Latest / 360 with Katie Woolf / RACGP's Rural Chair Dr Michael Clements explains why some Territorians are paying more at the doctors

Transcript

RACGP's Rural Chair Dr Michael Clements explains why some Territorians are paying more at the doctors · 360 with Katie Woolf

• 0:00
  Speaker 1: I do want to take you across well to a
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  Speaker 1: topic that was raised with you our listeners on the
• 0:04
  Speaker 1: tech line and also on the phone line. In recent
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  Speaker 1: days we had a number of listeners calling in and
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  Speaker 1: saying that all of a sudden they've been charged to
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  Speaker 1: see a doctor to give a bit of an update
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  Speaker 1: and well and let us know what.
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  Speaker 2: The situation is.
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  Speaker 1: But on the GPS in general is Michael Clements from
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  Speaker 1: the Royal Australian College of General Practitioners.
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  Speaker 2: Good morning to you, Michael, Good morning.
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  Speaker 3: How is it Dan?
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  Speaker 2: Yeah, really well, thank you so much for your time.
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  Speaker 1: Now, Michael, do you know why some patients have noticed
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  Speaker 1: billing changes at the doctors?
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  Speaker 3: Well, the short term answer is that the Medicare rebate
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  Speaker 3: having kept pace with the cost of business. So I'm
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  Speaker 3: a practice owner myself and I run a couple of practices.
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  Speaker 3: Year on year inflation goes up, we have pay more
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  Speaker 3: in rent, wetuff more and cost more to keep the
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  Speaker 3: lights turned on. But Medicare has been held back by
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  Speaker 3: successive government for the last fifteen years and is far.
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  Speaker 4: Below what it actually costs to provide a serve.
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  Speaker 3: So sadly, the federal governments decided that people need to
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  Speaker 3: start contributing themselves.
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  Speaker 2: Michael, why is that?
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  Speaker 4: You know?
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  Speaker 2: Why have that? Look, why hasn't.
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  Speaker 1: It gone up over fifteen years?
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  Speaker 3: Yeah, well, it seems that the governments have really decided
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  Speaker 3: to withdraw money from medicare by still.
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  Speaker 4: The clearest example is this year.
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  Speaker 3: When the Medicare rebate that a patient gets for seeing
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  Speaker 3: us was only increased by one point sixty six. But
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  Speaker 3: we all know the headline inflation to give this year
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  Speaker 3: as above six. And if Medicare rebates had just kept
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  Speaker 3: pace with inflation with no other increases other than inflation
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  Speaker 3: from when it was brought in, the current rebate would
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  Speaker 3: be double what they are now.
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  Speaker 1: All right, we've learned that some gps here in the territory,
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  Speaker 1: and I'm assuming across the nation as well, some of
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  Speaker 1: the big local practices have moved to mixed billing.
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  Speaker 2: What exactly does that mean?
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  Speaker 3: Yeah, well, remembering that as small businesses that most general
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  Speaker 3: practices are.
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  Speaker 4: If we've got a rebate.
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  Speaker 3: That's getting lower and lower year on year, we either
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  Speaker 3: have to increase the number of patients we see per
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  Speaker 3: hour and go from going to quicker medicine and try
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  Speaker 3: and get people in and out as quickly as possible.
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  Speaker 3: All we've got to ask them to contribute to the fee.
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  Speaker 3: So what's happening more and more now is practices are
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  Speaker 3: asking patients to reach into their pocket and actually contribute
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  Speaker 3: to that consultation. So if Medicare had been indexed with inflation,
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  Speaker 3: that the fee would be about eighty to eighty five dollars,
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  Speaker 3: And in fact, that's what a lot of people are
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  Speaker 3: now paying to see their GP. So that the patiental
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  Speaker 3: pay the clinic eighty or eighty five dollars and now
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  Speaker 3: get forty dollars back from Medicare.
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  Speaker 1: Okay, And have these changes impacted our seniors and those
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  Speaker 1: that are maybe on pension and concession cars or does
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  Speaker 1: it not affect them?
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  Speaker 3: It's been creeping towards the pensioners and those that are
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  Speaker 3: most honorable. Many people, professionals would be used to paying
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  Speaker 3: when they see their GP, and for a long time
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  Speaker 3: GP practices where you're poessentially using that money to subsidize
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  Speaker 3: the care for pensioners.
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  Speaker 4: And age care and children.
