Election done and dusted: Now is the time for real reform

Dr Danielle McMullen
AMA President

The major parties showed a real commitment to investing in the nation’s health system, particularly with historic funding announced for primary care.

We welcomed this focus — the quantum of funding that has been committed is what we need — but sadly, a significant proportion of this money could have been better directed.

This election represented a missed opportunity for significant, structural reforms to the health system.

But now it’s time to look ahead. As the dust settles, we can get on with the job of pushing for meaningful reform in general practice, public hospitals, private health and more.

General practice and Medicare
The $8.5 billion for Medicare announced before the election was called, supported by the Coalition and locked into the budget, set the tone for the rest of the campaign.

While this funding is welcome and will help some patients and practices, we will continue to highlight through our Modernise Medicare campaign the need to rethink and redesign our out-of-date Medicare rebate structure.

Australia needs a new seven-tier GP consultation item structure designed to meet the challenges of an ageing population and the growing burden of complex and chronic disease.

Throughout the campaign, Prime Minister Anthony Albanese consistently said 90 per cent of all GP visits will be bulk billed by 2030 under his policy to extend triple incentives to all patients.

While modelling in the years leading up to 2030 is not available, this 90 per cent figure will be the figure that this policy will be squarely judged on. We will do our level best to ensure the government is held to account in improving affordable access to high quality GP services,  while still pushing hard for the broader reforms we need to improve Medicare.

Workforce
Some big wins came our way on workforce. Following years of AMA advocacy, both Labor and the Coalition made commitments to increase our GP workforce. Labor locked in funding in the budget to grow Australia’s specialist GP training places together with funding for additional training rotations in general practice for prevocational doctors, and to improve employment conditions for GP registrars, including the important addition of paid parental and study leave.

Looking forward, we will continue to be vocal about the need for an independent national health workforce planning agency to guide new policies and provide a clearer picture about the state of our workforce, including in regional, rural and remote areas. It is crucial to ensure the medical workforce is distributed where it’s needed most — but this has been a huge blind spot since Health Workforce Australia was abolished in 2014.

Public hospitals
As we highlighted several times during the campaign, our public hospitals continue to be logjammed and our recent report found there is no end in sight to ambulance ramping.

There were some commitments to hospital funding made during the campaign, and indeed in the months before. But were know there is an urgent need to lock in a new National Health Reform Agreement. Without a new funding deal, these top-up funding commitments are little more than a nice idea.

We will be taking this government to task to ensure they expedite a new agreement for the sake of our patients, who are suffering, and our dedicated public hospital doctors.

Private health
The issue of private health sustainability was absent in this year’s federal election campaign. We know the system is demonstrating unprecedented vulnerability — just look at the recent closures of maternity wards and other private hospital services around the country.

This is proving to be one of Australia’s big sleeper issues, and if governments don’t act quickly, there will be devastating consequences for patients (even more so than there already are). We will engage with this government and continue to champion our proposal of a new independent authority that can create a platform for all the key players in the sector to create once-in-a-generation reforms. We will also be calling for a mandated minimum payout by insurers of 90 per cent as a proportion of their premiums to encourage greater uptake of private health insurance.

Our Vice President A/Prof Julian Rait, a specialist ophthalmologist, sits on the Private Health CEO Forum created by Labor and will continue our strong representations on this platform.

Public health
We gained significant traction in the media for all our policy proposals throughout the course of the federal election campaign. And one of those was our proposal for a tax on sugar-sweetened beverages. This is a common-sense policy — backed by evidence and proven success around the world — that can address Australia’s obsession with sugar.

Sadly, no party committed to a sugar tax during the campaign, despite the clear need to help tackle Australia’s rising rates of chronic disease, and the clear opportunity to raise much needed funding, which could be used for preventive health activities. 

Political analysts will continue dissecting this year’s election result. For us, our mission remains the same. Our commitment to advocating for doctors, patients and the health system is unwavering. We will continue to work tirelessly across the political divide, ensuring that the voices of medical professionals are heard and that meaningful reforms are achieved.