Doctors group condemns Medicare review as an attack on GP integrity

The Australian Medical Association (AMA) has condemned suggestions that a review into Medicare would improve patients’ safety, saying the consultation is a “direct attack on the integrity of the medical profession”.

She rejected suggestions that the consultation process was a cost-cutting measure.

“It’s definitely not about winners and losers,” Ley told reporters on Sunday. “It’s about patient safety. It’s about building the best possible health system for the 21st century.”

Ley cited figures released by the chair of the review task force, Bruce Robinson, which found that 30% of expenditure on the MBS was for services or technologies that were out of date, unnecessary or harmful to patients. A wholesale review of the system has not taken place since it was introduced in the early 1980s.

The consultation “allows us to reinvest in new technologies, new services and new procedures,” Ley said, despite the terms of reference of the review saying that the addition of new services to the MBS was outside its remit.

The president of the AMA, Dr Brian Owler, said that doctors “cannot accept” the suggestion that they are using Medicare as a cash cow and, in the process, putting patients in harm’s way.

“This is a direct attack on the integrity of the medical profession. It is an approach that undermines the confidence that patients have in their doctors. It’s unacceptable,” Owler told reporters on Sunday.

The AMA had signed up for review of the remuneration paid to doctors for MBS services, Owler said. It had been hoped that the review would recoup some of the money lost in the budget when the government was forced to scrap its GP co-payment in December last year.

Ley has not yet had discussions on the direction of future health policy with the freshly-sworn in cabinet, and denies that the new treasurer, Scott Morrison, has asked her to find savings in the $70bn health portfolio.

Owler said the review announced on Sunday aimed to take a scalpel to services provided under Medicare.

“It’s clearly a cost-cutting exercise. It’s about removing services for patients,” Owler said.

Ley admitted that there were savings to be found from the review.

“Yes it is about harvesting efficiencies, and we know that there are large inefficiencies in the system already,” the health minister said, adding that cost-saving was not the main point of the exercise.

Labor’s health spokeswoman, Catherine King, acknowledged that there was scope to undertake a review of certain procedures, but said that the wholesale nature of this consultation raised questions about its main goal.

“It is clear that this MBS review is only an excuse to find further savings in health,” King told reporters on Sunday. “[The government] can’t be trusted when it comes to Medicare.”

Earlier in the day, the opposition leader, Bill Shorten, tweeted his criticism of the review.

 

King said that Labor had undertaken reviews of Medicare services “quietly” when it was in power, and that the government needed to engage with the medical profession in the consultation process.

The review is being led by Robinson, the dean of Sydney University’s medical school, and calls for input by doctors and specialists. The taskforce has met with several doctors’ groups including the AMA already.

Early intervention tonsillectomies for children, high density bone scans for seniors and tests on lower back pain are just a few of the services that could be in danger when the taskforce reports back at the end of the year.

The chief executive of the Consumers Health Forum, Leanne Wells, welcomed the review.

“We know there are tens if not hundreds of items on the schedule that need revising. We can stop wasting money on items that are not effective and that money can be reinvested into new items. This should ensure Australians in the future have access to the best treatment options that are available,” she said.

Owler said the health minister was “pre-empting” the outcome of the review by highlighting procedures she thought were unnecessary, effectively “politicising” the process.

The relationship between the AMA and the Coalition soured shortly after the government introduced a $7 GP co-payment in the 2014 budget.

The group waged a strong campaign against the co-payment which, paired with opposition from voters and the Senate crossbench, lead to the government dropping the payment in December of that year.

It was replaced with a plan to give doctors $5 less in rebates, leaving it up to them as to whether they passed on charges to their patients.

A subsequent plan, to cut short visits to the GP by $20, was also scrapped in January after it faced fierce backlash.

Ley, who came into the health portfolio in December, promised to consult more with doctors and patients before formulating policy.