AUSTRALIA (Commonwealth Union)_The Australian Medical Association has cautioned that Medicare rebates to GPs must be doubled to stem the flood of doctors quitting bulk billing, while also raising concerns about “catastrophically terrible” access in rural and regional areas.
According to doctor’s groups, an increasing number of general practitioners are unable to offer bulk billing because government subsidies have not kept up with rising costs.
The premiers of New South Wales and Victoria, Dominic Perrottet and Daniel Andrews, have similarly demanded that the Albanese administration significantly increase Medicare funding.
“Not to pre-empt the Strengthening Medicare taskforce, but the government needs to be prepared for a three-figure percentage hike,” AMA president Prof Steve Robson told Guardian Australia.
“When you look at the scale that has to be achieved, the [announced] funds for changes in primary care is essentially little.”
On Thursday, Perrottet and Andrews began a collaborative push for the February national cabinet meeting to address primary care swiftly, calling for salary increases for GPs, more university spaces to train more physicians, and better cooperation with hospitals.
“Mark Butler has stated that it is a top priority for him, and he has some funds… “However, what has been presented does not even come close to touching the sides of what we require,” he stated. “We need to raise rebates. There is no other way around it.”
Robson said that relying only on Medicare money was no longer financially viable for GPs. “Getting in to visit doctors in tiny towns or non-urban areas is catastrophically terrible,” he said.
Dr Nicole Higgins, president of the Royal Australian College of General Practitioners, alleged that the Coalition-era rebate freeze and fee indexation below inflation cost doctors billions of dollars in recent years.
“Over time, we’ve gotten to the point where GPs can no longer afford to bulk bill the majority of patients,” the Mackay GP explained.
“The majority of them are modest local companies. They must pay personnel, utilities, and rent, and they cannot remain open if they just accept Medicare for services… The cost of Medicare has not kept pace with the cost of providing services.”
However, he argued that just boosting Medicare rebates was not the solution. Duckett stated that Australia needs to reconsider how healthcare looked and functioned.
“The primary care system is predominantly GP-oriented, with a focus on doctors. “General practise needs to be more multidisciplinary; we need to use more nurses, physiotherapists, and podiatrists,” he says.
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“The old model of a single GP has long since disappeared. GPs recognise the abilities of other experts. We need to create a new paradigm that makes it financially feasible for a nurse to work in a GP room.”
Duckett warned that paying doctors more without changing the incentive system could lead to some GPs giving less services in order to make more money in less time.
“More money thrown towards rebates is not a good solution,” he said.
The president of the Australian College of Nurse Practitioners, Leanne Boase, has called for the conversation to extend beyond GPs.
Nurses should be better deployed and allowed to perform vital responsibilities, particularly in remote regions, she believes. Many were qualified to perform tasks comparable to those of general practitioners, such as evaluations for psychologist referrals.
“We have a really fantastic chance since the system is now flawed, and this allows us to reconstruct it with a consumer or patient focus,” Boase added.
“A wage increase for doctors will do very little to help. We need to look at the entire system, not just the role of general practitioners.”
Boase advocated for reducing red tape that prevents adequately qualified nurse practitioners from performing more jobs in order to increase workforce numbers and access.
“Positioning GPs as the sole gatekeeper to health endangers people’s health. Medicare is owned by Australians, not doctors.”
