TOP STORIES

Bridging the gap on Medicare

Health Minister Tony Abbott will be pleased that the Medicare safety net and with it the total Government Medicare package has now been secured, following his deal with four independent senators. 

But there are still significant problems to be solved - a curious determination by the Federal Government to stick with bulk billing as a panacea for our ailing health system, more red tape and a Medicare that has become even more complex.

Mr Abbott calls the agreement 'a watershed moment for Medicare'.

Independent Senator Meg Lees, who negotiated the allied health part of Medicare Plus, says it will give the poorest access to the care they need most.

And naturally enough, Opposition Health Shadow Minister Julia Gillard claims the revised package is 'another political fix and pure pork barrelling'.

Rural health plan may have merit

The Australian Medical Association says plans in a recent rural health paper for 'walk in, walk out' medical clinics in country areas may have some merit.

The clinics, bought via an infrastructure fund, would allow GPs to work in rural areas without having to buy a surgery.

The infrastructure plan is part of the 10-point Good Health to the Bush initiative presented to Deputy Prime Minister John Anderson in Canberra recently.  It is backed by several groups including the Rural Doctors Association of Australia.

AMA Council of General Practice Chairman Dr David Rivett says the idea has worked in some towns where councils buy medical facilities and hire GPs as employees.

Urgent action needed over child abuse

A swift and committed national response to the appalling and increasing incidence of child abuse must be a top priority for Federal, State and Territory Governments, says AMA President Dr Bill Glasson.

Dr Glasson was commenting on the release of a Jesuit Social Services study, Community Adversity and Resilience, which used the incidence of confirmed cases of child abuse as one of 13 social indicators to rate Victorian postcodes on a general disadvantage index.

The report says social disadvantage can be addressed by building a sense of community and by increasing opportunities in education, training and employment to open up life opportunities.

Smoke signal from AMA on film characters

The AMA has sent a strong signal to all Australian governments that they must legislate to introduce anti-smoking health warnings in cinemas before showing any films that contain images of characters smoking cigarettes.

Research from the University of California shows that smoking on the big screen is at its highest level for 50 years, with about 11 depictions of smoking in every hour of the typical film.

AMA President Dr Bill Glasson says young people are influenced by screen characters and, with most big films aimed at youth audiences, it is inevitable they will ape the actions and mannerisms and habits of their screen idols.

INSIDE

AusMed Feature

WHERE HAS THE LOVE GONE?

This edition AusMed follows a medical student from university to hospital as he deals with the conflict of work duty and being 'human'.  We also hear four very different opinions from a GP, a surgeon, a psychiatrist and an emergency physician.

FROM THE PRESIDENT - Dr Bill Glasson

The doctor drought

I visited Wagga Wagga in country NSW recently to meet the local doctors and to hear their concerns.  Wagga is a big town with a big population and quite a few GPs and specialists.  There are two hospitals.

But not enough doctors, it seems.

Here's what the local ABC Radio announcer had to say when interviewing me: 'Recently, I tried to see a doctor just for a check-up here in Wagga and I was told it would take me 10 weeks because it wasn't an emergency.  It would take me 10 weeks to see a doctor here because all the doctors had closed their books.'

Now, things are getting pretty crook when the local radio talkback host can't get to see a GP.

Stories of doctor shortages in small country towns are common.  But we are not talking about Woop Woop here.  We are still this side of the Black Stump.

Wagga has a population of about 60,000 people but serves a wider district of 200,000.  It is an inland city with lots of attractions and a great lifestyle but not enough doctors.

The doctor drought is not selective.  Small towns, big towns, inland cities and the suburbs of our capitals.  No matter where you live, patients can't find a doctor or are waiting longer to get to see one.

Over the past year we have seen big Medicare policy announcements.  There was Labor's New Deal on Medicare.  Then there was the Government's A Fairer Medicare, followed by Medicare Plus and Medicare Plus Plus, a product of deals with the independent senators.

At the heart of all these policies is a blind commitment to bulk billing.  In fact, the policies are all built on the concept of, and apparent need for, increased GP bulk billing rates.

Funny, then, that the more than 30 GPs I met in Wagga unanimously agreed with the AMA that bulk billing is not the answer - no matter what the question was.

The Medicare policies of both the Government and the Opposition miss one key point; patient gaps for medical services now exceed the $5 and $7.50 top-ups at the heart of the bulk-billing pork barrel.

Many patients pay $10 or more over the Medicare patient rebate of $25.70 and are happy to pay that amount.  It is a small price to pay to keep their doctors in their communities.  They have what they need and what the health system needs - access and affordability.

Those two words again - access and affordability.  Whenever you see the words 'bulk billing', scratch them out and put 'access' and 'affordability' in their place.

On the other hand, you have to give credit to Tony Abbott and Julia Gillard for putting new funding into Medicare, even if they are for the most part putting it in the wrong places in the wrong way.

If both sides of politics had followed the advice of the Relative Value Study (RVS) and injected today's funding into Medicare a few years ago as across-the-board patient rebates, they would find the quest for palatable vote-winning health policy today much easier.

Instead, the years of Medicare neglect since the RVS - on top of the decades of neglect before that - have thrown up new problems that are harder and more expensive to solve.

Things like the doctor drought, for example.

The people of Wagga are doing it tough on the access and affordability front.  There are towns and suburbs and communities doing far worse.  The doctor drought is biting hard.  But the drought-breaking rains are nowhere in sight.

With a Federal election later this year, don't be surprised at reports of sightings of Tony Abbott and Julia Gillard standing in the middle of parched wheat paddocks, staring desperately at the sky and screaming at the top of their voices: 'Send it down, Hughie!'

Dr Bill Glasson is President of the Federal AMA.