NSW Premier Dominic Perrottet will push the federal government to overhaul Medicare, arguing the system is broken and more free GPs are urgently needed to stop patients clogging emergency departments.
Perrottet and Victorian Premier Daniel Andrews will unite to pressure the Albanese government to improve access to GPs and want it to be national cabinet’s top priority when it meets on February 1.
NSW Premier Dominic Perrottet and Victorian Premier Daniel Andrews will unite to pressure the Albanese government to fix general practice.Credit: Rhett Wyman
A new report from a federal taskforce on Medicare reform will be finalised this month and Labor has promised to use the $750 million Strengthening Medicare Fund to enact its recommendations.
Perrottet is also working on a proposal with Andrews to take to national cabinet which is likely to include changing the Medicare schedule rebates that have failed to keep up with inflation. This would ensure GPs are paid more, rather than passing off extra costs to patients.
“We need more bulk-billing doctors across NSW to treat patients for free and stop unnecessary emergency department visits clogging up our hospitals,” Perrottet told the Herald. “We are seeing so many presentations into our hospitals that could be treated by a GP.”
The Commonwealth established the Strengthening Medicare Taskforce in July. It met for the sixth and final time before Christmas and has been examining ways to increase access to GP clinics, allow doctors to better manage chronically ill patients with nurses and physiotherapists, link primary care to hospitals and increase digitisation.
Andrews said the solutions to Australia’s broken primary care system were clear.
“We urgently need to pay GPs more, increase university places to get a pipeline of new doctors across the nation, attract GPs from overseas to Australia faster – and break down the barriers between primary care and our hospital system,” Andrews said in a statement.
“Medicare should be fast, free and local. We’ve done enough talking about its issues – now it’s time for the Commonwealth to prioritise taking action and reform our primary care system.”
The intervention by the premiers follows a series of reports by the Herald late last year which examined how billing fraud, waste and errors have heaped extra pressure on the sustainability of the already-strained Medicare system.
Perrottet also said the Commonwealth needed to provide more free GP services, attract doctors from Australia and from overseas, and integrate the GP system with state hospitals.
“NSW is stepping up and partnering with Victoria to deliver 25 urgent care clinics that provide services to patients which reduce pressure on emergency departments,” he said. “We have also acted by providing greater access to medications and vaccines through local pharmacists and have a policy to get people out of hospital wards faster.”
Perrottet stressed he was not picking a fight with the Commonwealth government on money, but “this is about working together to provide better health services”.
“We have a once-in-a-generation opportunity for the Commonwealth, and the states to work together to make our health system better across the entire country,” he said.
The Australian Medical Association and Royal Australian College of General Practitioners support similar policies to those detailed by the premiers, but both organisations said billions in extra funds would probably be needed.
Leading healthcare academic Stephen Duckett, a member of the taskforce, said the estimated long-term cost of improving primary care would be more than the $250 million budgeted over three years.
He predicted the government would not enact all the desired changes in one go.
“It’s going to be ongoing, it’s a really complex issue and there’s not a single solution, there’s many,” he said. “You’ve got to be careful of not putting in money that doesn’t go to improvements to services for consumers.”
The government estimates about two-thirds of patients are treated by bulk-billing doctors, many of whom say government rebates are not high enough to cover the cost of running a business.
Royal Australian College of General Practitioners president Dr Nicole Higgins, also a taskforce participant, said $2 billion per annum had effectively been stripped out of Medicare as a result of rebate freezes and insufficient indexation. This should be reinstated, she said, and funding should be diverted from hospitals to primary health.
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