Latest / 360 with Katie Woolf / Palmerston GP Super Clinic CEO Robyn Cahill expects kids, concession card holders and seniors will likely be bulk billed again at the doctors following a $3 billion injection into Medicare

Transcript

Palmerston GP Super Clinic CEO Robyn Cahill expects kids, concession card holders and seniors will likely be bulk billed again at the doctors following a $3 billion injection into Medicare · 360 with Katie Woolf

• 0:00
  Speaker 1: So we know that primary health was a big winner
• 0:02
  Speaker 1: in the federal budget with a raft of measures announced
• 0:04
  Speaker 1: to make it easier and cheaper to see a doctor. Well,
• 0:08
  Speaker 1: that's certainly the aim and the hope. The bulk billing
• 0:10
  Speaker 1: incentive has been tripled for GPS with three billion dollars
• 0:15
  Speaker 1: injected into Medicare. The Palmerston GP Superclinic, Robin Karl, she
• 0:20
  Speaker 1: is going to join us in just a moment's time
• 0:23
  Speaker 1: to tell us how this break well, you know how
• 0:27
  Speaker 1: this change, i should say, is going to make a difference,
• 0:30
  Speaker 1: and joining me on the line right now. It is
• 0:32
  Speaker 1: the Palmeston GP Superclinics CEO, Robin Carl.
• 0:36
  Speaker 2: Good morning, Robin, Good morning Katie.
• 0:39
  Speaker 1: Robin. What was your reaction to the federal budget announcement.
• 0:44
  Speaker 2: Well, I think the first reaction was it's about time
• 0:47
  Speaker 2: there's been some increases to Medicare that were more realistic
• 0:51
  Speaker 2: and more reflective of the actual cost of delivering services.
• 0:55
  Speaker 2: So that initial announcement where the bulk billing benefits for
• 1:00
  Speaker 2: those people that Medicare really is intended to assist, so
• 1:05
  Speaker 2: kids and people on concession cards and low income earners,
• 1:09
  Speaker 2: that's fantastic. I think there's a few other things in
• 1:13
  Speaker 2: there that sound okay on the surface, but until we
• 1:15
  Speaker 2: see a little bit more detail, it's going to be
• 1:17
  Speaker 2: a little harder to know just what impact it's going
• 1:20
  Speaker 2: to have.
• 1:20
  Speaker 1: Yeah, right, So obviously the you know, the headline was
• 1:24
  Speaker 1: the fact that it's going to hopefully help a lot
• 1:28
  Speaker 1: of territories and a lot of assies when it comes
• 1:30
  Speaker 1: to bold billing due to the to the changes. But
• 1:33
  Speaker 1: what do you think that it actually will. Do you
• 1:36
  Speaker 1: think it's going to sort of pass down that far,
• 1:38
  Speaker 1: or how do you reckon it's going to work.
• 1:40
  Speaker 2: I think what we're going to see is those practice
• 1:43
  Speaker 2: that historically have been bulk billing young children, pensioners, healthcare cardholders,
• 1:50
  Speaker 2: and sea who have over the past couple of years
• 1:53
  Speaker 2: in particulars are increasingly difficult to be able to afford
• 1:56
  Speaker 2: to do. So that tripling of the bulk billing incentive
• 2:00
  Speaker 2: actually brings the amount of money that Medicare will support
• 2:05
  Speaker 2: much closer to the actual cost of delivering that service.
• 2:07
  Speaker 2: So I think particularly families with lots of young children.
• 2:11
  Speaker 2: So if you've got three kids and they're all sick,
• 2:13
  Speaker 2: and you take them to the doctor and you have
• 2:15
  Speaker 2: to pay out of pocket, it's going to get very expensive,
• 2:18
  Speaker 2: but it looks like now that benefit's going to be
• 2:21
  Speaker 2: much close to that sixty to seventy dollars range that
• 2:25
  Speaker 2: practices have been charging for those consultations. So if they're
• 2:29
  Speaker 2: able to move back to building those particular patients, that
• 2:33
  Speaker 2: will be very good for the community. Obviously, the biggest
• 2:37
  Speaker 2: issue is access. We still have a chronic shortage of
• 2:40
  Speaker 2: general practitioners across the country that most particularly in regional
• 2:45
  Speaker 2: or my areas. So even getting that incentive, if you
• 2:48
  Speaker 2: can't actually access the doctor, it's not going to be
• 2:51
  Speaker 2: particularly helpful.
• 2:52
  Speaker 1: Robin, where are we at from your perspective when it
• 2:54
  Speaker 1: comes to that GP shortage here in the Northern Territory.
