spread of this disease.”

“We are also getting different advice from the states and territories on the tests for coronavirus and who should be taking them – should they be done by a GP in a clinic or should they be done in a hospital in a negative pressure room?

“So, at a time when GPs are on heightened alert and may be seeing more patients than usual, we have the extra burden of needing to call around to various health agencies to work out what the current advice is.

“It has taken too long for state health agencies to update their advice in line with the federal advice. GPs have faced weeks of confusion trying to figure out which guidelines they should follow. It’s undermining the critical work GPs do in caring for patients and in controlling outbreaks like coronavirus. 

“It’s essential that we are receiving timely, evidence-based and consistent advice from the outset of an outbreak, so we can continue providing safe and high-quality care.”

The latest advice from the Department of Health is that GPs should wear a surgical mask for consultations with patients who have mild or no respiratory symptoms.

P2/N95 masks, which prevent 95 per cent of small particles from entering the nose and mouth, should be worn when a patient has severe respiratory symptoms suggestive of pneumonia. Patients with these symptoms should be managed in hospital.

Previously, GPs were told they should use P2/N95 masks when taking specimens from all patients suspected of having coronavirus.

Dr Nespolon said another concern was the availability of protective equipment.

“We have heard that some GPs are still finding it difficult to get their hands on protective equipment like face masks.

“The Federal Government acted on our call to release face masks from the national emergency stockpile – they have provided surgical masks, and some states have also released P2/N95 masks.

“While we welcomed the response from government and appreciate this is an evolving space, the problem again was the lack of consistency. What it means for GPs on the ground is that some are receiving both masks while others are missing out.

Dr Nespolon said that GPs were being asked to take on greater responsibilities without adequate consultation, planning or remuneration.

“GPs are called on to do more and more without much thought given to how this affects our day to day work.

“For example, some of the states have told people to call their GPs if they suspect they have coronavirus. The problem with that is GPs who are booked out are going to have to stop seeing practice patients and act as a free telephone triage service.

“We are not remunerated for that and it can take up a lot of time. It’s just another instance of why we need a consistent nation-wide approach.

“The questions we are now asking are how can we solve these problems and how can we do better?

“GPs are at the frontline in the fight against coronavirus – it’s absolutely critical that they have the right information, the right resourcing and the right support to help their patients and control not just coronavirus, but any potential pandemics we will face in the future.”

Dr Nespolon has called for general practice to be included in both federal and state government planning for public health responses to potential pandemics.

“When our country faces a potential pandemic like coronavirus, the first place people turn to is their GP. General practice is fundamental to the response, clearly we need to be included in all of the planning for disease outbreaks, yet we are not involved – it’s a massive oversight and risk to people’s health.”

The RACGP is calling for:

• A national plan for dealing with potential pandemics to ensure a timely, evidence-based and consistent public health response and high quality care across Australia
   
• A single centralised, national body dispensing information (General Practice Round Table)*, rather than advice from multiple health agencies at state and territory level
   
• General practice to be included in federal and state planning for public health responses to potential pandemics
   
• A nation-wide approach to testing that features consistent information on how these tests should be carried out and where
   
• A system to capture intelligence from GPs on the frontline to monitor and report on the potential pandemic, any changes in the nature of the outbreak and its impact on patients