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13 May 2015

Transcript: AMA President, A/Prof Brian Owler, Doorstop, Parliament House, 13 May 2015

Subject: 2015 Health Budget


BRIAN OWLER: Good morning.

Last night I commented on the health budget that was delivered, and certainly one of the concerns of the AMA has been the fact that the health budget was presented with the MBS schedule review as the centrepiece of the health budget. I have sought clarification from the Minister last night that there is no dollar amount attached to the MBS review, which was one of the conditions on the AMA and the profession supporting this process. So we remain committed to the process of the MBS review. It is not purely about a savings measure, this must be about making sure that we have a modern MBS that actually reflects modern medical practice, and it actually maintains access for patient services.

The Budget unfortunately does not go anywhere near addressing the concerns of the AMA from last year's Budget. Last year we saw not only the GP co-payment introduced and a number of other measures, but we had the savage cuts to the public hospital system. There is no indication in this Budget that those cuts are going to be restored. Nor is there any indication about the required changes for the indexation freeze that we are seeing for GP and specialist patient rebates. People need to remember that the indexation freeze is a freeze for the patient's rebate. It is not about the doctors' income, it is actually about the patient's rebate and their access to services. And, unfortunately, we have seen in the health budget last night no indication that those freezes are going to be lifted any earlier than 2018.

We have also seen other cuts. Unfortunately, we have seen $150 million, or near $150 million, taken out of general practice from changes to the child health checks, apparently because of duplication – although it is very unclear in my mind as to whether or not there is any duplication. And with the announced primary health care review, that would have obviously have been the perfect place to assess whether the child health assessments were a necessary part, and whether any changes should be made to those assessments. Hopefully, there will be an opportunity to revisit that.

There is also a lack of clarity around some of the announced cuts. There was a package of $1.7 billion that was presented last night at the Department of Health Budget lock-up. That $1.7 billion over four years included a number of aspects, including changes to the child health assessments and a number of dental programs. But it also left non-Government organisations that are funded through what we call flexible funds from the Department up in the air. There is a lot of uncertainty in Canberra and around the country at the moment as to whether those important programs, those important organisations, such as Palliative Care Australia, Alzheimer's Australia, the Foundation for Alcohol Research and Education, and many other non-government organisations, are going to be continued to be funded. Now, rather than announcing that these- almost a billion dollars are going to be made to those cuts of almost $1 billion are going to be made to those flexible funds, and leaving it up in the air for these organisations, we need to see certainty around where those cuts are going to be made, how they are going to be applied, so that these organisations can not only plan for their future but also continue their very important work.

So there are obviously things that need to be clarified. There is more work to do. But, unfortunately, what we are left with is still the lingering effects from the 2014 Budget, which are going to continue for many years to come. And this Budget has not gone anywhere near addressing those concerns.

QUESTION: You talk about the lingering effects of last year's Budget, does the freeze on Medicare rebates mean we will see an $8 GP co-payment by stealth?

BRIAN OWLER: Well that's some of the modelling that has come out of some of the academics at the University of Sydney. At the end of the day, we know that doctors' costs are going to keep rising. The costs for their practice staff is going to keep rising. The costs to lease their premises and to provide quality practice as a GP or a specialist is going to keep rising. If the rebates don't rise, those costs have to be passed on in out-of-pocket expenses - we will see less bulk-billing, and there is the possibility of seeing a co-payment by stealth as has been alluded to by some. When that is going to happen, this will be a gradual process that happens over time, and it is unfortunate that patient rebates and their access to services are not going to be maintained. The out-of-pocket expenses for specialists are going to be most severely hit. I think there is a real issue for private health insurers; if they choose to index independently of the MBS, they are going to have to pass on higher private health insurance premiums to people, or, if they choose not to index, there is a real chance that out-of-pocket expenses for specialist costs are going to rise significantly.

QUESTION: We've heard today that some of the Budget documents weren't provided to you in the Health Budget lock-up last night. Can you elaborate a little bit on that?

BRIAN OWLER: Well, it's fair to say that none of the health budget documents were provided to the health sector. You had several hundred representatives from stakeholder groups from right across the country who had flown into Canberra, who obviously take a very keen interest in the Federal Budget and what it means for health. They are there to provide commentary, to interpret the Budget and provide interpretation for people around the country. A lock-up means you are provided with that information. Everyone has to check in their mobile phones. What we were provided with was a two-page press release with announcements that it already been made. That is not good enough. And I think in this day and age if you are having a lock-up and you have people and stakeholders in a room, you need to be provided with the information and also be able to answer the questions with some clarity about the announcements that are going to be made.

QUESTION: So, as a result of that, are you going to be looking for some sort of meeting with Sussan Ley to explain and go right through the health budget papers?

BRIAN OWLER: I spoke to Sussan Ley last night. We talked about the issue of the Budget lock-up and I think it is fair to say that that is unlikely to happen again next year. She has offered the opportunity for our representatives to sit down with various members of her staff to go through the Budget line by line, so there is certainly, from the Minister's point of view, an openness and willingness to go through the Budget documents in detail.

QUESTION: The Budget papers show that the Government is banking a big saving, I think a half a billion dollars, which it is expecting to save from kicking parents who don't get their kids vaccinated off child care subsidies and Family Tax Benefits. Do you think that is a good move? Do you think that's fair enough?

BRIAN OWLER: I think it is a concern that we are planning to make that amount of savings from that measure, because it indicates that a number of people aren't going to vaccinate their children. What we should be saying is we need to make sure that we do get all those children vaccinated and we should be aiming to actually continue to spend the same amount on those sorts of Family Tax Benefits.

Now, we know that for some people, particularly in some areas - and there are many affluent areas, particularly in the lower North Shore of Sydney for example and its eastern suburbs - where actually the vaccination rates are very low. And for some of those people, the Family Tax Benefit Part A, the financial implications of losing out on that will be a lot less. So there no doubt will be some savings, but I think it is a concern that clearly that amount of savings has been banked, given that that means that a child won't be vaccinated.

QUESTION: It is about 150,000 kids according to the Government's figures. Is that just though the hard-core element who just refuse point-blank to believe in keeping their kids immunised because they don't believe in vaccinations?

BRIAN OWLER: No, I think it's fair to say I would be surprised if it was 150,000 children. We know that the number of conscientious objectors is around 39,000, I think, at last report. So, to say it is going to be 150,000, I think, is a concern. I think our aim should be to make sure that all of those people get their children immunised. If it is that number of people, we should really be saying, well, how can we invest even further to make sure that the message gets out there around vaccination, and that we make sure that people do the right thing by their children, do the right thing by everyone else in the community as well, and get their children vaccinated.

JOURNALIST: Dr Owler, thank you.

BRIAN OWLER: Okay, thank you.


13 May 2015

 

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Published: 13 May 2015