General practice needs big injection of funds to exist

The arguments around GP bulk-billing rates are becoming depressing and fatiguing for us GPs (“Price of seeing a GP soars”,November 15). We provide a quality complex service that is increasingly expensive to run. We constantly fill the shoes of psychiatrists,general physicians,paediatricians,gynaecologists etc. We know our patients can’t always afford them;their fees are five to 10-fold what we charge. We show billing compassion when needed (often a rarity from our specialist colleagues) and yet it’s us who gets hounded about bulk-billing. We have offered solutions to workforce and financial viability issues such as the reasonable,cost-neutral idea of a vaccine rebate for our nurses – unfathomably,Health Minister Mark Butler says no.

The new incentive payments are a $14 rise if we bulk-bill only certain groups,but it simply isn’t enough. Meanwhile,I received a $6000 penalty from state revenue last week when my payroll tax was a day late during the Optus outage. I throw my hands up!Lucy France,Cronulla

It is all very well for Mark Butler to point the finger at the former Coalition government for the parlous state of Medicare and to comment that it will take “sustained investment” to rectify the situation. After 18 months in government,we are yet to see the much-needed investment,in particular for general practice.

The recent survey of GPs clearly identifies what every patient and their GP knows:the level of Medicare rebates for regular appointments at a GP practice is far too low and bears no relation to the fee that GPs are forced to charge to maintain a viable practice. Hence the continuing decline in bulk-billing and patients not seeing their GP because of the ever-increasing gap payment.

Everyone is well aware of the constraints on the government due to the tightness of the budget that has existed since the Albanese government came to power. The solution is simple – increase revenue. Many have suggested how the tax system can be updated and amended to provide that revenue. It is well past the time for the government to act in this area.Ross Butler,Rodd Point

Why aren’t there constant complaints about fees for plumbers and electricians? Few would come near you for under $100 minimum. Yet the government repeatedly encourages the public to complain bitterly when a GP charges more than $45 for a 20-minute consultation. GPs have many years of training – far more than required for a trade certificate. They have huge expenses – indemnity insurance,registration,ongoing education costs (yes,many hours of education annually is compulsory),secretarial and nursing staff costs,rent,telephone and IT costs to mention only a few. There is no holiday or sick pay. It is no wonder few graduating doctors choose a career in general practice,and no wonder it is so hard to find a good GP. General practice is a dying profession unless there is a huge injection of funds.
Katriona Herborn,Blackheath

Peter Dutton always complains but never explains

Peter Dutton wastes no time complaining about anything and everything that the government does,without ever offering any positive solutions (“Misused millions:Top spy’s secret report slams Home Affairs”,November 15). Perhaps he’d like to explain how,under his watch as home affairs minister,millions of taxpayer dollars were wasted and ended up in foreign bank accounts. Richardson’s inquiry lists “serious failures” within Home Affairs;“lack of adequate due diligence” and hiring of contractors and subcontractors with “dubious business dealings or foreign officials”. Incompetence,poor oversight,bad management,and massive wastage of taxpayer funds require a detailed explanation from Dutton.Alan Marel,North Curl Curl

Richardson’s report on the massive waste of taxpayers’ funds under the watchful eye of “the good economic managers” must be released to the public. The electorate has a right to know. But you have to admire the initiative shown by Home Affairs under the Coalition. “Arm’s length” outsourcing to contractors who then engaged a web of subcontractors was a stroke of genius. Some of these subcontractors were then free to use suspect practices to get government dirty work done. Isn’t plausible deniability great?
George Rosier,Carlingford

The Richardson enquiry:what the ex-spy chief saw;the so-called Pacific Solution and who did what and when. Well,what a story. Interesting that these issues occurred on the watch of the so-called superior financial managers,our former LNP government(s). We expect taxpayers money to be spent honestly and not frittered away in places where corruption could occur.
John Kingsmill,Fairlight

For those of us still getting over the life-threatening arrogance and inhumanity of robodebt,those great money-managers at the LNP are back with a new horror show,Paladin. Political corruption,international intrigue,bikie gangs,human rights abuse and half a billion in taxpayer funds. It should be remembered that Opposition Leader Peter Dutton awarded the massive contract,without going to tender,to a company run out of a post box on Kangaroo Island.Phil Bradshaw,Naremburn

First we have the ruling that indefinite detention is illegal. Now we learn the financial cost of the so-called Pacific Solution. It is easy for the Coalition to throw around terms such as hard-core criminals but it was the government which presided over the implementation of these responses to refugees and asylum seekers. Instead of seeking to score political points,the opposition must share the responsibility and seek to be part of the solution.Philip Cooney,Wentworth Falls

Gaza conflict needs gentler leaders

In a maelstrom of religious and ethnic intolerance,ideological rigidity and ego and power-driven leadership one wonders whether there will ever be a solution to the challenges facing Israel and the Palestinians (Letters,November 15). One thing is certain. Having lost a child to a terrorist bomb I know the that the pain inflicted by Hamas and the Israelis alike is insufferable and the grief inconsolable. I also know that unless there are leaders who are gentler,kinder,more accepting and less self-focused,the carnage will continue.Peter Singer,Hamilton South

I’m genuinely exhausted by the polarised debate and the stigmatising of anyone genuinely concerned about the deaths of innocent civilians. It seems to be across all industries and corners of society,even here,so far from the conflict itself. Surely we can be simultaneously horrified at the attacks against innocent Israelis and the killing of innocents in Gaza,without being branded antisemitic for saying so?Chris Lamaro,Leichhardt

