GPs again listed among Australia’s most ethical

Most Australians consider GPs to be ‘very ethical’, findings contained in the Governance Institute of Australia’s Ethics Index 2023 report have revealed.
 
The report, based on a nationally representative Ipsos survey of 1000 people weighted according to age, gender and location, ranked GP as the fifth-most ethical occupation in Australia, behind fire and ambulance services, pharmacists and nurses.
 
It also ranked health overall as the most ethical sector in Australia and cost of living pressures as the top ethical challenge for 2024.
 
However, while GPs rated well compared to most other occupations, the report did suggest that those who do not bulk bill are seen as ‘somewhat unethical’.
 
In response to the findings, Dr Emil Djakic, a member of RACGP Expert Committee – Funding and Health System Reform, told newsGP ‘the significant confidence’ those surveyed have in general practice is ‘obviously’ important.
 
But he queries whether respondents were provided the full context of the situation before labelling GPs who do not offer bulk billing as ‘unethical’.
 
‘I suspect that the nature of the question doesn’t share the alternative with the survey population,’ he said.
 
‘And that is, in the absence of appropriate business cases in general practice, then that practice would be likely to close or no longer exist.
 
‘If GPs do not ascertain and take the appropriate advice from their financial advisers and manage their business accordingly, then that would potentially bankrupt companies and mean the wholesale closure of general practices.
 
‘It’s all very well to call it unethical, but I would actually say the alternative is worse.’
 
Rather than seeing it as a failure of ethics on behalf of those who no longer bulk bill, Dr Djakic instead sees it as an issue for government.
 
‘The breach of ethics is actually with the Medicare system and the Government in failing to support the community through appropriate insurance to fund primary healthcare for general practice patients,’ he said.
 
‘The consumer perhaps hasn’t been adequately brought the information they need to realise that various administrations over the past 15 years have failed to invest properly in general practice.’
 
He also said GPs who privately bill would already likely have had to ask and answer their own moral questions before making the shift.
 
‘All of them have wrestled with the philosophy of wanting to ensure that they can deliver care and keep the cost barriers to the very minimum,’ Dr Djakic said.
 
‘But the fact is, [governments] have well and truly broken the camel’s back by freezing indexation … and then failing to actually match indexation to adequate CPI, particularly in the last two years when inflation was running at 6–7%.
 
‘So while calling the failure to bulk bill “unethical” is a very sad description, I have to accept that as I’d be even more embarrassed about putting a “closed” sign up in the door.’
 
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