It’s six weeks until the federal budget. Will the government do something concrete for general practice?
Health Minister Mark Butler has raised the hopes of GPs across the country by promising a budget in six weeks’ time that will “give people confidence that we’re committed to turning this around”.
Speaking on 2GB this morning, Mr Butler said “there is no higher priority for us than to rebuild general practice and to strengthen Medicare”.
“It’s under enormous pressure – the most parlous state general practice has been in in the 40-year history of Medicare. We’re very focused on it … I’m deeply worried about the state of general practice in general.”
In its pre-budget submission the RACGP recommended the following changes:
- a 20% increase to Medicare patient rebates for Level C and Level D general practice consultations;
- the reintroduction of Medicare patient rebates for consultations lasting longer than 20 minutes, mental health and GP management plans conducted via telephone;
- new Service Incentive Payments that support care for older people, people with mental health conditions, people with disability;
- tripling of the Medicare patient rebate for the bulk billing incentive items;
- the introduction of a program of junior doctor placements in general practice;
- support for GPs who see their patient within seven days of an unplanned hospital admission or emergency department presentation; and,
- a feasibility study to assess the economic and health benefits of reforms to pharmacy ownership and location laws, and to research and develop alternative models in general practice and Aboriginal Community Controlled Health Organisations (ACCHOs).
While refusing to be drawn on specifics, Mr Butler said the health provisions in the budget would be a response to the six Strengthening Medicare Taskforce meetings he chaired before Christmas.
“There is no higher priority for us than to turn around the decline in general practice,” he said.
“As [we] see general practice decline, what that’s leading to is more people having to go to an emergency department. That’s already putting even more pressure on already stressed hospital emergency departments.”
He confirmed that raising the Medicare rebate remained “on the table”, but repeated that he would not be pouring money into the system as it is without reform.
“Everything’s on the table,” he said, before adding one exception – raising the Medicare levy. “That’s not something we’re considering.”
Mr Butler made it clear he did not want to see an end to bulk billing.
“Many doctors went into general practice wanting to bulk bill. They see it as a very important part of their philosophy, so obviously, we’ve got to deal with the financial pressures,” he said.
“The big problem we have is that the current Medicare system just isn’t delivering the sort of care that we need in 2023. When the Medicare system was designed 40 years ago, people generally went to the doctor because they were sick with an infectious disease, they needed some treatment, some medicines, they got better and they went away.
“That’s not what patients tend to have today. They tend to have much more chronic disease that needs more intensive, ongoing management from their doctors.
“That needs a different type of money rather than for the fee for individual service, which you see in Medicare now.
“GPs are telling me this, the AMA, the RACGP, the nurses’ groups, they’re all singing off the same song sheet – it’s not just about whether there’s enough money in the system, it’s also about how the system is designed.
“So [we’re] not just going to put more money into a system that was built around the 1980s. We need to change the system to reflect what patients need today.”
Comment was sought from the RACGP and ACRRM for this article.
