Can Ley’s legacy be Hunt’s glory?

4 minute read

The new health minister faces a daunting agenda, balancing costs pressures with the need for reform


GP remuneration will be a recurring theme on Greg Hunt’s agenda in coming months, both in terms of demands for fresh reforms and repairing faltering projects left behind by Sussan Ley.

Specific work to overhaul rates for GP consultations is getting under way this month as part of a case to be put to the MBS Review working group on GP items.

“There’s no doubt the MBS review is going to be the single most important policy initiative that could benefit general practice,” RACGP President Dr Bastian Seidel told The Medical Republic.

“(The outcome) should reflect the value of general practice to the government, to the taxpayer, and to the nation. I am very optimistic there.”

The College is seeking better remuneration for the conversations GPs have with patients, as opposed to procedural items, and for longer consultations.

“We need to make it fair and equitable,” Dr Seidel said.

As a first priority for the new health minister, doctors’ groups are unanimous in urging an end to the six-year freeze on patients’ Medicare rebates.

The RACGP argues that stopping the freeze for GP visits will cost some $160 million a year but reap far greater long-term benefits by keeping patients out of hospital.

“Lifting the Medicare rebate freeze is financially responsible policy. It’s a simple solution, to take the pressure off patients who see their GPs on a regular basis,” Dr Seidel said.

The AMA, meanwhile, wants the freeze lifted for all specialties, as well as pathology and radiology, but acknowledges GPs suffer the most from the squeeze on patients and incomes.

Minister Hunt, acutely aware of the Coalition’s vulnerability on healthcare among voters after last year’s “Mediscare” election campaign theme, will be warned the unpopular policy carries a political cost.

“We regard the Medicare freeze not only as bad policy but one that is a barrier to cooperation,” AMA President Dr Michael Gannon told The Medical Republic.

“It would be a sign of good faith for a new minister taking the job, or in terms of driving the 2017 Budget, to make those changes.”

Elsewhere, a sense of doom surrounds the Health Care Homes initiative, which was supposed to bring about a general practice-led solution to the growing burden of chronic disease on the Australian health system.

The scheme, launched last year with fanfare by ex-minister Ley and Prime Minister Malcolm Turnbull as a “radical” step to transform Medicare, is now at risk of collapse for lack of funding and policy detail.

The RACGP says the proposed HCH trials are “set up to fail” and has advised members not to take part. It calls for the government to abandon the planned July 1 start date and take a more considered approach.

Dr John Deery, chair of the General Practice Owners Association, which was formed last year, said the proposed trial program, scheduled to involve some 200 practices, was a good example of how not to proceed.

“It lacks the detail of the RACGP’s proposed model,” he added.

“I think the first priority for a new minister is to consult with general practice owners. If you want to get things done, they are the people who can help you do it.”

Ms Ley won praise as minister for her consultative approach, if not for her success in wrangling more investment in health from a government bent on cutting expenditure.

Doctors hope the legacy of consultation will continue.

“A new minister needs to ensure Health Care Homes, and the momentum of the MBS review, but consult more closely with the public and the profession,” Dr Ewen McPhee, president of the Rural Doctors Association of Australia, said.

Rural doctors have a large stake in the success of the Health Care Homes scheme, declining to join the RACGP boycott call.

They are also awaiting the passage of legislation for the appointment of a rural health commissioner, as well as promised action on the maldistribution of doctors around the country.

Dr Gannon agreed the change of minister could bring new headway in health investment.

“It is an opportunity to re-set,” he said.

“Sadly we have to start again with a minister coming to terms with the massive depth of the health portfolio.”

He commended Ms Ley’s achievement in setting up the MBS review with representation from senior doctors across the specialities.

“We are not naive enough to expect a bonanza from the MBS review, but it needs to be modernised,” he said.

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