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Into the 21st Century: Relative Value Study

The Relative Value Study, conducted by AMA and government members of the MSRB, had been completed and the MSRB had handed its report to the Government and the AMA in December 2000. The AMA saw the result as providing a realistic picture of the cost structure on which fees should be adjusted. It recognised that several details had to be sorted out before implementation, but it expressed its strong expectation to Minister Wooldridge that implementation would be settled in the 2001-02 Budget and the results of the survey in operation by November 2001 – round about the expected date of the next federal election. The 2000 Annual Report commented that successful implementation “will be a necessary commitment for any political party wishing to claim a commitment to Medicare in the coming election”.

The election took place early in November and the Howard Government was returned. Senator Kay Patterson was appointed Minister for Health in place of Dr Wooldridge, who had retired and whose relationship with the AMA President had been notoriously fraught until what Dr Phelps called “a delicate détente” had been reached towards the end of Dr Wooldridge’s tenure. But the return of the Government and the appointment as Minister of somebody other than Dr Wooldridge were no help, as far as they concerned the RVS. Instead of moving on its implementation, the Budget ignored it, choosing instead “to put money into a number of disease-specific items in general practice,” in Dr Phelps’ words, “which may well involve more red tape than benefit and have the potential to fragment patient care.” At this point, after nearly seven years of work by the AMA, the RVS – which had never really been high on the Government’s list of priorities – seems to have disappeared off the Government’s radar, and the AMA Economic and Workforce Committee started looking at alternative ways to update the MBS, “as well as making appropriate adjustments to the AMA’s own List of Medical Services and Fees”.