Rebate increases ‘not off the table’: Health Minister

Matt Woodley

6/02/2023 4:58:46 PM

Payments and ‘flexible funding’ for practices to employ more nurses and allied health professionals are also being considered.

Federal Health and Aged Care Minister Mark Butler
Federal Health and Aged Care Minister Mark Butler has not ruled out increasing patient rebates.

Federal Health and Aged Care Minister Mark Butler has not ruled out increasing patient rebates, despite extra funding not being mentioned in the recently released Strengthening Medicare Taskforce report.

Speaking on Sky News over the weekend, Minister Butler described general practice as the ‘backbone’ of the healthcare system and said National Cabinet understands there is a need to make the specialty ‘much more attractive’ to young doctors and medical graduates

‘It’s not too long ago that about 50% of all medical graduates chose general practice as their career,’ he said. 

‘If we think it’s hard to find a GP now, and it is harder than ever before, in five or 10 years, if we haven’t turned that figure around, it’s going to be even harder. 

‘I think the premiers and chief ministers recognised that last week. They’re seeing the pressure on their hospital systems because of the problems in general practice. 

‘If we don’t turn that around then the whole of our healthcare system is going to be under enormous pressure.’

He also said state and territory leaders now appear to be much more invested in the future of primary care than they have been in the past.

‘The key change over the last year or two … is that state premiers and chief ministers now recognise they have skin in the game of a primary care system that’s operating effectively because they know when it’s not operating effectively, as it isn’t right now, the consequences end up in the hospital emergency departments,’ Minister Butler said.

‘Health ministers are desperately keen to be a part of this discussion. It’s not like the old days where they ran the hospital system and we ran primary care through Medicare, aged care and the like. 

‘They recognised and we recognise we’ve got to work together.’

However, while higher rebates have consistently been identified by GPs as the most effective way of easing pressure on the system, Minister Butler believes that funding increases alone will not be enough to make a difference.

‘Affordability was a major pressure that we discussed at the Taskforce, but I’ve also said you can’t just put more money into the existing systems … there’s got to be reform,’ he said.

‘The existing systems do not reflect the needs of Australians today.

‘Yes, there’s got to be more money ... but it won’t be delivered on existing systems designed in the 1980s. What the report that we released last week shows is the need to change the way in which the system operates to take account of the care needs of modern Australia.’

Instead, Minister Butler said ‘the most significant demand’ emerging from the Taskforce is the need to provide more support to general practice and ‘other primary care services’ to have a range of healthcare professionals operating in their practice.

‘There’s already some of that now, but I think a key message from healthcare professionals was they’re not adequate,’ he said. 

‘So, workforce payments that enable a practice to employ practice nurses [and] allied health professionals, and the consideration of some more flexible funding arrangements that really allow those primary healthcare teams to focus on the ongoing often chronic and complex needs of a very different patient group that we have in the country.’

RACGP President Dr Nicole Higgins has cautiously welcomed investment in more multidisciplinary care, provided that it reinforces the role of GPs as the custodians of patient care.

‘If the current model is broken and GPs – the specialists in coordinating complex care, with well over 10 years of training in diagnostics, treatment, and quality care – are no longer at the centre of care management, patient care will be compromised,’ she said. 

‘We need GPs working hand in glove with allied health professionals, pharmacists, and practice nurses, and they should be supported within general practice, with GPs as the stewards of patient care.’

She has also said urgent funding increases are needed now to ‘stem the bleeding’.

‘Funding has been ripped from general practice patients for decades – the Medicare freeze cost $2 billion and counting – and so now we’re seeing the decline of bulk billing, people across the country are struggling to get in to see their GP, and they’re being turned away from overloaded hospitals,’ she said.
‘It’s [also] a time when spiralling inflation and cost of living pressures are forcing some people to make the impossible choice between spending on healthcare and other essentials.
‘Without urgent action to stem the bleeding and improve access to care for Australians, inequality, and the gap between rich and poor will get much worse.’

The Health Ministers subcommittee of National Cabinet is due to meet in the coming fortnight, before National Cabinet reconvenes in late April.

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