Poorhouse philanthropy

Millie Muroi rightly decries the inequity in NSW school funding. (“Digging deep for school equity” November 15). However her solution,for philanthropy donations to be directed towards public schools,creates charities of our public schools. It is our tax monies that should be adequately directed towards those most at need in our public schools. Promoting philanthropy for basic funding needs,as she suggests,only places our children in the charitable “poorhouse”.Janice Creenaune,Austinmer

There is no doubt that the system is unfair to public schools. Until this is sorted,supporters of public education can donate to thePublic Education Foundation which gives scholarships to students in need.Valerie Hoogstad,Clontarf

Public education doesn’t want charity,it wants justice.Keith Binns,Goulburn

Congratulations to Millie Muroi for raising an issue my cohort of public school alumni has often discussed. If the education department simply helped all public schools to establish and publish a bank account for alumni to make donations directly to their own school and then promoted this at school reunions and across the local community,then significant funding for extra curriculum activities and resources might be raised. Muroi asks “why aren’t we digging into our pockets and sowing the seeds?” Because we haven’t been asked,and the process has not been made easy.Ray Thompson,Randwick

Chase for rankings

So things haven’t changed since my days in academia 30 years ago (“Uni research teams ‘stuck in pursuit of rankings’”,November 15). It was not uncommon for a single study to be published a number of times in slightly changed formats. Supervisors encouraged students to publish their findings only to place themselves as the chief investigator. The most serious outcome of this is that groundbreaking research and findings can languish unpublished and thus unrecognised to the detriment of advancement of knowledge.Christine Perrot,Armidale

Swiss rights

There is more to the story by Thomas Fuller (“Renting for Life”,November 15) on the Swiss rental market. It is true that many Swiss are content to rent for life without the pressure of having to buy. This is because tenants’ rights are protected from unjustified rental increases. Many properties are owned by banks and superannuation firms who are content with a steady but adequate return that does not fluctuate on the whim of market forces. It is expected that tenants will remain in properties possibly for life with the ability to decorate the place to their own taste. We have friends in Switzerland whose wealthy grandfather rented an apartment all his life,even though he could afford to buy. He saw ownership as an unnecessary shackle and lived securely and comfortably without the stress of eviction at the whim of his landlord.
Peter Hobbs,Brighton

Limp response

In the face of soaring motorway tolls,the crisis in affordable housing and struggling hospitals,Chris Minns is working hard on legislation to save Russell Balding’s job (“All bets are off as racing’s rich and powerful jockey over controversial 14-year posting”,November 15). Taken with their limp response to poker machine reform and casino compliance it’s hard not to see a pattern emerging.Colin Stokes,Camperdown

Pick me

Rod Leonarder (Letters,November 15) asked,“Has the time arrived to deputise some readers to carry out dessert reviews?“. As a founding member of the 1980s Randwick TAFE College Dessert Club,where we visited restaurants and ate every dessert on the menu,and chief dessert chief in my family,I nominate myself. I’ll be very happy to take over the dessert reviews.
Anne Elliott,Balmain

Well travelled

Your correspondent,Rosemary O’Brien,describes PM Albanese’s overseas visits as merely “striding up yet another long aircraft stairway into first-class luxury” (Letters,November 15). Really? How simplistic and insulting. It says much that she omits his reasons for travelling. A few include:the first Australian PM visit to China in seven years;a visit to Washington,our key strategic ally;to the Cook Islands for the Pacific Islands Forum to show support in the face of Chinese incursion;and to attend Quad and NATO summits. These are not jaunts. She says former PM Scott Morrison was “clobbered” for being – note,not staying - on holiday while our country burned. She omits that he also tried to keep it secret. So,is she saying he was blameless and voters were cruel? Furthermore,she well knows he was “clobbered” for much more than “not holding a hose”.Jennifer Fergus,Croydon

Is your correspondent seriously comparing Morrison being on holidays during the worst bushfires on record with Albanese visiting our largest trading partner to repair an important relationship badly damaged by the aforementioned during his miserable tenure?Brett Jack,Bonnyrigg Heights

To compare Scott Morrison’s holiday jaunt with his family while the bushfires were raging with the prime minister’s important meetings with world leaders is just a bit rich!Kerrie Johnman,Noraville

Could the Double 0 in 007 stand for Optus Outage?

Either I’m paranoid,or I’ve watched too many spy movies late at night,but I do wonder what dastardly deeds were possibly taking place elsewhere while we were all being distracted by the major network outage which effectively paralysed us for 16 hours (“The ‘third’ party’ that brought down Optus revealed”,November 15).Alicia Dawson,Balmain

Wrong way

When I use a paper map,it always seems to be the wrong way up (Letters,November 15).John Christie,Oatley

Letter connections

I met Sarah Johnson of Sandy Bay just after the death of my partner Ian Hicks,aHerald journalist for 35 years (Letters,November 15). We were delighted to discover that we were both avid readers of letters to theHerald,which we discuss several days a week.Jane Tolman,Sandy Bay

Jane Tolman and I are the founding members of the Sandy Bay chapter of theHerald letter-writers club. We regularly discuss our choice for Letter of the Day.Sarah Johnson,Sandy Bay

You know you are a letters addict when you recognise names of contributors more readily than journalists,friends or even family members.Elizabeth Darton,Lane Cove West