Cancer doctors: Labor plan won’t cure system

Bill Shorten’s $2.3bn cancer treatment plan will fail to deliver on a key promise, doctors say.

Ben Brady, director of medical oncology and haematology, at Cabrini Hospital in Melbourne yesterday. Picture: Aaron Francis

Bill Shorten’s $2.3 billion cancer treatment plan will fail to deliver his promise of eliminating significant out-of-pocket costs for many private ­patients, with leading oncologists warning yesterday they could not guarantee they would bulk-bill their services.

The ALP’s cancer package — a key plank of the Opposition Leader’s election campaign unveiled in his budget-reply speech — was also labelled by a leading oncologist as “un-Australian” because it overlooked patients with other diseases such as heart disease, the top cause of death in Australia.

Another said free cancer treatment was “unachievable’’ in both the public and private systems.

Australians receive treatment in public hospitals free of charge under the National Health ­Reform Agreement, but just over 50 per cent of all cancer care is delivered through the private sector.

Private Cancer Physicians of Australia, a not-for-profit organisation, said it was blindsided by Mr Shorten’s $600 million proposal to eliminate all out-of-pocket costs for cancer diagnostic imaging and substantially increase bulk-billing consultations for patients seeing specialist oncologists and cancer surgeons.

“There’s certainly been no consultation with cancer doctors that we’re aware of,’’ said Ben Brady, the Victorian director of PCPA.

Labor’s policy has also opened the potential for new claims on health funding by pathologists, who argue they need more money to perform tests on Australians with cancer.

PCPA wants a meeting with Labor to discuss details of the plan as early as next week.

Dr Brady, the director of haematology and medical oncology at Cabrini Health in Melbourne, said the organisation rejected compulsory bulk-billing.

“I don’t think the PCPA and people like myself are willing to guarantee that (bulk-billing),” Dr Brady said.

“If they (Labor) would equal what I’m charging at the ­moment, in my case I’d say ‘fine’. But if it wasn’t indexed — Medicare rebates have been frozen since 2013 (and) we’ve still got to run our practices, we’ve got to remain ­viable — there’d be a split in the ­future.”

Labor has promised to invest $433m under its $2.3bn cancer package to introduce a Medicare item, with the rebate worth about $150, to cover the cost of a person with cancer seeing a specialist oncologist and surgeon.

PCPA president Christopher Steer said $150 was much less than the cost of an initial patient consultation and slightly more than regular reviews of patients.

“It’s a meaningless number at this point because we don’t know what it (the rebate) applies to or who’s able to charge it,” he said.

“As private cancer physicians we value our autonomy and ­independence. That includes ­independence to run our practice, to set our fees.”

The Parliamentary Budget ­Office estimates the bulk-billing rate for surgeons will increase from 36 per cent to 80 per cent under Labor’s policy and from 43 per cent to 85 per cent for oncologists.

A Labor spokeswoman said the opposition did not expect oncologists to guarantee they would bulk-bill and it had “of course” consulted with medical practitioners on the policy before it was announced. “Labor has designed the new item to address the most consistent cost interactions the majority of cancer patients have during the course of their treatment and that is with oncologists and surgeons,” she said.

“The existing MBS (Medicare Benefits Schedule) items will remain and oncologists who have billing rights for those items can continue to bill them.”

Dr Brady, Dr Steer and John Bashford, a clinical haematologist and medical oncologist at The Wesley Hospital in Brisbane, said surgeons and oncologists worked as part of much bigger cancer teams but it was unclear if Labor’s bulk-billing incentive would capture other specialists. “We don’t know where this proposal begins and ends,” Dr Bashford said. “Which members of the cancer team will be affected? If I ask one of my cardiology colleagues … are they going to be covered? How do you stop gaps completely?

“It’s far more complex than it’s being portrayed and the achieving of a completely no-gap product is a very difficult thing for anybody to say ‘we’re going to do this’. We all struggle to understand how that concept will work in practice.

“Our primary concern is to see what this means from the perspective of our patients. What would concern us is an expectation that suddenly all cancer care can be free. That’s unachievable in both the public and private sectors with the detail so far provided by Labor.”

Health Minister Greg Hunt declared Mr Shorten had been “caught out misleading the public with a phony guarantee”.

“His so-called bulk-billing guarantee for cancer care has been exposed as a hoax within four days,” Mr Hunt said. “He should immediately apologise to patients and their families.”

The Royal College of Pathologists of Australasia yesterday complained that both sides of politics were ignoring the cost pressures. “Whilst we welcome the intention to more adequately fund diagnostic imaging, oncology and surgery, it is important to note that none of these modalities actually diagnose cancer,” RCPA president Bruce Latham said.

The Royal Australian and New Zealand College of Radiologists, which had called for increased MRI access, welcomed Labor’s announcement. So too did the Australian Diagnostic Imaging Association, which had campaigned for the restoration of Medicare indexation but not specifically sought special cancer rebates for MRIs.

Visiting the Royal Brisbane and Women’s Hospital in Brisbane yesterday, Mr Shorten said Labor’s cancer plan, which he hailed as the single biggest investment in Medicare, was “the right thing to do”.

“The out-of-pocket costs of fighting cancer are too big,” he said. “This country is not doing enough to help patients in the fight of their life.”

Dr Brady said Labor’s plan to focus on cancer was “certainly ­opportunistic” and he was concerned about potential inequality it created among private patients.

“What about all the other diseases? … It’s kind of un-Australian I think,” he said.