The RACGP and AMA should fight the foreshadowed changes, which will amount to cost-cutting and put our patients at risk.
Leaders within the RACGP and AMA have long wanted a utopian primary care system in which teams of allied health care for patients under the watchful gaze of a consultant GP – just as hospital or academic physicians operate their teams of registrars and residents.
This is a beautiful dream that will never happen. The longer our leaders entertain this fantasy the more at risk our patients become.
The current Labor government wants free healthcare for Australians. It just doesn’t want to pay properly for it, and doesn’t particularly care how good it is.
The money is there for excellent primary care led by GPs: this Labor government is investing an extra $4.7 billion into childcare (an admirable target) over four years among billions of dollars of tax cuts and many other non-health spending splurges. They just do not wish to spend the money in primary health care.
We know that funding cuts of both major political parties have resulted in a situation where the Medicare rebate is worth less than half of what it should have been if it had just kept up with inflation. The concept of fee-for-service Medicare in itself is not broken, but the will to maintain it.
We know that every $1 invested into general practice reaps $8-13 in savings in secondary and tertiary care, ignoring the massive unaccounted-for economic benefit of having many patients not fall sick before their heart attacks, avoidable cancers and strokes, meaning they can still contribute fully to the economy. We know this is madness. It is madness propagated by politics and ignorance.
The RACGP and AMA need to realise that the “brave new world” of Medicare envisaged by Labor is not for the benefit of the patient. It is a cost-saving measure, in which the government is also able to cosy up to its political fundraisers and unionists. The government aims to provide “free” primary health care by cutting general practice out of the loop – by increasing the scope of practice of pharmacists and nurses at the expense of general practice and medicine.
There is nothing wrong with the excellent pharmacists and nurses of our country, they are excellently trained for what they do: provide expert pharmacist and nursing care. You do not need a medical degree to understand that asking a firewoman to investigate a murder will result in substandard outcomes, and even if you pay the firewoman less per hour, it will eventually end up costing the government and society far more.
But this is exactly what the government thinks is a good idea. We can’t let blind idealistic capitation ideology lead us down a path of patient harm.
We have a moral imperative to let go of utopian, ivory tower ideals. The best thing we can do is stand up for our patients and unite with one voice to reject this “modern Medicare” and call it out for what it is: cost cutting, increasing bureaucratic control and data mining.
We must fight politics and ignorance to do what is best for our patients. We must fight Guild fire with our fire, and to do that we need millions of dollars. I call upon the AMA and RACGP to mount an organised campaign against these changes and “get out of the tent” – just as they did with the Guild pharmacy prescribing trials (this is essentially the same thing). We must spend some of the $130 million annual revenue of the RACGP to mount advertised campaigns against these changes and start influencing politicians the only way they understand: through the ballot box.
Dr Chris Irwin is a Melbourne GP, practice owner and founder and president of the Australian Society of General Practice.
