Medicare a ‘mere shadow’ of what it could be: Daniel Andrews

The comments come as declining bulk billing rates leave practices with no choice but to charge higher fees to supplement Medicare rebates.

Australia’s primary health care system is “broken” according to Victorian premier Daniel Andrews - and he says he has plans to fix it.

Ahead of national cabinet on Friday, Mr Andrews has said his priority will be reform of the primary care system by bridging gaps in pay between hospital doctor and general practitioners, getting more international doctors working in hospitals, and working with the federal government to fund more places in university.

A plan will be considered when national cabinet looks a report by the Strengthening Medicare Taskforce.

“I look forward to being briefed on what’s coming out of the Medicare Taskforce,” Mr Andrews said.

The need for urgent reform is due to declining bulk billing rates, which have plummeted by seven per cent in the past year and are continuing to fall.

General practice surgeries have been left with no choice but to charge higher fees to supplement Medicare rebates.

The Blue Report, from online healthcare directory Cleanbill, revealed only 39 per cent of Greater Melbourne general practitioners clinics bulk bill – meaning they do not charge any fees above the Medicare rebate to all patients.

“Medicare is not what it is designed to be; it is a mere shadow of what it was supposed to be,” Mr Andrews said, adding that necessary changes to the system were “profound” but “simple”.

“We have to pay out GPs more, we have to recognise that we are not rewarding them properly,” he said.

“Secondly, we have to train more GPs and that means more fully funded university places and we will play our part … because we want to see more and more doctors in university and then on the wards and then ultimately we want more in general practice.

“And we made some commitments about bridging that pay gap between what a hospital doctor gets paid and what a GP gets paid. We also promised to pay the exam fees for those people wanting to be admitted into the College of General Practice.”

Mr Andrews said Australia needs a “national approach” to attract more GPs from other parts of the world.

“We know international medical graduates are a really important part of our healthcare system,” he said.

The average out-of-pocket fee for a standard GP appointment in Melbourne is more than $40, though in Port Melbourne this figure has climbed to more than $60.

Mr Andrews said this was leaving people clogging up emergency departments or with the choice to either pay their bills or receive the care they need.

“If you don’t get the primary care that you need, there is only one other place to go that’s free,” he said, referring to emergency departments.

“Those people are simply using the only option that is available to them and that puts stress on our system.”

Mr Andrews said the federal government was paying the price for Medicare’s failure.

“If you finish up in hospital because primary care doesn’t work it costs more,” he said.

“If people don’t get the right care, at the right time, in the right place it costs, in every sense of the word.”

“So for every reason we need to make Medicare work.”

He also said the state government was essentially “doing some of the federal government’s work for them” by establishing the primary care clinics throughout Victoria.

“No federal health minister or federal government should be pleased to see the two biggest states in the country invest hundreds of millions of dollars to open up state run bulk billing clinics,” he said.

“That is in many respects a defining feature of failure.”