GP Network News, Issue 13 Number 34

Week four of the Federal election campaign lacked the energy and excitement of the first few weeks as the media and the public began to tire of set pieces, high visibility vests, and rehearsed lines.

Worse, it looked like the supply of political gaffes was drying up. Even The Daily Telegraph had to resort to creating its own cartoon characters, with PM Rudd portrayed as Mr Rude and then Mr Chatterbox due to his lack of words to a make-up artist and his over-use of words in the Leaders’ Debate.

The big events of the week were the Liberal Party Campaign launch last Sunday, the Health Debate at the National Press Club on Tuesday, and the aforementioned Leaders’ Debate on Wednesday night at Rooty Hill in Sydney.

At his Campaign launch, Tony Abbott laid out a ten-year plan to shrink Government and deliver a significant Budget surplus. In health, the biggest pledge was to fully reinstate the private health insurance rebate.

The launch received broad positive media coverage and coincided, ironically, with a slightly better showing by Labor in Newspoll. While Labor’s voter support returned to its level at the start of the campaign, Newspoll still has the Coalition heading for a comfortable victory on the basis of a two party preferred vote of 53-47.

The health debate at the National Press Club between Health Minister Tanya Plibersek and her Shadow, Peter Dutton, provided more nuance than news. It was good theatre, nevertheless, with lively debate in a room overflowing with the leading lights from across the health profession.

Ms Plibersek said the Government remained proud of its record in health under very difficult circumstances.

She said the health system Labor is building is one with a much greater focus on primary and preventive care, aimed at keeping people well and out of hospital.

Mr Dutton said the Coalition’s Policy to Support Australia’s Health System would tackle chronic diseases, provide faster access to newly approved medicines, invest in Australia’s medical workforce and help prepare the health system for the demographic changes ahead.

The big pledges from the Coalition include a review of Medicare Locals and cuts to the health bureaucracy.

Key grabs from Health Minister Tanya Plibersek included:

• “the GP-patient relationship should be at the centre of care”
• “the architecture of the health system is broadly right”
• “one of the biggest challenges is getting the States to stick to the provision of key hospital performance data”
• “the best chance people have for better health care is always under Labor. Bulk-billing rates are at their highest”
• “there has been a 21 per cent increase in bush doctors under Labor”

Key grabs from Shadow Minister for Health and Ageing Peter Dutton included:

• “some Agencies may fold into neighbouring Agencies”
• “if you are spending an extra billion dollars a year on bureaucracy you are not spending it on frontline services”
• “people in the health sector are angry at Labor for missed opportunity”
• “we do not propose any change to alcohol taxation”
• “I want to make sure that where possible we devolve more power down to local communities”

The audience gave Kevin Rudd a slight points victory over Tony Abbott in the Rooty Hill Debate but neither side delivered a killer blow that dominated the headlines or caused controversy.

The issues that received most attention were perceived as policy on the run – Labor’s pledge to revisit the matter of foreign ownership of land and Tony Abbott’s lack of clarity over the Coalition’s policy on Medicare Locals (will they just be reviewed, would they all survive, would some survive).

Attention now turns to the Labor Campaign Launch in Brisbane on Sunday, followed by a plethora of pledges and promises and pointing of fingers in the final week before Election Day on 7 September.

John Flannery
Editor, Australian Medicine

Uptake of Medicare Local Contract Still Problematic

From 1 July 2013, funding for GP after hours services is no longer being provided via the Practice Incentives Program and is now administered via Medicare Locals.

From April to June various Medicare Locals from around Australia began to issue draft contracts to medical practices for the provision of after-hours services. Many members contacted the AMA expressing concerns at the nature and content of these contracts. Federal and State AMAs reviewed many of these agreements and identified a range of issues with the agreements which required some revision.

As a result of the AMA’s advocacy, in June the Department of Health and Ageing (DoHA) re-issued guidelines to MLs inviting negotiation of a more simplified, fairer agreement.

In June, Federal and State AMAs had strong input into the development of a more straightforward, workable agreement by the Australian Medicare Local Alliance (AMLA). A revised template contract was issued by AMLA based on the AMA’s negotiated position. The revised contracts are far clearer and fairer to all parties, with many of the more troubling clauses having been removed. The AMA understands that not all Medicare Locals have adopted this template, which is designed to be clear, fair and efficient, thereby reducing costs for all parties.

Those who haven’t adopted it include Northern Adelaide Medicare Local. The AMA has been contacted by members in that area with concerns about the contract on offer. It includes some onerous clauses around indemnity and intellectual property rights. Intellectual property rights are very important because they can impact on rights around patient records.

More troublingly, a cover letter attached to the agreement purports to impose on the practice the right for the ML to enter their premises to search for information. The AMA has consistently warned against these ‘search and seize’ clauses which we believe are extreme and have no place in an agreement such as this.

The ML concerned has written to members in an attempt to allay certain concerns, but the AMA remains unconvinced, as the agreement on offer is, after all, designed to be binding.

The AMA has raised concerns about the implementation of after hours contracts by MLs during the current evaluation of MLs that is being conducted and will press these concerns further with the Coalition if it is elected on 7 September. The Coalition has committed to conduct a review of MLs and the AMA considers the after-hours contracts an important subject of any review.

