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07 Oct 2013

Some statements from patients can certainly cause mirth.

I was recently conducting a pre-op check on an ageing patient with Alzheimer’s when he volunteered that he had recently had shingles. I asked where he had it, and he replied, in some detail, that he “got it in the garden under a bush - I just ducked in to weed under a tree, and came out with shingles”.  My concentration was gone. I had to leave the room for a minute to compose myself. Often our questions are open to misinterpretation and I guess I was the guilty party.

The political scene has certainly changed, with the Coalition assuming control of the House of Representatives. Any waste seems to be in their sights, as exemplified by the Prime Minister’s decision to quarter himself in inexpensive digs while The Lodge is renovated. His deputy, Foreign Affairs Minister Julie Bishop, slashed her party’s travel costs to New York. Leading by example such as this always inspires my respect.

I feel any waste in the provision of medical services will now be high on the agenda for cuts. So, wishing to be helpful, I will offer some suggestions:

First and foremost, end the subsidy through private health insurance of snake oil therapies with no scientific validity. All government /taxpayer subsidised care should be evidence-based. 

Secondly, continue Mr Rudd’s agenda of renegotiating pharmacy agreements so that the taxpayer meets no more than the true cost of PBS medicines to the pharmacist, plus a realistic dispensing fee.

Take this further and decree that pharmacies accepting government monies for PBS prescribing will not market “alternative” or “natural” concoctions unless such have sound evidence of efficacy.

And should stable patients on meds such as statins and antihypertensives really have to front up monthly at the pharmacy for repeats on their 28 to 30 day supply of medications?

Thirdly, start a cost-benefit analysis of the multiple government and quasi-government bodies that regulate the provision of health care. Medicare Locals are already up for review, and the requirement for accreditation to access Commonwealth Practice/Service Incentive Payment schemes should also get a guernsey.

Multiple big budget taxpayer-funded bodies need similar and timely review. The National E-Health Transition Authority, Health Workforce Australia, and many subsections of the Department of Health and Ageing should be independently reviewed. Any savings should be directed toward service provision, not more grandiose enquiries and regulatory bodies.

Fourth, the Government should simplify the Enhanced Primary Care program, and the authority script red tape, which is wasting GP time.

On a positive note, we have in Peter Dutton a Health Minister who respects the medical profession, and Fiona Nash, his assistant in the Senate, is a fierce advocate for rural Australia.

I trust we are entering a new era where a sound foundation for a better healthcare system can be laid and the AMA can be truly involved in guiding positive change.

Published: 07 Oct 2013