The Bettering the Evaluation and Care of Health (BEACH) program may be left high and dry

Withdrawal of government funding may force the closure of this invaluable resource eneral practice remains the cornerstone of Australia' s health services. About 85% of the population sees a general practitioner at least once in any year. 1 Last financial year, that amounted to 103 million general practice services, at a cost to Medicare of $4 billion. 2 Over the past decade, the Bettering the Evaluation and Care of Health (BEACH) program has provided a unique insight into these clinical encounters between GPs and their patients. BEACH tells us about the patients that GPs see, the problems that are encountered, and the treatment provided. The BEACH program is a continuous national study of general practice activity in Australia. Indeed, it is the only such study in the world. To date, it includes details of 900 000 encounters between GPs and patients. Every year another 100 000 encounters from a random, ever-changing sample of 1000 GPs are added. The strength of the BEACH data lies first in its sheer sample size, and second in that it provides a reliable, continuous measure of changes in general practice since 1998. Since that time, there have been a number of important changes to Medicare and a raft of new programs and initiatives to help GPs better manage their patients. These include financial incentives to boost bulk-billing, reimbursement for services provided by practice nurses, practice and service incentive payments for the management of patients with asthma and diabetes and for the provision of immunisations and cervical cancer screening tests, and new Medicare items to encourage GPs to work with allied health professionals to provide coordinated care for patients with complex and chronic health problems. Other factors have also intervened in the relationship between GPs and their patients. The GP workforce is increasingly older, has a higher proportion of women, and is looking to work fewer hours. 3 At the same time there' s a growing shortage of GPs, especially outside metropolitan areas. 4 Their patients are also ageing and beset by chronic illnesses such as heart disease, diabetes, arthritis, depression, and chronic obstructive airway disease. Many struggle to afford the out-of-pocket costs associated with their care, which have grown by 50% over the past decade. 5 The push is on to get GPs to encourage their patients to exercise more and smoke less, to prescribe fewer diagnostic tests and medications, to talk to their patients …