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  Speaker 3: And we'd love to love nothing more than to be
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  Speaker 3: able to bulkle everybody that walks through the door, but
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  Speaker 3: we just can't recruit, and we just can't afford to
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  Speaker 3: pay the staff if we accepted that. So more and
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  Speaker 3: more practices now are asking pensioners and children to actually
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  Speaker 3: check their wallets before they see their doctor. And this
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  Speaker 3: is well within the realm of the federal government to fix,
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  Speaker 3: but the government act the government has chosen not to
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  Speaker 3: do so.
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  Speaker 1: Yeah, right, so doctor clements, you know, I mean, what's
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  Speaker 1: the message for the federal government here? Is it time
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  Speaker 1: for our gps to sort of step up and go, hey,
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  Speaker 1: enough's enough. We actually need this man care rebate to change.
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  Speaker 3: Well, we've got to remember the many care rebate is
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  Speaker 3: the patients. It's not a to the doctor. It's actually
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  Speaker 3: what the patient receives from the government as a support
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  Speaker 3: and like an.
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  Speaker 4: Insurance to see the doctor.
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  Speaker 3: The federal government needs to listen to the constituents and
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  Speaker 3: listen to these vulnerable patients and how hard is getting
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  Speaker 3: for them to see a GP and how much it's
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  Speaker 3: costing them. And if the federal government wants to support
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  Speaker 3: these most vulnerable patients, it needs to give them a
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  Speaker 3: higher rebate. That'll certainly be something that improves their access.
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  Speaker 3: But there's another raft of things. There's no one syllabullet
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  Speaker 3: that's going to work towards increasing the number of gps
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  Speaker 3: in the workforce.
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  Speaker 1: What kind of impact do you reckon that it is
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  Speaker 1: going to have. Presumably some people, and I know that
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  Speaker 1: they shouldn't, But for some people, they might think, well, look,
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  Speaker 1: I actually can't afford to go to the GP, so
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  Speaker 1: I'm just going to front up an emergency.
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  Speaker 2: Do you think that there's.
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  Speaker 1: Going to be an impact in terms of greater pressure
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  Speaker 1: on emergency and on our hospitals.
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  Speaker 3: Well, there already is, so you're right. So some people
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  Speaker 3: absolutely choosing not to see their GP because they can't
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  Speaker 3: afford that out of proper cross and that's very sad,
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  Speaker 3: and we really wish to settle government hadn't chosen the path.
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  Speaker 3: What we'd prefer is that the federal government subsidize them
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  Speaker 3: so that they could see US. And so two things
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  Speaker 3: are happening, and it's already happening at different parts of
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  Speaker 3: the country. People will present to the emergent departments for
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  Speaker 3: non urgent things.
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  Speaker 4: But that's actually not a big deal.
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  Speaker 3: The biggest deal is when people don't see us as
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  Speaker 3: their GP early on in their blood pressure gen or
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  Speaker 3: their mental health journey, or with their shortness of breath
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  Speaker 3: then we can't prevent that first heart attack of CROW
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  Speaker 3: or admission to pneumonia. So with all these people not
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  Speaker 3: seeing their GP when they should, now they're actually getting
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  Speaker 3: further down the track of chronic disease. With their heart
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  Speaker 3: disease are their diabetes, and they're actually more likely to
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  Speaker 3: end up in hospital with admissions or dying from disease. Now,
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  Speaker 3: this is already happening and we need it to stop.
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  Speaker 1: Yeah, well, and it's quite a worry, you know, if
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  Speaker 1: that is the case. Now, I do want to ask
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  Speaker 1: you how's the Northern Territory going in regards to doctors.
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  Speaker 1: Is there still a shortage?
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  Speaker 4: Yes, sainly there's a shortage. There's an absolute shortage.
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  Speaker 3: Of doctors in the Northern Territory and in the country,
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  Speaker 3: but certainly felt strongly in the Northern Territory. I mean,
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  Speaker 3: you've actually trained in the Northern Territory as a GP register
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  Speaker 3: and Catherine and I really remember my time very fondly.
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  Speaker 3: It was a very rich experience. But we know that
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  Speaker 3: lesson less doctors are choosing general practice, and so we
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  Speaker 3: are looking pulling out all stops, trying to find out
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  Speaker 3: the incentives to get people to try out the Northern
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  Speaker 3: Territory had mentioned too, it's not just the doctors, your
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  Speaker 3: remote area nurses which are crucial for the workforce out
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  Speaker 3: there are in very short supply, Aboriginal health workers and
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  Speaker 3: all the other alloyed health So this in Northern Territory
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  Speaker 3: is certainly feeling the crisis that's going on nationally more
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  Speaker 3: and we really do need the government, through its Primary
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  Speaker 3: Care Plan which is underway, to recognize and actually invest
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  Speaker 3: some new and real resources into fixing it.
