NSW Premier Dominic Perrottet wants Medicare reform.

NSW Premier Dominic Perrottet wants Medicare reform.Credit:Anna Kucera

In a blunt response to doctors who oppose the changes,Perrottet declared the GP groups to be wrong and said this Friday’s meeting of national cabinet had to agree on a roadmap for reform before later decisions to boost funding for primary care and hospitals.

The premier will alsojoin forces with Victorian counterpart Daniel Andrews to press for more federal funding for public hospitals by extending a 50:50 funding deal with Canberra that was agreed during the pandemic but lapsed at the end of last year.

“The federal and state health systems don’t work alongside each other,they work against each other,” Perrottet said in an interview.

“As a result,we have a situation where people can’t get access to their GP and they end up presenting in emergency departments by no fault of their own for matters that aren’t an emergency.”

NSW Premier Dominic Perrottet flew to Melbourne last year to announce a health policy with Victorian Premier Daniel Andrews.

NSW Premier Dominic Perrottet flew to Melbourne last year to announce a health policy with Victorian Premier Daniel Andrews.Credit:Justin McManus

Perrottet said he “absolutely” wanted a national deal to replicate a NSW trial that gives pharmacies the power to prescribe medication for urinary tract infections,hormonal contraception and conditions such as skin ailments as well as allowing them to administer vaccinations.

“That eases the pressure on our doctors and,in turn,it eases pressure on our emergency departments because we need to have a system where emergency departments are for emergencies,” he said.

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Prime Minister Anthony Albanese heads into the national cabinet meeting with demands from all states and territories for more spending on hospitals and Medicare after federal Health Minister Mark Butler admitted the system was under the greatest strain in four decades.

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The government will release the findings of itsStrengthening Medicare Taskforce within days,guiding how it will spend $750 million promised at the election last May,and is also due to release a report on fraud in the system after revelations by this masthead about rorts costing billions of dollars.

Andrews said Friday’s meeting was the moment for action on healthcare reform,including the renewed commitment to the 50-50 hospital funding split,estimated to increase federal funding by billions of dollars each year.

“We know how to fix Medicare – better pay for GPs,more university places for young people studying medicine and more incentives for international GPs to make Australia home,” Andrews told this masthead.

“Without this funding,hospitals across Australia risk becoming even more overburdened – which,coupled with the broken primary care issue,will put extra pressure on every part of our health system.”

South Australian Premier Peter Malinauskas said that people in his state were waiting 55 per cent longer to see a doctor than they were three years ago. “Think about what that means in terms of impact on EDs,” he said. “If we’re honest,the hospital system is on the precipice of an almost permanent state of crisis.”

‘We know how to fix Medicare – better pay for GPs,more university places for young people studying medicine and more incentives for international GPs to make Australia home.’

Victorian Premier Daniel Andrews

”There are things the states can do,but we really need dramatic action in the short and long term … We can’t fight the battle with one arm tied behind our back.“

Malinauskas said he wanted to see the government’s Medicare report that will guide future policy decisions. However,Health Minister Mark Butler has not committed to releasing it before the national cabinet meeting.

Andrews and Perrottet have both called for an increase in Medicare rebates to lift funding for primary care but the NSW premier said he wanted a roadmap for reform this Friday to ensure structural change before new funding flowed into the system.

“Let’s lead with the new way of doing things and what should be the best health care possible,and then let’s have the discussion around funding,” Perrottet said. “If we lead with funding we’re not going to have a discussion on the right policy.”

Perrottet and Andrews have also agreed to build25 “urgent care clinics” in each state to help patients who cannot find a GP,while they support the election pledge from Albanese last year to fund 50 similar care clinics.

The Australian Medical Association warned last November that Perrottet was “writing a prescription for the collapse of general practice” by allowing pharmacies to offer more primary care,highlighting the ferocious lobbying against any proposal to embrace the NSW trial at a national level.

Asked if doctors were wrong to oppose the move to let pharmacists do more of the primary care,Perrottet said:“I believe they are,but change is always difficult,and there will always be different opinions and I completely respect that.”

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Perrottet cited NSW health figures showing that 77 per cent of emergency department presentations were seen on time at NSW hospitals during the pandemic,higher than the figure of 67 per cent nationally,and the median waiting time of 14 minutes compared to 20 minutes nationally.

The state figures highlight the pressure on emergency departments,however,from 1.5 million presentations each year by patients with relatively low-level illnesses known as category four and five illnesses and ranging from sprained ankles to migraines or aches.

“We need to get emergency departments back to doing what they do best,and that is looking after patients who have an emergency illness.

“And that also means providing greater opportunities for GPs to bulk bill to see patients and ensure the best health care for people across the nation.”

Cut through the noise of federal politics with news,views and expert analysis from Jacqueline Maley.Subscribers can sign up to our weekly Inside Politics newsletter here.

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