By Natassia Chrysanthos
Prime Minister Anthony Albanese has promised $2.2 billion in the federal budget to launch the biggest overhaul of Medicare in its 40-year history while pledging to clamp down on spiralling costs in the National Disability Insurance Scheme.
Nurses and pharmacists will play a greater role in the health system while new funding streams for GPs starting from July signal a significant shift away from the traditional fee-for-service model that has driven how doctors are paid since the universal healthcare scheme began.
Prime Minister Anthony Albanese (centre), Queensland Premier Annastacia Palaszczuk and Victorian Premier Daniel Andrews during Friday’s national cabinet meeting.Credit: Dan Peled
By the end of the year, Australians will be able to register as ongoing patients with their GP through a new My Medicare patient enrolment system that will unlock additional funding packages tailored to their needs. Doctors will also be able to access a larger pot of money to employ nurses and allied health professionals in their clinics.
Health policy experts said the measures indicated strong first steps towards long-term reform that would transform the ailing health system if they were implemented in full and adequately funded in the budget on May 9.
State governments will keep pushing Albanese on Medicare reform while their hospital systems and emergency departments buckle under pressure caused by declining GP bulk-billing rates and rising out-of-pocket costs for primary care.
Albanese said state and territory leaders agreed health would be their “front and centre” concern for the rest of the year in a national cabinet meeting in Brisbane on Friday.
He said leaders also agreed to curb spending on the NDIS, now the government’s second-fastest-growing budget pressure, which had been projected to cost $97 billion in a decade. The scheme, forecast to grow by up to 14 per cent a year as thousands more people join, will now have an 8 per cent annual growth target by July 2026.
A government calculation suggests that would save $57 billion over the decade when compared with spending that would occur under business as usual.
“We know that the trajectory of NDIS expenditure is just not sustainable into the future,” Albanese said. “There are obvious issues with the way that the scheme is being administered.”
A further $720 million in the budget will be allocated to the National Disability Insurance Agency, which administers the NDIS, over four years to enable it to boost its capacity and workforce and improve the overall scheme.
The $2.2 billion health spend over four years – which includes a $750 million election promise to strengthen Medicare and some savings from pharmacy fees under new 60-day dispensing rules – will be clearer on May 9.
But it will involve boosted funds to enable GPs to open after hours as well as new investment in the digital My Health Record so that pathology and radiology results are easily shared and patients do not have to retell their history every time they see a new professional.
The Commonwealth will support placements for 6000 nursing students in primary care settings, while all pharmacists will be able to administer vaccines under the National Immunisation Program from next year, at a $19 charge to patients that will eliminate variations between states and territories.
The Pharmacy Guild – still reeling from the government’s decision to halve its dispensing fees for common medicines – did not comment on the new measure.
“If [Health Minister] Mark Butler is serious about rebuilding the health system then he should reverse the $3.5 billion he is cutting out of primary care and community pharmacies,” Victorian president Anthony Tassone said.
The most significant changes involve how GPs are funded, and focus on wraparound care at a primary care level to keep people out of hospital.
The voluntary My Medicare enrolment system, linking patients to their doctor, could give a GP practice annual payments, lump sums or other benefits when a person signs up for continued care.
The government will also increase and index the money it pays clinics to employ teams of health professionals – such as nurses, mental health practitioners and physiotherapists – who can help treat patients with chronic and complex conditions.
‘If undertakings on that list are seen through, we’re looking at the potential to go beyond refinement to true reform.’
Professor Adam Elshaug
Royal Australian College of General Practitioners president Nicole Higgins said she was particularly happy with the boosted funding for team-based care, which would enable clinics to scale up what they could do.
But she said the budget would determine how impactful that funding was, and whether there would be an increase in Medicare rebates or additional bulk-billing incentives for doctors, which the college has been calling for.
Professor Adam Elshaug, director of Melbourne University’s Centre for Health Policy who sat on the Strengthening Medicare taskforce, said Friday’s announcements could mark a significant turning point for Medicare.
“If undertakings on that list are seen through, we’re looking at the potential to go beyond refinement to true reform, which I think people should be excited about,” he said.
“The minister is explicitly stating he wants a more digitally connected health system. That alone is going to be major.”
Former Health Department secretary Stephen Duckett, also on the taskforce, said it was “a very good start” that signalled further changes to come. However, he said the dollar figures attached to the measures in next month’s budget would be critical.
Health economist Professor Lesley Russell said putting money down was the easy part.
“I think there’s a lot of hard work and politics ahead ... But this is a really good beginning,” she said.
“You start off slowly and then it builds. Part of the issue is going to be explaining what the new processes are, particularly to the people most likely to benefit, with chronic and complex conditions.”
Coalition health spokeswoman Anne Ruston said these were piecemeal measures and criticised the government for failing to release a workforce plan.
“The opposition supports sensible and considered measures to address the significant pressures currently facing our healthcare system, but we must be given the details,” she said.
Cut through the noise of federal politics with news, views and expert analysis from Jacqueline Maley. Subscribers can sign up to our weekly Inside Politics newsletter here.