What’s in the RACGP’s pre-Budget submission?

Matt Woodley

11/10/2022 4:50:32 PM

The college has again requested more support for longer consultations, while it is also urging for greater investment in rural health.

Graphic representing Medicare
The RACGP is calling for an increase of at least 10% to Medicare rebates for consults that last 20 minutes or more.

In about two weeks, Federal Treasurer Jim Chalmers will hand down the first Budget from the new Albanese Labor Government.
The Government has already committed to nearly $1 billion in new general practice funding – $750 million of which is tied to the new Strengthening Medicare Taskforce – but the RACGP is also pushing for more immediate support in a number of areas.
Specifically, the college’s 2022–23 pre-Budget submission is calling for: 

  • increased Medicare rebates for longer consultations
  • the creation of a new Medicare item for general practice consultations longer than 60 minutes
  • investment in rural and remote health via increased incentives that recognise the unique role of rural-based GPs and encourage GPs to work in rural communities
  • Medicare support for longer telehealth phone consultations lasting more than 20 minutes
  • new service incentive payments to better care for older people, those with mental health conditions and people with disability
  • additional support for patients to see their GP within seven days of an unplanned hospital admission or emergency department presentation.
Speaking in the wake of last week’s ‘crisis summit’, RACGP President Adjunct Professor Karen Price said the time for investment is now.
‘General practice is on life support and urgent action is needed,’ she said.
‘GPs and general practice teams are up against it. The pandemic has exposed cracks in our health system, including primary care, that need repairing so that patient care is not compromised.’
According to Professor Price, the college’s ‘number one priority’ is ensuring that GPs are able to take the time to talk to their patients.
‘Unfortunately, the current Medicare rebate structure discourages us from doing just that,’ she said.
‘We have the absurd situation where rebates decrease as a person spends more time with their GP – the exact opposite of what we should be aiming for.
‘Longer consults are particularly important for people with multiple, chronic health conditions and those with mental health concerns – and I can tell you that we are seeing patients with those sorts of health issues in spades.’
However, while Federal Health and Aged Care Minister Mark Butler has said addressing the general practice workforce shortage is his ‘highest priority’, Treasurer Chalmers – who previously described the Medicare freeze as a ‘back door’ GP tax – has warned spending in the Budget will likely be conservative.
Citing a ‘deteriorating global situation’, he told reporters the focus will be on addressing the cost of living, investing in skills and training, and unwinding ‘wasteful spending’.
‘It won’t be fancy, it won’t be flashy. It will be responsible. It will be solid,’ Treasurer Chalmers said.
‘It will put a premium on what’s responsible and affordable and sustainable, and it will be targeted to the economic conditions that we confront together in the here and now.’
But despite the economic headwinds, Professor Price believes there has ‘never been a more important time’ to invest in general practice.
‘The RACGP is calling for an increase of at least 10% to Medicare rebates for consults which last 20 minutes or more,’ she said.
‘In addition, we need a brand-new rebate for consultations lasting more than 60 minutes, so we can take the time to really get the bottom of what is going on.
‘This was a recommendation made by the MBS Review General Practice and Primary Care Clinical Committee in 2019 and endorsed by the previous Government’s MBS Review Taskforce in 2020, yet it’s still to be actioned or implemented.’
Professor Price also said introducing ‘service incentive payments’ would make a ‘real difference’ for many patients, particularly those who frequently see their GP.
‘[These payments] basically involve the grouping of services for certain patients so that they can have their complex health conditions carefully monitored and treated,’ she said.
‘This includes older people, patients with mental health issues and those living with disability. It will allow us to have more time to assess their health, figure out where improvements could made in their treatment and care and help establish a trusted, long-term relationship.
‘The Government must use this Budget to show Australians that they are prioritising their healthcare.
‘Time is of the essence, let’s get this done.’
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Harps   12/10/2022 12:13:22 PM

Personally I think we need to have a level A/item 3 that is mandated as 'under 5 minute consult' regardless of complexity.
Item 23 needs to be fro consultations of 5 to 15 mins duration, interpretation for nurse's 'for and on behalf of GP' to remain unchanged and included in this item number.
Item 36 to enumerate more and be for consultations of 15 to 30 mins
Item 44 to cover 30 to 45 min consults.
and new item numbers for 45 - 60min and over 60 min consultations.

Dr George Al-Horani   12/10/2022 1:19:25 PM

This is absolutely a joke , an increase in fees for consultation over 60 minutes !!!!??? You need to :

1. increase the fees for the standard consultation which should be ( 5-15 minutes ).
2. Increase fees for long consultation which is above 15 minutes .
3. Follow the AMA recommendation in rebate billing .
4. Have a health minister to be a Doctor who will understand directly the suffering of General practice , not learn through different advisors and channels.

Red tape is suffocating us , low income , high inflation and high running costs, unsupportive state & federal governments . Really we can’t do it anymore, we need to stand up for our rights , we need a strong representation ( not by an organization which calls itself non for profit organization paid by the government to operate ) .
We need our own funded organization to fight for our rights .
( practice owners & contractors doctors association) ASAP .

Rural GP   12/10/2022 3:21:12 PM

I agree with Harps. Surely strategic negotiations involve trading something different : soemthing they don't expect. The wording is strong but lets be honest: I cant see me much value in a consult that is over one hour: even in the most holistic environment, it not practical for anyone. I also think, any phone consult over 20 minutes has to be mental health related, and that should be funded separately. I am very frustrated with patients now expecting me to diagnose and manage complex problems over the phone. Its not safe or good medicine . Unfortunately it feels like bluster from the negotiators who have made token suggestions, that could only become appropriate for those offering psychologists services. Its the everyday rebates that need fixing, please.