News

Health budget is all 'smoke and mirrors'

AMA President, Dr Kerryn Phelps, said today that Michael Wooldridge's Health Budget did not get any better overnight.

Dr Phelps said that the AMA's initial appraisal of the Budget still holds true:

a total snub to the Relative Value Study (RVS)

no effort to seriously ease pressure on GPs

nothing to reduce patient gaps

no relief for public hospitals

no reductions in waiting lists for operations

nothing substantial for the long term needs in indigenous health, and

a shortage of places in high care residential aged care facilities.

"This Budget has not responded to the major structural problems confronting Medicare," Dr Phelps said.

"At a time when there was obviously money to spend in the Budget, you would have thought a responsible Minister would have had an eye on the health needs of the next generation of Australians by implementing the RVS.

"The Health Minister has shown no commitment to Medicare.

"The failure of this Budget to address the major health needs of the Australian community - for doctors and patients - ensures that health will be a big election issue.

"Dr Wooldridge expects doctors to do tricks to get funding for important public health programs.

"He has ignored the AMA's constructive advice and continues with his 'divide and rule' mentality by tying most funding arrangements to his MoU group, of which the AMA is not and will not be a signatory, and which does not have the support of Ausralia's GPs.

"In fact, the AMA will carry out the wishes of doctors - AMA members and non-members - by calling on the RACGP, the ADGP and the RDAA to withdraw from the MoU.

"The leaders of these groups cannot allow the best interests of their members and their patients to be bound up in this bureaucratic exercise.

"The MoU does not reflect the reality of delivering quality medical services to the Australian people - it must be scrapped."

Dr Phelps said major AMA criticisms of the Budget include:

RVS and General Practice

The Budget figures show an increase of $577m over 4 years in Medicare expenditure. Only $6141 per GP per year ($300.6m over 4 years) of that is to be spent in rebates for longer consultations - the Government's only response to the RVS. This is about 1/10th of the figure necessary to implement the RVS in General Practice. There are no budget announcements for the implementation of the RVS for specialists.

The remainder will be paid out for specific programs according to geographical location and other criteria. The Budget purports to improve the "level" and "effectiveness" of GP care but it has only added complexity to the MBS system and failed to take into account extra costs incurred by GPs.

GPs will have to jump through hoops to receive payment for providing asthma care ($48.4 over 4 years), diabetes care ($49.8m over 4 years), cervical cancer screening ($71.9m) and mental health care $120.4m).

General practices in rural and remote, provincial and outer metropolitan areas with doctor shortages will have access to funding through PIP of up to $8000 per year to assist in employing a practice nurse for two sessions a week. This sum is likely to be a financial burden when additional costs involved in the employment of a nurse are taken into account.

A revised MBS consultation structure for GPs only (not specialists) is to be considered without acknowledgment that the joint RVS structure was created with broad consultation and agreement with the profession.

Negotiations over all new initiatives will occur with the MoU Group, deliberately excluding the AMA.

There are no expenditure initiatives in relation to public hospitals in Australia. A Senate Committee recommendation to inject a further $900 million over 2 years ($450 million from the Commonwealth) has been ignored.

As a result of no action on the RVS and on public hospitals, medical gaps will increase and access to public hospitals will at best stay the same.

Chronic disease - Asthma and diabetes

Although the AMA is not against the programs announced in the Budget, the Government needs to focus on a broader, holistic strategy for chronic disease rather than simply target individual diseases (such as asthma and diabetes). An overall program for chronic disease could have been effectively linked into the full implementation of the RVS. There also appears to be strings attached to these programs.

There is a lack of detail on how the Divisions of General Practice will be supported for diabetes care.

Indigenous Health

The Budget does not deliver anything until 2003-2004. The only exception is a national childhood pneumococcal vaccination program which we welcome, and it starts now, but addresses more than just ATSIC children

Alcohol, Tobacco and Other Drugs

The Budget has failed to deliver any significant advances in the integrated prevention and treatment of Australia's drug problems.

ADCA and the AMA have previously welcomed the establishment of the Alcohol Education and Rehabilitation Foundation, which was re-announced in this Budget.

This Budget does nothing to address the legitimate concerns of the Australian public about the enormous damage caused by the misuse of illicit drugs and tobacco. The community is seeking solutions and had a right to expect additional funding for prevention and treatment programs.

The AMA and ADCA provided the Federal Government with comprehensive budget submissions outlining priority areas for reducing drug related harm. We are disappointed that our submissions have been largely ignored, especially in prevention programs.

ADCA and the AMA call on the Federal Government to immediately commit to significantly increase resources for programs that prevent the misuse of drugs in an integrated manner; treat and rehabilitate dependent drug users; and reduce smoking levels.

ADCA and the AMA also call for a commitment to a national alcohol and other drug workforce development strategy, including compensation for the increased costs associated with the implementation of the GST and changes to fringe benefits tax. This Budget provides only limited compensation for fringe benefits tax changes for Indigenous organisations, but does not provide similar compensation for alcohol and other drug agencies

Aged Care

Additional funds for aged care are welcomed. However, funding is being provided for compliance ($10 million for Accreditation Agency checks of residential aged care services, $3.8 million for effective and responsive complaints handling) but at the detriment of care.

Where is the funding for education and retention of aged care staff, for transitional care or step down facilities, and for benchmarking of quality care?

Still more places are needed in high care residential aged care facilities.

CONTACT: John Flannery (02) 6270 5400 / (0419) 494 761

Sarah Bucknell (02) 6270 5400 / (0419) 440 076

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