Feature

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GPs around Australia getting political

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RACGP President Dr Harry Nespolon wrote to all college members in March, urging GPs and their patients to press the Federal Government to provide better support for general practice.
 
Dr Nespolon called on GPs to visit local MPs to talk about the issues facing primary care, and to get patients involved on the issue of out-of-pocket costs.
 
Many grassroots GPs are responding to the call.
 
As the Federal Election looms, the RACGP is calling for political action in four key areas:

• Improved technology
• Higher patient rebates to address out-of-pocket costs
• Improved mental health support
• Recognition of the time and skill required for complex health issues.

Medtech entrepreneur and GP Jared Dart has penned an open letter to the top health decision-makers from both major parties, asking for a ‘fair go’ for the two million patients GPs see every week.
 
The letter has been signed by 150 GPs so far, in what Associate Professor Dart describes as a grassroots campaign aligning with the RACGP’s push.
 
The letter calls for urgent attention to ‘the crisis facing our patients’ due to the estimated $1 billion stripped from general practice since 2013 through the rebate freeze, leading to substantially higher costs for patients.
 
‘Patients urgently require a correction of this under-funding of primary care. Patient out-of-pocket costs are higher than ever before,’ Associate Professor Dart’s letter states.  
 
‘Practice costs have been increasing every year and many are finding it hard to sustainably maintain the facilities our patients deserve. General practices who bulk bill patients for services have been absorbing the reduced patient rebate, while others have been forced to increase the out-of-pocket costs to our patients.’
 
The letter points out that health inflation has been more than 5% since 2010, with an average annual increase of 4.5% in the pharmacy sector and 5% or more in private health insurance, while state health funding had grown by almost 30% between 2012 and 2018.
 
Associate Professor Dart told newsGP that he wrote the letter out of frustration.
 
‘It seemed clear to me that the [Federal] Government was willing to make investments in the health sector, just not in general practice, and that the people who were ultimately disadvantaged were our patients and their constituents,’ he said.
 
‘It also seemed clear that the noisiest lobbyists got more funding.  
 
‘GPs are absorbing the lack of a real funding increase. We’re finding it difficult to provide our facilities and services in a sustainable way.
 
‘GPs are dedicated to the care of patients. We deal with considerable uncertainty and a high volume of patients and the majority of GPs are self-employed. Put simply, we generally don’t have the time or energy to lobby effectively. For this reason we are often ignored by politicians.
 
‘But I sensed a change. GPs were unable to continue to absorb the financial impact of bulk billing their disadvantaged patients. They wanted to have a voice and be heard.’

RACGP President Dr Harry Nespolon said staying silent during elections had gotten GPs nowhere.
 
Adelaide GP Dr Alvin Chua has already had more than 300 patients sign the RACGP’s election letter to politicians.
 
He told newsGP his move into the political realm comes from a deep sense of frustration.
 
‘I’m fed up with politicians taking credit for increasing the Medicare rebate by 50 cents – whoop-de-doo,’ he said.
 
‘Our [payment] gap has gone from $32 to $39, and on weekends it’s gone from $32 to $49. That’s just over the last term [of Government]. And my overheads have gone up significantly.
 
‘We have got fed up with patients abusing staff and doctors, saying we’re money grabbing. They need to sort it out with the politicians.
 
‘We feel like we are the scapegoats for the Government not indexing Medicare. But when I point out to my patients that the rebate has been frozen while politicians’ pay and electricity prices have gone up, that everything has gone up except the rebate, then they realise.’
 
Dr Chua has put posters up around his three clinics and printed stacks of the letters. If a patient expresses anger about the out-of-pocket cost, Dr Chua’s practice staff give them a copy of the letter. The signed letters will be sent to local candidates during the formal election campaign, expected to be announced in coming days.  
 
‘When patients come in, I don’t try to make it political. But if it comes up [in a consultation], I basically say, “This is your interest, your rebate”. Everyone understands,’ Dr Chua said.
 
‘We are not a churn-and-burn five-minute medicine practice. But we can only keep bulk billing pensioners and slugging our non-pension patients so much.’

Dr Nespolon told newsGP that GPs’ strength lies in their combined numbers.

‘Ninety-five per cent of our members want us to be political,’ he said. ‘We want GPs to reflect on their own experiences and tell them to the politicians, tell them to their patients.
 
‘GPs are angry about the way politicians have been treating us over the last six to 10 years. They’re angry about the rebate freeze, which has really dug into the ability to provide care to patients.’
 
Dr Nespolon said staying silent during elections had gotten GPs nowhere.
 
‘We have much more influence if politicians can see GPs are together,’ he said. ‘Just look at our “You’ve Been Targeted” campaign [against a proposed co-payment].
 
‘That worked very well because GPs worked together to achieve an outcome. Now we need to work together towards ensuring rebates are sufficient to provide good service and good care for our patients.
 
‘The more often this message is repeated by us and by our patients, the louder that message.’
 
Dr Nespolon said that GPs who do not want to bring politics into the consulting room could participate in other grassroots ways, such as visiting MPs and political candidates.

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Federal election Healthcare funding Medicare Medicare rebate Rebate freeze

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