Dr Bartone - ABC News Breakfast - Changes in Government Arrangements

ANDREW GEOGHEGAN: And someone with a keen eye on developments is Dr Tony Bartone, President of the Australian Medical Association. He joins us now. Tony Bartone, welcome.

TONY BARTONE: Good morning, how are you?

ANDREW GEOGHEGAN: Good thanks. First, your reaction to the events of the past week, and Scott Morrison as the new Prime Minister?

TONY BARTONE: Look, the events of the past week have been a significant distraction from matters at hand and in particular in health. We want to get on with the job. We want to get on with trying to advocate for the best policy for the best outcomes for patients of Australia.

ANDREW GEOGHEGAN: I'm sure you're aware in Scott Morrison's first speech - he hadn't become Prime Minister, but obviously after the vote where it was clear that he would be the next Prime Minister - he outlined his priorities. The drought was on top of the list, no surprise there for most. But then he began to list some priorities in health. Initially he said he's distressed by chronic illness. What did you take from that?

TONY BARTONE: Well, it's an appreciation that chronic illness, chronic disease is becoming an increasing focus of healthcare delivery in this country. It's becoming increasingly the principal presentation, whether it's general practice, in primary care, whether it's in our hospitals, an understanding that it's a significant burden on the health portfolio, on the health budget. It needs a long term strategy to deal with it, not just in terms of funding hospitals now, but a long term outlook in terms of prevention and primary care, and having a purpose and a direction in terms of trying to reduce the burden of that chronic disease as we go into the decades ahead.

ANDREW GEOGHEGAN: Another priority area was aged care, that he pointed out. That's certainly an issue that you've advocated for, saying essentially there is a crisis in aged care at the moment.

TONY BARTONE: Absolutely, we've had a number of reviews, a number of inquiries, lots of media attention on an area that's really devoid of attention up to now you might say. But the spotlight is firmly focused on the outcomes for our senior citizens at that time of life where they need the access to good quality, long-term care in their twilight years. They deserve the best, they've really served this country well, they've contributed to the growth, to the prosperity that we've come to accept now, and it's our time to ensure that they get the access that they need.

ANDREW GEOGHEGAN: Part of the problem here is that GPs are just finding it too difficult to visit nursing homes and the like to support those people in their older years. What is the solution, as far as you're concerned?

TONY BARTONE: We need to acknowledge that over the last decade or more there's been a significant disinvestment in general practice, in all facets of that care delivery. We've had a long-term freeze in the Medicare indexation, which is only just starting to thaw out now after decades of partial indexation.

We've had virtually no attention to the issues of funding of aged care. We've put out a whole series of pointers, of directions, of policies for the improvement in aged care funding and in aged care excess. And if we look in particular, we're looking at trying- not only is it the Medicare rebate, to incentivise and increase the number of doctors visiting, but it's also the access and the facilities. It's the nursing staff that's really been short and not available for our doctors when we go there. It's about the technology and the access to even just the computer software, and having that communication between our practice and them.

And it's also the non-face-to-face burden of the workload, which is not remunerated and creates that extra burden. We know from our aged care survey that a number of GPs are considering not continuing their present visitation of our aged care facilities. It's a crisis, we need to address that right now.

ANDREW GEOGHEGAN: So, you're calling obviously for more funding in that area, but of course the Government will say: if we're going to pay for that we need to find ways to fund that. How are they likely to do that, do you think?

TONY BARTONE: My job, our Association's job, is to highlight the policies and the needs and the requirements of our patients, of Australians, and the expectations and the needs in the current situation. The way the Government funds that is up to the Government. They are the managers of the entire budgetary portfolio.

We are trying to highlight the needs of the health portfolio, which, in comparison to other countries we still are remarkably efficient and prudent. If we compare with OECD countries, even European comparators, we're significantly less when it comes to the funding of health from Government sources and nowhere near the means of the US and others.

ANDREW GEOGHEGAN: And Tony Bartone, would you be happy for Greg Hunt to remain as Health Minister?

TONY BARTONE: Look, clearly, the ex-Minister Hunt has made an enormous impact in that portfolio over the previous year or so. He came at a time when it was very difficult. He immediately showed an appreciation of the issues.

We're at a critical juncture with the impending election. It's going to be very difficult for anyone else to get across the raft of reviews, of submissions, of other policy initiatives.

We're at a delicate situation with a primary care reform package, we've got an MBS review that's going to wrap up towards the end of this year. We've got private health insurance implementations and out-of-pocket Ministerial advisory committees.

Everything was wrapping to a crescendo and now someone new, potentially, has to come up at a very short period of time to get across that very difficult portfolio. It makes sense to keep the previous Minister in that role.

ANDREW GEOGHEGAN: Tony Bartone, AMA President, thanks for joining us.

TONY BARTONE: My pleasure, thank you.

25 August 2018

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