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12 Feb 2016

A major task: AMA President Professor Brian Owler looks on as Professor Bruce Robinson addresses AMA's MBS Review forum 

The hand-picked head of the Commonwealth’s Medicare Benefits Schedule Review has taken a veiled swipe at the Government over its handling of plans to axe 23 MBS items.

Confirming medical profession fears about the potential politicisation of the process, Professor Bruce Robinson told an AMA-hosted forum on the MBS Review that the taskforce co-ordinating the review had been given no say over a 28 December announcement by Health Minister Sussan Ley that an initial batch of 23 items had been recommended for removal from the MBS.

Professor Robinson told the forum, which was attended by representatives from almost 50 specialist colleges and societies, that the announcement was “something we did not have control over”.

In her announcement, Ms Ley said the items were obsolete and no longer consistent with clinical best-practice. The Government suggested axing them would save around $6.8 million a year.

But Professor Robinson cast doubt on the scale of savings from the measure, and lamented that the Government’s handling of the issue had tarnished medical profession support for the MBS review.

“The announcement was unfortunate, because it is one of those things that has caused criticism of the review process,” Professor Robinson said, adding that “those items to be deleted are not going to save much money; it’s a tidying up exercise.”

AMA President Professor Brian Owler told the forum, the second organised by the AMA, that the medical profession had taken part in the review with enthusiasm and goodwill, but that had been put at risk by the Minister’s post-Christmas announcement, as well as the Government’s unilateral action to unveil cuts to bulk billing incentives for pathology and diagnostic imaging services in the Mid-Year Economic and Fiscal Outlook (MYEFO).

“There's a lot of goodwill within the medical profession to work with Professor Robinson and the Taskforce to improve the MBS. We all want a more modern MBS that reflects modern medical practice that is going to benefit patients,” Professor Owler said. “[But] if you engage the profession on that basis and then come out with an announcement in MYEFO, without any consultation or discussions…of course people are going to be upset.”

Dr Michael Harrison, from the Royal College of Pathologists of Australia, told Professor Robinson that the Government’s decision to axe bulk billing incentives for pathology services, taken without consultation, had “undermined the credibility of the [MBS] review”.

“Our confidence in the review has been severely affected,” he warned.

Much of the medical profession’s concern about the Medicare review has centred on doubts about its over-riding purpose.

Professor Robinson told the forum the focus was to modernise the MBS and align it with current clinical practice.

“My task is not to save money”, Professor Robinson said, and added that the taskforce did not have a savings target.

But the Government is intent on using the exercise to achieve savings, much of which will be used to help cut the Budget deficit. Ms Ley has indicated only half of any funds freed up as a result of the review will be re-invested in health.

Professor Owler acknowledged the review was like to deliver some savings (though probably not as many as the Government hoped), but warned the profession’s goodwill and support was contingent on any savings made were “held within health, to provide better services to patients”.

Adrian Rollins

Published: 12 Feb 2016