If you are approached by a Medicare Local, ask them whether the contract on offer is the AMLA template. If not, we strongly recommend that you get proper advice before signing. As with any contract, you should not be rushed into signing and obtain proper legal and or financial advice as necessary. Contact your State or Territory AMA for further information.

Telephone and Australian Health Professionals Directory scam alert

Medical practices, including general practices, are continuing to be the subject of a range of telephone and other scams. Among them, there have been an increasing number of scams whereby medical practices are contacted and asked for general practitioners' personal information. Directory scams are also prevalent, where practices are being billed for listings in directories, which they thought, were free of charge.

The prevalence of these scams highlights the need for general practices to implement processes, policies and procedures that will protect them from being caught up in fraudulent dealings. Practices should also be aware of security issues and ensure they take steps to protect against potential loss of sensitive data.

The AMA has issued several advices to members, and provided individual practices with advice and support. The AMA has recommended that practices take care and be alert for scams based overseas and in Australia, particularly directory listing scams.

The AMA has recommended that practices which have been the subject of a scam report it to their local Fair Trading authority or the Australian Competition and Consumer Commission (ACCC).

There is a great deal of information in the article on scams from Federal AMA in the July 29 edition of Australian Medicine.

The AMA urges its members to remain vigilant if contacted by unknown organisations requesting information, or seeking signatures on documents authorising 'free' listings. The AMA believes that education is the best strategy to avoid being caught. Doctors and practice staff should educate themselves to spot a potential scam and avoid it.

Payment Delays - Defence

AMA members treating Defence personnel are advised that they may experience some delay in payment if their invoices do not include the Defence Approval Number (DAN) and the Entitled Person Identification number (EP ID).

More information

Presentation of AMA Indigenous Peoples’ Medical Scholarship

AMA President, Dr Steve Hambleton, will next week present the AMA Indigenous Peoples’ Medical Scholarship for 2013 to an Indigenous medical student from the University of Melbourne.

Valued at $9,000 for each year of study, the scholarship provides support and encouragement for Aboriginal and Torres Strait Islander students studying medicine.

Event details.

Chronic health down to the wire

An article in this week’s Australian Medicine, reports that telephone coaching can help people with chronic diseases to self-manage their conditions and may be particularly useful in targeting vulnerable and disadvantaged populations.

New research has found that telephone coaching can be used to address the impact of some of the health workforce shortages in Australia, particularly in areas where people with chronic disease may not have direct access to many health services.

Lead researcher Dr Sarah Dennis from the University of New South Wales said more than a third of the papers reviewed focussed on vulnerable people and telephone coaching was found to be effective.

However the researchers warned about making assumptions about the cost of coaching relative to other forms of care, saying the study found that in most cases it did not reduce health care costs and, in some cases, costs could increase.

Full article.

GPs invited to participate in survey on the use of alcohol guidelines

Many Australians continue to defy health guidelines on alcohol, with a recent study from the Centre for Alcohol Policy Research finding that over half of Australia’s drinkers consume alcohol in excess of the NHMRC Guidelines on Alcohol Consumption.

In response to this issue, the Commonwealth Department of Health and Ageing are currently funding a project to promote the use of the NHMRC Guidelines by health professionals, with a focus on GPs, obstetricians/gynaecologists, and midwives.

Ensuring the perspectives of GPs inform this project is essential and, to support this, health professionals have been invited to participate in a survey about alcohol use and the NHMRC Guidelines. The survey takes approximately 10 minutes to complete. All responses will remain anonymous be reported in aggregate.

Participate in the survey.

The survey closes on closes 6th September.

Medical Journal of Australia

Next week’s edition of the AMA’s Medical Journal of Australia (MJA), available from 2 September 2013, will focus on advancing knowledge and practice in obstetrics and gynaecology. Content will cover research on medically managing miscarriage, unexplained variations in caesarean section rates, and changes in alcohol consumption during pregnancy, as well as discussions on long-acting contraceptives, integrated health research and a look at alcohol promotion on Twitter. The upcoming edition will also feature part 4 in the Cardiology series – Management of heart failure.

Middle East respiratory syndrome (MERS) coronavirus - update

More cases of the MERS-coronavirus have been confirmed. As of 28 August 2013, the WHO had received reports of 102 laboratory-confirmed cases, including 49 deaths. Two new cases each in both Saudi Arabia and Qatar have also been announced by the respective authorities – but these are yet to be included in the WHO case count.

GPs should be aware that many Muslims will be travelling to Saudi Arabia in August and October to undertake the Umrah and Hajj. Most of those infected have had a history of residence in or travel to the Middle East, or contact with travellers from these areas. Most patients have presented with or later developed severe acute respiratory symptoms. Mild flu-like illnesses, asymptomatic cases and atypical presentations have also been reported. Cases with severe symptoms have been most commonly reported in older and middle-aged males with underlying conditions. To date there have been no cases in Australia.

The Department of Foreign Affairs and Trade (DFAT) has updated the Smarttraveller advice for Saudi Arabia, Qatar, the United Arab Emirates and Jordan to include information about the outbreak.

The latest update from the Department of Health and Ageing is available online.