AMA Transcript - Medicare

ELEANOR HALL: Staying with federal politics, the President of the Australian Medical Association says it's offensive for the Federal Health Minister, Sussan Ley, to warn about doctors rorting Medicare. Ms Ley released figures showing that doctors had to repay more than $4 million in the last financial year because of fraud. But, in a sign of a deteriorating relationship between the Health Minister and the doctor’s group, the AMA accuses her of politicising the report. Its President, Brian Owler, has been speaking to our political correspondent Louise Yaxley.

[Excerpt]

BRIAN OWLER: Politicising the Professional Services Review, which is a very important part of the compliance process, is an unprecedented action, but also something that I think makes people very weary of this Health Minister and her approach to general practitioners. We at the AMA have said to ministers for some time now that the chronic disease management items and the GP management plans need to be reviewed. We know that the rules around them are somewhat difficult, and we know that there have been cases of misuse. We know that there is going to be restructuring of those items, and that's something that we plan to support. There is no reason for the Minister for Health to come out trying to flex her muscles and suggest that the profession is rorting the system, and that she's taking action.

REPORTER: In practical terms, how do you address those grey areas in the Medicare Benefits Schedule?

BRIAN OWLER: Well, I think we need to tighten up, particularly the relationship between the GP and that patient. What galls many GPs that are out there every day seeing very complex patients is when their patient goes down the road to another practitioner who then signs them up for a GP management plan or some sort of chronic disease management plan. And we need to make sure that it's the regular GP that is the one that benefits from any GP management plan rebate that there might be. There are ways of tightening the rules up, making sure that it applies to, I think, a more specific number of chronic diseases, rather than it being more open as it is at the present time, and I think that's what we're likely to see out of the primary health care review in the near future.

REPORTER: But how do you stop a patient doctor shopping or going to a different doctor for some reason?

BRIAN OWLER: Some of the suggestions are around concepts like medical homes, where you have a system of voluntary registration with a GP or practice so that there is a tighter relationship between that GP, particularly for a patient that has chronic diseases that need to rely on their GP more heavily.

REPORTER: Do you have any concerns about the big bulk-billing clinics being the ones who are most active in these compliance issues?

BRIAN OWLER: Certainly, there are some of those clinics that do the wrong thing. But the majority of them actually operate well within the rules, and are actually an important part of our GP workforce as well. I think just suggesting that it's the big bad medical centres is not really consistent with what some of the other evidence that we've seen around patterns for billing. I think one of the issues that people need to understand is that part of the reason that medical centres and practices rely on GP management plans and chronic disease management items for revenue is because of the pathetically low Medicare rebate that this Government has frozen and continues to freeze, even now, up to a period of four years. That is one of the real problems that we have with general practice, and we need to address some of those issues, and they are in the hands of the Minister. She needs to address some of those issues before we start really pointing the finger at GP practices that are doing the right thing and operating in the rules.

REPORTER: Given these figures show that there were reprimands in 24 cases, two people were disqualified from accessing Medicare and 21 partially disqualified, how concerned should patients be about the potential for rorting?

BRIAN OWLER: We've got 100,000 doctors registered in this country, many of them, of course, are GPs, at least 30,000 or so working GPs. And so, when you look at those figures, it is a very, very small number of people that are doing the wrong thing. And I think what most people appreciate, particularly when they go and see their GP, is that GPs are incredibly hard working, have the best interests of their patients at heart, and I think they can have every confidence in their GP and their GP practice.

REPORTER: What does this say about the relationship between the medical profession and the Minister at the moment?

BRIAN OWLER: The Government tries to come out with this narrative about GPs doing the wrong thing. We've seen this from this Government before, and I think it's about time that this Government actually started to appreciate, particularly their general practitioners, and stop painting the profession as people doing the wrong thing so that they can just find more savings in the Budget. I mean, at the end of the day, if they're really interested in making general practice better, they would lift the Medicare freeze and they would actually start to invest properly in general practice, particularly around some of the chronic disease management.

[End of excerpt]

ELEANOR HALL: That's the AMA President, Brian Owler, speaking to political correspondent Louise Yaxley.

2 November 2015

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