Absolutely nothing in Medicare report for immediate relief of hospital logjams and limited accessibility to GPs

On Friday, the Albanese Government released the report of the Strengthening Medicare Taskforce which sets out a recommended pathway for significant reforms to strengthen Medicare and rebuild general practice.

After nine years of cuts and neglect by the former Government, primary care is in the worst shape it has been in 40 years – bulk billing rates are in decline, the average gap fee for a standard GP consult is now more than the Medicare rebate itself, and only 14% of medical graduates now choose to work in general practice, dropping from 50%.

Professor Steve Robson, Federal President of the Australian Medical Association (AMA), said “There is absolutely nothing in the report that will allow Australians who are struggling to see a GP or struggling to afford to see a GP, see that GP any more quickly, any more affordably, and Australians who are waiting for operations and surgery to relieve pain to have these procedures any more quickly. So, while the report is very welcome and certainly has changes that will strengthen the system that we know, there is absolutely nothing in the report at the moment that will provide anything immediate, and that is what we need.”

He added “We were hearing talk from all of the premiers, chief ministers, and the Health Minister that health is the highest priority for the Government at the moment and Australians can see the crisis the health system is in. We were surprised to see nothing more come out of it. We had the most powerful political leaders in the country, all in one room. Doesn’t seem they could agree on anything.”

Australians delaying essential healthcare and medicines due to cost

To manage the health of an older population with more complex and chronic disease, the report recommends new blended funding models – integrated with the existing fee-for-service model – allowing teams of GPs, nurses, midwives, and allied health professionals to work together to deliver the care people need.

Mark Butler MP, Minister for Health and Aged Care, encouraged an end to the turf wars between different health professional groups. He said “This is a sector that has a lot of loud voices and sharp elbows. Everyone – the doctors’ groups, the nurses, the allied health groups and others, but most importantly the patient representatives – know that they need to bust down these silos and have all of their healthcare professionals working together genuinely as a team. Anyone with a bit of analysis of where demand and supply is in the healthcare system understands we can’t continue to have people who have been trained at vast taxpayer expense operating below their scope of practice.”

Recognising the unique challenges in rural and remote Australia, the report calls for a greater role for Primary Health Networks (PHN), including to commission nursing and allied health services to bolster general practice teams in these areas. The Taskforce also found that Strengthening Medicare requires the modernisation of digital systems and significant improvements in the way patients’ information is accessed and shared across the health system.

Professor Robson called out the gap in immediate impact for many Australians. He said “$250 million a year over three years is a very good starting point. There’s no doubt. And there are initiatives that will improve the relationship between patient and general practitioner. And the report emphasises the fact that the GP is the linchpin of the healthcare in the country. But all of the reforms the Minister himself has said, these are going to take a long time, potentially years to implement, and none with any immediate impact on making healthcare affordable and accessible tomorrow for Australians.”

Dr Tim Woodruff, President of Doctors Reform Society, said “We know that big changes take time to plan and implement. But tomorrow we could have increased funding for the care of pensioners and health care card holders simply by increasing the existing bulk billing incentive for that group. That would mean many of the most vulnerable would have some chance of getting care when they need it.”

The Royal Australian College of GPs (RACGP) cautiously welcomed many measures contained in the Strengthening Medicare Taskforce Report but warned that even greater reform is required to secure the future of general practice care.

Despite repeated RACGP calls for greater investment in general practice care, the report is silent on measures such as boosting Medicare rebates and increasing incentives for bulk-billing. The RACGP is encouraged that Minister Butler has not ruled out increases to Medicare rebates in Friday’s press conference following the release of the report.

Mark Butler MP, Minister for Health and Aged Care, said “I’m not ruling anything out [relating to Medicare rebates]. There was a very clear discussion in the Taskforce about affordability. What I have said is we can’t just add more money to existing systems, particularly where those systems aren’t performing against the range of indicators.”

RACGP President Dr Nicole Higgins said the report held many promising elements, but that more action was needed to secure the future viability of general practice care. She doubled down on calls for any reforms to reinforce the role of GPs as the stewards of patient care.

“The devil is in the detail here. If the current model is broken and GPs are no longer at the centre of care management, patient care will be compromised. 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.

“I’m also slightly concerned that the report identifies a ‘strengthened role for PHNs’ to drive organisational and cultural change. Again, general practice needs to be at the centre of any changes and if you ask many GPs, they will tell you that adding another layer of bureaucracy by further empowering and funding PHNs is not the best solution.

“Digital modernisation also holds great promise, and we are keen to work with government to make sure we get this right, including privacy and security concerns. As the report makes clear, it’s no use having vital patient health information locked away in different information systems and not shared easily – no one wins in that scenario.”

The government will confirm how the allocated funding of $750 million will be spent in the upcoming May Budget. However, Minister Butler was unable to confirm any additional funding to implement the recommendations from the report.

Minister Butler said “We will respond to this report in the Budget. We might not accept every single recommendation right now, but this is a really good set of recommendations that the ERC and the Cabinet can get their teeth into. We recognise the need to deliver on this Budget with funding flowing from the 1st of July. The report makes clear there are some things you could do very, very quickly – a longer consult is probably one example. There are other changes that are really, really quite substantial – blended funding models, for example – that are going to take time.”

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