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  Speaker 1: And so what's driving it for making it more difficult
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  Speaker 1: in the territory than some of our other locations around Australia.
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  Speaker 4: Well coming having.
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  Speaker 3: Actually grown up a fair bit in the territory and
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  Speaker 3: work there. I don't know why everybody knows the territory
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  Speaker 3: is the best place in Australia, but we know that
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  Speaker 3: some of the remoteness, some of the isolation is a
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  Speaker 3: bit can be a bit of a disincentive to some.
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  Speaker 3: So that's why we're trying to get those with a
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  Speaker 3: sense of adventure. But you know, if you're intended Creek,
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  Speaker 3: can you see a GP for your mental health or
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  Speaker 3: for your new blood pressure change?
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  Speaker 4: The actual medicare rebate.
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  Speaker 3: To see you in Greek is exactly the same as
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  Speaker 3: in the middle of Sydney. So if you're a doctor
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  Speaker 3: and you're thinking about where you want to work, there's
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  Speaker 3: actually nothing really pulling you. There's not enough to pull
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  Speaker 3: you out to some of those remarkable places. So we
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  Speaker 3: do need to see a real shift where the government
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  Speaker 3: actually incentivizes doctors to go to the areas that most
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  Speaker 3: need them. And once they figure out how to do that,
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  Speaker 3: and I guess listen to the advocacy agencies, then we
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  Speaker 3: should get much better health care for everywhere from Tennant
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  Speaker 3: Creek and Sextimber Creek, for Alice Springs and surrounds.
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  Speaker 1: I mean, do you think that we could be doing
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  Speaker 1: more in terms of incentives as well to attract doctors
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  Speaker 1: to regional and remote parts of the territory.
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  Speaker 3: Well, it's not just about money, but money does need
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  Speaker 3: to be part.
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  Speaker 4: Of the solution.
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  Speaker 3: I know one of the practice owners now in Katherine
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  Speaker 3: is doing a wonderful job. One of heard and that
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  Speaker 3: in fact is it's housing. It can often be housing
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  Speaker 3: that's the main barrier. It might be schooling for the
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  Speaker 3: children or childcare for very young children. For our doctors' families.
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  Speaker 3: It can be thousand, employment and travel and access and
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  Speaker 3: all of these things need to be looked at me
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  Speaker 3: and that's what the whole community benefits from. So there
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  Speaker 3: does need a community based approachach. Community Catherine needs a
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  Speaker 3: different solution to everywhere else, to Tennant Creek, to all
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  Speaker 3: of the beautiful places in arnam Land, which I know
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  Speaker 3: still screaming for doctors. Man and Greed is a beautiful spot,
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  Speaker 3: but they're often recruiting as well. We need to find
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  Speaker 3: local solutions that cover both financial incentives to the doctor
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  Speaker 3: but also community packages that can help recruit.
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  Speaker 1: Now, before I let you go, are we attracting overseas
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  Speaker 1: doctors as well? Now that those borders have reopened.
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  Speaker 3: The borders reopening is certainly going to make it easier
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  Speaker 3: for us to recruse, and there's been an expansion in
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  Speaker 3: what's called GPA, which means that there's going.
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  Speaker 4: To be a lot more places that these doctors can work. Sadly,
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  Speaker 4: the whole world is busy.
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  Speaker 3: Gps all across the world are really flat chat with
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  Speaker 3: the effects of COVID, and so there's been a lot
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  Speaker 3: less movement even though the borders are open. So there
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  Speaker 3: is movement and we Northern territory and most of the
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  Speaker 3: rule Remote Australia relies very heavily on the osea's trained
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  Speaker 3: doctors and we would like to see the federal government
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  Speaker 3: give a bit more support to them. In fact that
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  Speaker 3: they just stopped funding an incentive to help them cover
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  Speaker 3: their training costs for these overseas trained doctors. This year
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  Speaker 3: they're calling the government to reinstate what's called funding for
• 9:17
  Speaker 3: a f SPS. So we do need to do our
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  Speaker 3: best to recruit overseas and support them once they do
• 9:21
  Speaker 3: decide to come out here.
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  Speaker 1: Well, doctor Michael Clements, we really appreciate your time this morning.
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  Speaker 2: Thanks so much for having a chat with us.
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  Speaker 4: Good talking to you.
• 9:29
  Speaker 2: Thank you,