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Move to ease doctor shortage

AMA President Dr Bill Glasson has called for a moratorium to allow about 2,500 non-vocationally registered (VR) general practitioners to have their vocational registration 'grandfathered' - a move he says will bring instant benefits to the community.

Dr Glasson says: 'It is time to bring the non-VR GPs in from the cold.'

'There is a serious medical workforce shortage, which is being felt most in the area of general practice.  By 'grandfathering' the non-VRs we will see immediate benefits for patients.

'We will provide an incentive for those non-VR GPs in general practice to stay and possibly entice others back to general practice.

'And we will bring the Medicare patient rebate for patients treated by non-VR GPs back in line with that received by other patients.

Medicare: time for major changes

The AMA's submission to the Senate Select Committee on Medicare was to be presented by AMA President Dr Bill Glasson at a hearing in Brisbane on 26 August.  As Australian Medicine went to press, we had the opportunity to publish the edited extracts below from a supplementary AMA submission and recommendations to the Senate committee.

Calling for major changes to Australia's GP policies, the supplement emphasises the fact that the present dire crisis over Medicare has come to pass as a result of more than a decade of inaction, error, mismanagement and missed opportunities by successive Federal Governments.

Making hosptials safer places

A rostering kit to help hospitals implement safer and more efficient work practices for the benefit of doctors and patients has been launched by AMA President Dr Bill Glasson.

The Best Practice Rostering: Training and Resource Kit was produced by the AMA and the Australian Healthcare Association.

Speaking at The Alfred Hospital, Melbourne launch, Dr Glasson said: 'The patient throughput of hospitals has increased, the length of patient stay has decreased and the number of medical interventions available to doctors has risen dramatically - creating more work for doctors.

The kit is available in CD format and is being made available free to all public hospitals.

INSIDE

Long way round but no regrets

In May this year Brad Murphy, a fourth-year James Cook University medical student, was awarded the AMA's Best Individual Contribution to Health Care prize for developing an online first-aid program - Australian Rural and Remote Emergency Skills and Online Resource (ARRESTOR).

The program has stimulated serious interest overseas as a first-aid resource for a number of indigenous communities in Alaska and Canada.

And to cap it all, his commitment to remote area first-aid services throughout his career also has seen him awarded a Community Australia Day Award.

So who is Brad Murphy?  See this edition of AusMed.

Beware the cracks in no gaps

Some doctors are finding it necessary to increase their fees because of rising practice costs associated with soaring medical indemnity premiums, increased red tape costs and the soon-to-be-imposed IBNR levy.

AMA Legal Counsel explains whether charging an 'indemnity' or 'booking' fee along with a consultation fee breaches 'no gap' health fund agreements.

FROM THE PRESIDENT - DR BILL GLASSON

I.B.N.R.L.E.V.Y. SPELLS TROUBLE

The medical profession is confronted with many serious issues at the moment.  They all require AMA attention and action.

Health Care Agreements, bonded medical places versus AMA scholarships, Medicare rebates, workforce shortages, maintaining the private health rebate, protecting the PBS from unfair trade deals . . . and on it goes.  All these issues are being addressed by your AMA.

But one thing, above all, continues to irk.  Like a thorn in the paw.  Like a mozzie in the tent.  Like an itch you cannot scratch.  Like a time bomb ticking away just out of reach.  I'm talking about the Government's IBNR levy.

Don't get me wrong on the levy and the medical indemnity situation generally.  I'll give credit where credit is due.

We have worked closely with the Government to gain some important concessions from the levy.

Retiring doctors over 65 will be exempt but not for any deferred payment from a contribution year before they retired.

Doctors who have a pattern of earnings of less than $5,000 will be exempt.

Doctors who moved from private to public practice prior to May 2001 will be exempt.

Assistance will be given to GP registrars who undertake procedural training.

For these concessions and for all the other tough decisions made by the Government on indemnity I say thank you, thank you, and thank you again.

The question remains, however: why is the medical indemnity system still a major threat to the security of doctors and the certainty of access and affordability to health services for patients?

Why are premiums continuing to rise?

Why are specialists and GP proceduralists changing the way they practise to lighten the premium burden and lessen the risk of litigation?

Ultimately it is the patients who miss out - either they pay more for their health care or they have to send out scouts to find a doctor who can see them.

I firmly believe that the IBNR levy spells trouble.  Big trouble.  To borrow from Monty Python, the IBNR levy will be the 'wafer thin mint' that leads to disastrous consequences.

No matter how often and how loud we send this message to Government, it fails to grasp how serious the imposition of the levy is to doctors, patients and a fragile health system. 

It fails to see that in the great scheme of things the benefits of scrapping the levy far outweigh the benefits of imposing it.  The supposed benefits to the Government's budget bottom line do not justify the pain that will be inflicted on patients and the community through further disruptions to their access to doctors and the inevitable increased costs of health services.  Is it worth it?

The AMA continues to meet Ministers and officials regularly to achieve a better and more sensible outcome.

Despite our best efforts, there is little movement . . . yet.

Our next step is to take our arguments direct to the Prime Minister, who I will be meeting in person in Sydney in the first week of September.

In the past, the Prime Minister's political instincts have alerted him to the electoral risks associated with medical indemnity.  He has heard our arguments and acted in the best interests of the broader community.  He knows that good health policy translates to good electoral outcomes.

We will take our evidence from grassroots doctors and patients directly to the top.  Evidence that points to poor outcomes for patients and the community - not to mention doctors - when the IBNR levy bites.

The IBNR levy may be Patterson's Curse and Coonan's Plague but we are confident that the Prime Minister will not allow it to become Howard's End.

Dr Bill Glasson is Federal President of the AMA.