• 3:00
  Speaker 2: I think we're still a long way from resolving the shortage.
• 3:03
  Speaker 2: I think that there have been some major changes in
• 3:06
  Speaker 2: the federal government's approach to classifying region and remote communities
• 3:10
  Speaker 2: over the past five to six years that have seen
• 3:14
  Speaker 2: much easier for those doctors historically that we've depended on.
• 3:17
  Speaker 2: So overseas medical graduates, for example, that come to Australia,
• 3:21
  Speaker 2: they've come on board knowing that they would have to
• 3:24
  Speaker 2: serve some time in regional areas, but they change what's
• 3:28
  Speaker 2: called the MMR, which is the remote classification to areas
• 3:32
  Speaker 2: on the East coast of Australia not that long ago.
• 3:35
  Speaker 2: So the MMR for somewhere like Liverpool, which is not
• 3:39
  Speaker 2: too far from Sydney, is exactly the same as if
• 3:42
  Speaker 2: you're in Palmerston. So if I'm someone with a young family,
• 3:46
  Speaker 2: just move to a country that I don't know, and
• 3:48
  Speaker 2: I have the choice between living a couple of hours
• 3:51
  Speaker 2: out of Sydney or a four and a half hour
• 3:53
  Speaker 2: flight from Sydney, I'm probably going to do the out
• 3:57
  Speaker 2: of Sydney option.
• 3:58
  Speaker 1: Seems crazy.
• 3:59
  Speaker 2: That makes it re call.
• 4:00
  Speaker 1: Yeah, it really does.
• 4:01
  Speaker 2: I couldn't wrap my head around that one, except maybe
• 4:04
  Speaker 2: there's a few more votes in it. Yeah, that political
• 4:08
  Speaker 2: party decided with that decision. That's a very good point. Yeah,
• 4:13
  Speaker 2: we really have to look out why our graduate doctors
• 4:17
  Speaker 2: aren't moving into general practice and why they're not interested
• 4:21
  Speaker 2: in moving into the remote and regional areas. We're very
• 4:25
  Speaker 2: un fortunate we have a great training program here in
• 4:28
  Speaker 2: the territory, but it's a long term investment and we're
• 4:30
  Speaker 2: only just in the last two three years starting to
• 4:33
  Speaker 2: see a return on that investment. For example, we've got
• 4:36
  Speaker 2: a couple of doctors who are working with US now,
• 4:38
  Speaker 2: one who fellowed last year, who was a medical student
• 4:41
  Speaker 2: with US, who did her GP training with US, and
• 4:44
  Speaker 2: the stayed on met US. So the system works, it
• 4:46
  Speaker 2: just takes time.
• 4:47
  Speaker 1: Yeah, Robin, you and I have spoken before about local
• 4:51
  Speaker 1: doctors moving away from bulk billing and slugging patients fees
• 4:54
  Speaker 1: because they could no longer sort of absorb those costs.
• 4:57
  Speaker 1: Do you think that the changes that were announced in
• 4:59
  Speaker 1: terms solve Medicare and with the bolt billing, that it
• 5:02
  Speaker 1: will see some of those revert back to bulk billing.
• 5:06
  Speaker 2: I think it will see them revert back to bolk
• 5:08
  Speaker 2: billing for those patients that bulk billing was designed to support,
• 5:13
  Speaker 2: so the kids, the pensioners, and healthcare cardholders, and certainly
• 5:17
  Speaker 2: our practice has always bolt willed those patients because that's
• 5:20
  Speaker 2: what bolt billing is designed to support, those people who
• 5:23
  Speaker 2: are on lower incomes or who perhaps are struggling a
• 5:27
  Speaker 2: little more with their health outcomes. So that makes that
• 5:30
  Speaker 2: far more affordable for practicing to do that. They've also
• 5:34
  Speaker 2: announced that there's going to be two increases to the
• 5:36
  Speaker 2: Medicare rebate throughout the next six months, which is also great.
• 5:40
  Speaker 2: We've got a lot of catching up to do in
• 5:43
  Speaker 2: terms of making the medicare rebate more in line with
• 5:47
  Speaker 2: the cost of delivering services, but any increase that we
• 5:50
  Speaker 2: can get will actually make it far more palatable for
• 5:53
  Speaker 2: practices who've had to move away from bolt billing everybody
• 5:57
  Speaker 2: or those critical groups simply be because it's just not
• 6:01
  Speaker 2: viable for them. It'll make it a little easier for
• 6:04
  Speaker 2: them to move back into, particularly focusing on those high
• 6:08
  Speaker 2: risk kind needs groups.
