‘We need to protect our GPs’: MPs go in to bat for general practice

Two medical professionals-turned-politicians have kept the issue of the health of general practice firmly on the radar of policymakers in Parliament House this week.
 
Professor Monique Ryan, the paediatric neurologist elected as the Federal member for Kooyong in May, and Dr Sophie Scamps, a former GP now representing Mackellar in NSW, both focused on general practice challenges in the House of Representatives on Monday (28 November).

It comes after a concerted advocacy campaign this month in Canberra by the RACGP, with college representatives meeting with more than a third of Parliamentarians.
 
Professor Ryan spoke during a second reading of the Health Legislation Amendment (Medicare Compliance and Other Measures) Bill 2022, which is designed to expand the power of the Professional Services Review (PSR) to include corporates within its scope.
 
While she commended the Bill, Professor Ryan made a strong plea for deeper healthcare reform, saying the legislation – which was introduced to Parliament last year under the Coalition – is a ‘tinker at the edges’.
 
Professor Ryan used the platform to give her thoughts on what she labelled the ‘systemic malaise of our healthcare system’.
 
While noting the importance of Medicare in Australia, she also described its complexity and said the fear of audits creates ‘a significant conflict between the administrative obligations that GPs need to adhere to, as set out by this legislation, and their commitment to patient care’.
 
According to Professor Ryan, GPs are the ‘foundation’ of the healthcare system – and she noted the diminishing popularity of general practice among medical graduates.

 

 ‘Decades of significant underfunding and cost cutting have left our general practices on the verge of collapse,’ she told Parliament.
 
‘Almost half of our practising GPs have indicated that it is no longer financially sustainable for them to continue working in general practice.’
 
She also raised the impact of last month’s controversial and widely contested coverage of alleged Medicare rorting in Nine Newspapers and on ABC’s 7.30 program.
 
‘We need to stop accusing overworked, often underpaid professionals of widespread systemic abuse of the Medicare system,’ she said.

‘In fact, instances of proven Medicare fraud are minuscule.
 
‘The most recent report of the Professional Services Review itself found fewer than a hundred instances of proven inappropriate practice in 2020–21.
 
‘The sum total of these ill-gotten gains, all of which was recovered, was $24 million – a far cry from the fanciful $8 billion claimed by a gotcha media culture concerned less with the truth than with a cheap, demeaning headline.’
 
She also drew attention to widespread under-billing and non-billable activities – an area not addressed in either the 7.30 reports or in the Nine Newspapers articles.
 
‘GPs, especially female GPs, spend as much as 14% of their time on non-billable activities,’ she said.
 
Given the media portrayal, Professor Ryan said it is unsurprising many GPs found the coverage ‘soul-destroying, disappointing and insulting’.
 
She went on to argue for far reaching changes, including the need for collaboration between the Federal Government and states and territories for primary care improvements.
 
‘There seems to be no appetite or vision from this or other governments for what we need, which is large-scale generational reform of our healthcare system,’ she said.
 
‘We need to prevent healthcare from being just another political football between the Federal Government and state jurisdictions.
 
‘We need to protect our GPs. We need to treat them with respect, not suspicion. We need Medicare – that wonderful universal scheme – to be better, smarter, more generous and more suited to the 21st century.
 
‘We need to stop tinkering around the edges. We need a better and clearer vision of what we can achieve together.’
 
Later in the day’s proceedings, Dr Scamps returned to a similar theme during a further reading of the Higher Education Support Amendment.
 
Speaking about the new legislation, which will either waive or partially waive HELP debts for doctors and nurse practitioners who work in rural areas of particular need, Dr Scamps made a plea for more substantial reform.
 
‘I know first-hand the pressures GPs across the country, including in my electorate, are under,’ she said.
 
‘Very few [general] practices in my electorate offer comprehensive bulk billing to all their patients.’
 
Dr Scamps also said many have been advertising vacancies for months, which they are unable to fill.
 
‘This Parliament is on notice that we are facing a breakdown of Australia’s primary healthcare system.
 
‘It is now an emergency and in need of intensive care.
 
‘Despite welcoming this measure, I must acknowledge that this is the equivalent to placing a band-aid on a gaping arterial wound.’
 
Dr Scamps also referenced her role as co-Chair of the Parliamentary Friends of General Practice, a new group initiated by the RACGP with the goal of finding bipartisan solutions for the issues facing GPs.
 
She finished her speech by calling for the Government to prioritise reform and introduce ‘at minimum’ a substantial increase to Medicare rebates for general practice, as recommended by the Community Affairs References Committee earlier this year.
 
The two speeches on Monday follow a sharp focus on primary care last week, with Federal Health and Aged Care Minister Mark Butler referencing what he called the ‘worst crisis in general practice in the almost 40-year history of Medicare’ during Parliamentary Question Time.
 
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general practice Monique Ryan Parliament Sophie Scamps