AMA Vice President Dr Danielle McMullen on Grattan Report on Medicare and general practice

JAMES GLENDAY:  A new report from the Grattan Institute on Medicare suggests universal healthcare in Australia is stuck in the last century and in need of an urgent overhaul. For more, we're joined now from Sydney by AMA Vice President, Dr Danielle McMullen. Good morning, Doctor. Thank you so much for joining us. Can I get your reaction, first of all, to this report? Do you agree that the payment system is broken?

DANIELLE MCMULLEN:   So we would argue that our general fee-for-service system isn't broken, but has certainly been severely neglected by successive governments and is in strong need of repair. And part of that repair is reforming it to make sure that we've got more flexible funding options to take best care of our patients, particularly those with chronic and complex disease.

JAMES GLENDAY:  Do you support the idea of having more physiotherapists, nurses, different disciplinary areas involved in a care with a GP maybe leading a team doing that?

DANIELLE MCMULLEN:   Certainly. So what we want to see is the best possible patient care, and that is in patient-centred, GP-led care teams. Where fee-for-service, the way you normally see your GP now, remains the bedrock of primary care, but that we also have some flexible funding to make sure that we can bring in team members and work together for the best outcomes for patients, for example, to make sure that our patients with diabetes have ready access to diabetes educators, podiatrists, dieticians, and our practice nurses to help support them in their care, and that GP's are supported to be those clinical leaders and have oversight of that well-rounded clinical care and make sure that everyone is getting world leading best possible general practice care.

JAMES GLENDAY:  This report also says that doctors are doing okay at the moment and that the focus needs to be broader than just increasing payments. Do you agree with that or do you think it's a combination of ensuring some more money goes to doctors too?

DANIELLE MCMULLEN:   It's really a combination. That's certainly not the message we're hearing on the ground where, particularly in rural and remote Australia, doctors and medical practices are really struggling to keep their doors open and that's a problem that we are seeing come into the city. We know that at the moment bulk billing rates and the rebate back to patients is less than half of the cost of providing that consultation. So it does mean that practices out there trying to look after their most vulnerable patients are taking more than a 50 per cent discount on their services. So we do need to see some support behind fee for service and behind those doctors' fees, but also that flexibility to make sure that we can bring in a broader care team and make sure that we've got that support of that true multidisciplinary care.

JAMES GLENDAY:  Alright. Dr Danielle McMullen, thank you so much for speaking to News Breakfast.

DANIELLE MCMULLEN:   Thanks.