• 6:09
  Speaker 1: Yep. Now, Robin, I know a number of urgent care
• 6:12
  Speaker 1: clinics we're also announced federally. What can you tell us
• 6:14
  Speaker 1: about those and do you know who's going to be
• 6:17
  Speaker 1: able to access them or who's going to be operating
• 6:19
  Speaker 1: them at this point.
• 6:22
  Speaker 2: Well, I can't tell you a huge amount because it's
• 6:24
  Speaker 2: not a huge amount of information around and that's coming
• 6:27
  Speaker 2: from someone who has actively been involved in disgusting whether
• 6:31
  Speaker 2: or not we can actually open one of the USA
• 6:34
  Speaker 2: care clinics within our service. The intent of it is
• 6:37
  Speaker 2: that the government keeps using the word free. I think
• 6:39
  Speaker 2: it's really important. There is no such thing as a
• 6:41
  Speaker 2: free anything. When it comes to ELD. There's always a
• 6:44
  Speaker 2: cost attached, So we're really talking about services that are
• 6:48
  Speaker 2: able to accept as full payment the Medicare rebate. And
• 6:53
  Speaker 2: my best understanding of it is the intention needs that
• 6:57
  Speaker 2: it's for people who are it's a truly urgent requirement.
• 7:01
  Speaker 2: So it's not I felt stick last night. I need
• 7:03
  Speaker 2: a medical certificate today. I think I need a check
• 7:08
  Speaker 2: on my blood pressure, you know, because I'm overdue for
• 7:11
  Speaker 2: those sorts of things. It's really about my kid fell
• 7:14
  Speaker 2: off his bike. I need him to be seen really quickly.
• 7:16
  Speaker 2: Will we need an X ray? What will we need
• 7:18
  Speaker 2: to do. I've got a severe laceration. I need to
• 7:22
  Speaker 2: get that scene tore. Those sorts of things. I'm suffering
• 7:25
  Speaker 2: chest pain, I need to get an ECG. I need
• 7:28
  Speaker 2: to know what's wrong with me. That's my understanding of
• 7:31
  Speaker 2: what that's for, and the whole intent of it is
• 7:33
  Speaker 2: to reduce the pressure on the public hospital emergency departments.
• 7:38
  Speaker 2: Which if you've got an area where the additional services
• 7:42
  Speaker 2: are easily accessible, so for example, X ray services and
• 7:45
  Speaker 2: pathology services and they could all work together, then that's great.
• 7:49
  Speaker 2: But given the focus is on particular extended hours when
• 7:53
  Speaker 2: a lot of those services actually don't work, I'm not
• 7:56
  Speaker 2: entirely sure how government thinks it's going to reduce the
• 8:00
  Speaker 2: pressure on the hospital mansion to departments at the end
• 8:03
  Speaker 2: of the day, especially here in the territory. If you
• 8:06
  Speaker 2: want an X ray after ours, if you want pathology
• 8:09
  Speaker 2: tests done after ours, your only choice is to go
• 8:12
  Speaker 2: to the hospital. Yeah, so perhaps there'll be a little
• 8:16
  Speaker 2: bit of triaging. It may make the attendance of the
• 8:19
  Speaker 2: person at the hospital farm or streamlined, if all the
• 8:22
  Speaker 2: initial work has already be done, and when they arrive
• 8:25
  Speaker 2: at the hospital it's just because they need an X ray,
• 8:27
  Speaker 2: it's just because they need some blood's taken and a
• 8:30
  Speaker 2: pathology test done straight away. It's a little hard to
• 8:35
  Speaker 2: see how it's going to help. In the Northern Territory,
• 8:37
  Speaker 2: there's already some services that do provide urgent access to
• 8:41
  Speaker 2: care no matter what the time day is. So it's
• 8:45
  Speaker 2: great on the surface. It's when you dig into the detail,
• 8:48
  Speaker 2: it's a little hard to understand how it's going to
• 8:50
  Speaker 2: have the desired impact.
• 8:52
  Speaker 1: Sounds like there's quite a bit of detail still to
• 8:54
  Speaker 1: work through on those those urgent care clinics. So, oh, Carl,
• 8:59
  Speaker 1: it's all great to catch up with you. We really
• 9:01
  Speaker 1: appreciate your time this morning. Thanks so much for having
• 9:03
  Speaker 1: a chat with us and talking a little bit more
• 9:05
  Speaker 1: about those bulk billing incentives.
• 9:09
  Speaker 2: Yeah comment Katie, always your pleasure.
• 9:11
  Speaker 1: Thank you, We'll talk to you soon