Bulk billing, Parliament House, Canberra

PHELPS: I think GPs are just going to start charging what the RVS says is an appropriate average charge. Now, obviously the MBS can only give an average, some practices will be much more expensive to run. Others will be less expensive to run. That average comes out at around about $45.00 per consultation. And, that figure has been backed just yesterday by the College of General Practitioners. And so, GPs will charge the real value of the consultation and it will then be up to Medicare, as the insurer, to cover the rebate for the patients. And I think that unless the MBS is increased to reflect that value, then patients are going to have to pay that larger gap.

JOURNALIST: What sort of jump in doctors' wages will it mean?

PHELPS: Well we're not talking about doctors' wages. Doctors are independent business people, if you like. So what we're talking about at the moment is doctors' incomes really struggling and many of them selling out to corporate entities. Some of them going out of business - going into other professions. What we are wanting to see is the preservation of general practice as a specialty in its own right, doctors being able to maintain independent practise and have incomes that reflect the twelve years of training and education that they have to undertake and then take on the immense responsibility of general practice. Their incomes should reflect that.

JOURNALIST: Michael Wooldridge says that this is really a bid to increase doctors' incomes by up to $100,000 a year.

PHELPS: Well, I don't know where Dr Wooldridge gets his figures from, but there is no doubt that general practice is severely undervalued at the moment. And if this is, you know, a naked exercise in increasing general practice incomes, well, yes that's exactly what this is. Because general practitioners are undervalued and many of them have been trying to do it, tough. They've been trying to provide a service for about half of what it is worth, and they just can't keep on doing it. Practice costs have gone up 17 per cent in the last couple of years and doctors have to wear that cost without any increase in the MBS of any significant amount. So we have to see the increases.

JOURNALIST: If the rebate isn't increased, what will that mean for services from GPs?

PHELPS: Well, I think we're going to see a number of services … we're already seeing in the cities corporatisation of general practice and I think that that could well mean the loss of some of the small corner general practitioners, if you like. We may see patients having to travel further to see their doctors. We might also be seeing services provided in a setting that may not suit the patient as much. I think what we'll also see is patients having to pay larger gaps.

JOURNALIST: Dr Wooldridge says he may consider lifting fees but it would always have to be linked to better health outcomes for patients. Can you work with that? Do you see a possibility there?

PHELPS: GPs take that sort of comment as a direct professional insult. We are delivering health outcomes to the Australian people under very difficult circumstances. What we now want to see are appropriate rewards for that service. It has to either come from patients or it comes from Medicare as the insurer. And the Government is responsible for the levels that that insurer sets. The outcomes are there in general practice - it is being delivered under difficult circumstances. If the appropriate rebates for patients are improved then doctors will be able to do things like spending more time with their patients and doing after-hours work, which at the moment is completely unviable. And, the outcomes will follow.

JOURNALIST: If the RVS is adopted, are you saying that bulk-billing rates will stay at their present levels?

PHELPS: I think that we will see an arrest in the decline of bulk billing if the RVS is adopted. Unless the MBS then keeps up, which it has a history of not doing, unless it keeps up with the cost of running a practice and with the cost of the CPI then I think that once again the gaps will start to increase again. The MBS has to reflect the value of providing a service.

JOURNALIST: So at least somewhat it's on the way out, isn't it?

PHELPS: It certainly is at the moment. We've had two successive quarterly substantial falls in bulk billing rates. We're yet to see the March quarter figures, but they'll be on the way soon and I will be most surprised if we didn't see a similar decline and perhaps even a sharper decline.

JOURNALIST: Do doctors hate it? Do you hate bulk billing?

PHELPS: I think, as I've said before I'm on the record as saying yes, I think bulk billing is one of the most insidious and damaging things to general practice because it has forced shorter and shorter consultations, a higher, more rapid turnover of patients - doctors only being able to deal with one problem per consultation rather than going through a more extensive history, not being able to do counselling for mental health because it's not cost effective and it's only, I suppose, where doctors are able to charge a private fee and to be able to spend the extra time, or to be able to subsidise their more disadvantaged patients, that they're able to provide those sorts of services more extensively. I think that if we really look at a proper revision of the MBS then doctors will be able to spend more time to do the after-hours work - all of the things that I've been saying. But bulk billing, I think, has been responsible for a lot of the complaints that people have about not being able to spend enough time with their doctors.

JOURNALIST: The Minister last night seemed to be offering $10…. Have you seen that story and what are your thoughts about it?

PHELPS: Yes, I've seen that story, but I have to say that that might be best to speak to cardiologists about that particular issue because it really is about a clinical trial. I don't really want to make a comment about that. I think it's best that the cardiologists concerned comment on that one.

JOURNALIST: Just on Dr Wooldridge. You repeated the line yesterday that he was the Minister for Health and not the 'Minister for Doctors'. What do you think of that?

PHELPS: I think someone has to be responsible for the Government's relationship with the medical profession and if it's not the Health Minister, I don't know who it is. The doctors are, I think, making very reasonable and very well thought out approaches to Government about a range of issues. And, if the welfare and the quality of the professional life of doctors is not a concern of the Government, then I think that that is something that the public needs to be very concerned about. Thank you.

Ends