‘A referendum on Medicare’: Frontbenchers clash in Canberra

In his introduction to the National Press Club health debate, host Greg Jennett described a ‘brittle consensus’ between the two major parties – a reference to several Labor Party election commitments subsequently matched by the Coalition.
 
In a campaign dominated by health, that approach was put under the spotlight in Canberra on Wednesday as Federal Health and Aged Care Minister Mark Butler and his Opposition counterpart Senator Anne Ruston set out their stalls.
 
Echoing the leaders’ debate on Tuesday evening, the initial discussion centred more around historical differences than current policy, including an inevitable dispute around bulk-billing rates and Medicare freezes.
 
Minister Butler also faced queries on the central Labor Party commitment to invest $8.5 billion into Medicare with a focus on increasing bulk-bulling rates – and defended the modelling involved.
 
‘We’ve been very clear with our model, we think that we can get to 90% of bulk billing for non-concessional patients,’ he said.
 
‘There will be Australians who will continue to be charged a gap fee. But we think we can get to 90% for all Australians under these arrangements.’
 
Senator Ruston meanwhile highlighted some of the financial pressures facing general practices.
 
‘We also need to remember that most GP clinics are actually small businesses,’ she said. 

‘So we need to remember that they’re paying higher for their energy costs, they’re paying higher insurance, their mortgages or their rents are higher, so they are being impacted by the cost and the inflationary impacts of the cost of doing business in Australia just the same way as every other small business, and we need to recognise that and work together to make sure we’re resolving this so Australians can get access to affordable healthcare.’
 
Policy differences opened up in the discussion of urgent care clinics (UCCs), which has been another pillar of the Labor Party’s pitch to the electorate – and one where the RACGP has expressed significant concerns.
 
If re-elected the Labor Party has committed to adding 50 new clinics to the 87 established since the previous election, a promise the Coalition has not echoed.
 
Some GPs back the clinics, but almost four in five newsGP readers expressed concerns about their potential to exacerbate existing strains on the GP workforce in recent poll.
 
However, Minister Butler described the clinics as ‘a game changer for communities across the country’.
 
‘Over 1.3 million patients have already been seen nationwide, a third of whom are under the age of 15, taking pressure off busy hospital emergency departments,’ he said.

Senator Ruston said the Coalition would keep the existing UCCs open but again did not commit to expanding the network.
 
She also criticised the implementation of the clinics and queried whether GPs are consistently available for full opening hours.
 
‘I think you’ll find if you look at many of the UCCs around the country, that is not the case,’ she said.
 
One area for consensus was around workforce pressures, with Senator Ruston referencing the Coalition’s recent $100 million announcement focusing on rural healthcare.
 
‘We will commit towards an additional 200 Commonwealth Supported Places specifically dedicated to GPs working in regions and rural generalism, because we know that if you train young people in the bush, they’re more likely to stay in the bush,’ she said.
 
Minister Butler agreed with the need to invest in workforce.
 
‘We need more doctors,’ he said.
 
‘We’ve added more than 17,000 doctors to the system in the last two years, which is the biggest number in more than a decade.
 
‘We’re seeing GP training turn around from its long-term decline. We’re training more junior doctors as GPs this year than we ever have in Australia.
 
‘Last year was a record exceeded by this year. We want to grow that as well. We’re also cutting red tape to allow overseas-trained doctors who’ve always been such an important part of the market in rural Australia to get in more quickly, not to have to pay exorbitant fees to work in Australia, where they’re coming from comparable markets, places where we have high confidence in the training system.’
 
In their closing remarks, both politicians again emphasised the importance of health policy in this year’s election.
 
Minister Butler described the election as ‘a referendum on Medicare’, while Senator Ruston called it ‘a choice about Australia’s healthcare system’.
 
‘There are policy similarities and there are policy differences, I think that much is abundantly clear,’ Mr Jennett concluded.
 
Watch the debate in full:
 

 
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Anne Ruston Federal Election health policy Mark Butler