RACGP President outlines vision for Australian healthcare

It is a system designed to keep Australians healthy, but 40 years after being first introduced, ‘Medicare itself is sick’.
 
That is according to RACGP President Dr Nicole Higgins, who addressed a crowd of the nation’s healthcare leaders in Melbourne on Thursday.
 
Federal Health and Aged Care Minister Mark Butler was in attendance alongside lead of the Independent Scope of Practice Review, Professor Mark Cormack, as were numerous members of the health sector, academics, and public, all commemorating Medicare: A Forty-Year Health Check.
 
Exactly four decades ago on 1 February 1984, the Medicare scheme was introduced in Australia – a groundbreaking new idea designed to give more people access to affordable healthcare.
 
But in her speech to the health heavyweights, Dr Higgins said Medicare is now in need of a health check of its own, with much of it outdated and no longer serving GPs to its highest potential.
 
She said Medicare, and GPs, have suffered through a decade of ‘cuts and neglect’ which have left general practice ‘held back by red tape and regulation’, and this must change.
 
‘Australia’s health funding has shifted far from where it should be,’ Dr Higgins said.
 
‘Rather than helping people stay healthy, most of the funding goes to hospitals and emergency care – just 2% goes to preventive care.
 
‘The gap has grown too wide, Medicare first covered 85% of the costs of care, but today rebates don’t even come close to covering the full cost of providing care across Australia.’
 
Last year, the Federal Government took a welcome first step in strengthening Medicare when it tripled bulk-billing incentives in the Budget.
 
New data, published on Thursday to coincide with Medicare’s anniversary, suggests the investment is already making a difference, with the figures revealing a 2.1 percentage point increase in bulk billing nationally since the incentives went live in November.
 
In Tasmania, this increased to 5.7%, while in regional Queensland, fully subsidised general practice care has increased by 4%.
 
Since the November increase, Australians had an estimated 360,000 additional trips to the GP bulk billed, 56% of which were in rural and regional areas.
 
Dr Higgins said this long-awaited Budget boost was a gamechanger, but there is still much more work to be done if general practice is truly sustainable.
 
‘We knew it was just the first step, a downpayment,’ she said.
 
‘There is a long way to go to repair the decades of underfunding of Medicare and general practice, and more needs to be done to ensure care is affordable for all Australians.
 
‘We need to get it right, for all the Australians waiting too long for ambulances and in emergency departments, for things that should have been dealt with by a GP.’


Federal Health and Aged Care Minister Mark Butler speaking at the Medicare: A Forty-Year Health Check event.

Minister Butler said while Australia is now entering a new era of strengthened Medicare, it had previously been left in a ‘parlous condition’.
 
‘The era of calculated neglect of our great universal health system is now over,’ he said.
 
‘The complex nature of modern healthcare means it must involve a myriad of smaller improvements that are potentially life-changing and lifesaving for many people, delivering care faster and more efficiently.
 
‘A faster service, with less bureaucracy, delivering care more efficiently, freeing up resources to be spent on things like illness prevention.’
 
But while Dr Higgins is in favour of reduced red tape, she stressed that GPs must remain at the centre of the healthcare system, likening them to a conductor guiding an orchestra.
 
She also lamented the ongoing lack of understanding within general society about what GPs do and their role in the healthcare system.
 
‘We provide holistic patient-centred care from birth to death and know when to bring in the other specialists or allied health professionals to play their parts,’ Dr Higgins said.
 
‘Patients often need to pay a lot more and wait a lot longer to see other specialists for things GPs can do. And it costs the Government more.
 
‘Our hospitals and emergency departments are overflowing, because too many people can’t get the care they need. So, what’s the solution? General practice.’
 
Her calls come as the Scope of Practice review begins to take shape, aimed at ensuring all medical professionals are working to their full potential.
 
And Dr Higgins says GPs are capable of much more.
 
Every year, almost nine in 10 Australians visit a GP, and less than 1% of people said they were unable to see a GP when they needed to, according to the RACGP’s latest Health of the Nation report.
 
Dr Higgins said general practice has the evidence and the systems in place to create change, but national health reforms need to shift health funding, so it remains affordable and accessible for all.
 
‘The gap between patients’ Medicare rebates and the full costs of patient care needs to be reduced. We need to get the funding mix right – fee-for-service, block funding and incentives,’ she said.
 
‘This is vital to ensure vulnerable people, including those who can’t get a healthcare card, can still access care and the practices that serve them stay viable.
 
‘Our health system needs to support the role of GPs, working with other health professionals for our patients – giving the right care, at the right time.
 
‘We need a system where GPs aren’t bogged down in red tape and can spend the time they need with patients.’
 
Looking to the future, Minister Butler spruiked the Government’s commitment to return Medicare to its ‘rightful place’, saying it can once again be one of the world’s most envied public health systems.
 
‘As well as the $6.1 billion we have injected to strengthen Medicare and save bulk billing, we have reformed the Pharmaceutical Benefits Scheme, cutting the maximum co-payment, reducing the PBS safety net threshold, and delivering 60-day prescriptions,’ he said.
 
‘As we celebrate the 40-year anniversary of Medicare, a nation-shaping reform, we must always remember that universal healthcare is not now, and never has been, a given in this country. It has been fought for.
 
‘Medicare and its beating heart, bulk billing, are here to stay.’
 
In conclusion, Dr Higgins said Government must work to improve access to care for all Australians urgently, because too many people are missing out.
 
‘We need to get this right for the health of our children and generations to come,’ she said.
 
‘We must remember that the health of our country depends on general practice. It needs to be able to thrive in every community.
 
‘Australia prides itself in equality – everyone needs access to affordable care, so they can live healthier, and reach their potential.’
 
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bulk billing general practice reform Mark Butler Medicare strengthening Medicare