Push to boost GP pay not part of prescription to fix Medicare

Health Minister Mark Butler is not expected to announce an increase to doctors’ pay at Friday’s national cabinet meeting despite calls from state premiers at the start of the year for GPs to be paid more.

A highly anticipated report by the federal taskforce charged with overhauling Medicare that will be presented to state and territory leaders will not address the question of raising the rebate for GP visits.

Health Minister Mark Butler is not expected to announce an increase to doctors’ rebates this week.

Health Minister Mark Butler is not expected to announce an increase to doctors’ rebates this week.James Brickwood

Doctors have been calling on the federal government for years to increase the Medicare rebate for GP visits,which has barely risen in a decade,as costs of running general practice rise andbulk-billing rates fall,forcing more Australians to pay out-of-pocket for primary care.

The Strengthening Medicare report will canvass several fundamental reforms to Australia’s primary healthcare system – including models to encourage GP bulk-billing and enhance the role of health professionals such as nurses,physiotherapists and dieticians – but it will not include costings or tell the government how it should spend the $750 million allocated over the next three years to reform Medicare.

Prime Minister Anthony Albanese will discuss the advice with premiers and chief ministers in person at the national cabinet meeting following a sustained campaign by NSW and Victoria’s premiers for a Medicare overhaul.

The premiers are pushing for a 50/50 hospital funding split between states and the Commonwealth,which was introduced during the pandemic but lapsed last year,a boost to Medicare rebates,construction of more GP clinics,and a controversial shift toallow pharmacies to offer services currently restricted to doctors,such as prescribing some medicines.

The federal government has been tight-lipped on the specifics of the report,but taskforce members say it will reflect advice contained ina recent Grattan Institute reportand 10-year primary care plan that was developed for the Coalition government last year but never adopted.

One model of care expected to be recommended in the taskforce’s report is voluntary patient registration,whereby a patient would enrol for continued care with a general practice,and the practice would get an annual payment or other benefits from the government for caring for that patient.

The Grattan report,which was presented to the taskforce,also called for a model that would enable GPs to lead teams of health care professionals,suggesting that some work currently done by doctors could be safely carried out by nurse practitioners,physiotherapists and pharmacists at a far lower cost.

Butlerconfirmed last month he wanted all health practitioners “working to the top of their scope of practice” and a team-based approach to primary care.

Dr Danielle McMullen,vice president of the Australian Medical Association (AMA) and a member of the taskforce,said the reforms that would be outlined in the report were essential long-term solutions but primary healthcare also urgently needed short-term funding to save the sector.

“We need to keep clinic doors open,to make sure patients have access to care because we can’t wait for a 10-year reform program,” McMullen said.

The AMA broadly supports a multidisciplinary model of care so long as it is GP-led. “We want to make sure that the really important relationship with your usual GP remains a cornerstone of our health system … to make sure patients don’t have to tell their story 10 times,” McMullen said.

Butler on Thursday said Australians deserved access to a 21st century primary care system. “A system that reflects the disease profile of an older population,including a population that has more complex chronic disease,” he said.

“We said at the election that there was no higher priority for Labor in the Health portfolio than strengthening Medicare and rebuilding general practice,because the constant advice we have received across the country is that after nine years of cuts and neglect to Medicare,it has never been harder to see a doctor.”

The meeting agenda also includes an update on Closing the Gap,energy priorities,national firearms reform,local government and housing.

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Natassia Chrysanthos is the federal health reporter for The Sydney Morning Herald and The Age,based at Parliament House in Canberra.

Kate Aubusson is Health Editor of The Sydney Morning Herald.

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