Dr Bartone - Sky News - Federal Election Health Debate

Subject:   Health care in the Federal election campaign

STACEY LEE:         The Coalition has promised cheaper medicine for more than a million Australians, including cancer patients. It's also promised to inject funding in tests and scans to bring down the cost of detection.

Well, joining me live now for more on the debate is the AMA President, Tony Bartone. Tony, thanks so much for your time today. You were there in the room watching on, so who do you think came out the winner?

TONY BARTONE:  Look, it was a very, very robust and interesting debate. There were no real new announcements and we did really want to see an overarching, all encompassing health policy put on show, a vision for Australians to decide in their run up to the election. Obviously, the running early on in the campaign has been made by the Opposition and they've been making a number of announcements on many occasions. And basically, the Minister was putting up his past record. So it was a contrasting set of styles, you might say.

But clearly, there are some areas which still we're hoping to see some further announcements and some further attention and detail as we come towards the election.

STACEY LEE:         So do you think voters have enough to go off if they were looking at both parties' health policies? Do they have enough information at the moment?

TONY BARTONE:  We've already made the comments that there are still some gaps in both parties' plan or both parties' vision as we head towards the election. Aged care was an unusually very silent area of commitment and strategic announcements today, and that is a concern. Obviously, the commitment to primary health care, both by the current Minister and by the foreshadowing of the intention by Ms King to work with the various stakeholders in terms of formulating a primary health care policy into the future, and the importance of primary health care, was obviously very crucial. And that was one of the key takeout messages from the debate today from myself.

Mental health, there were obviously differing approaches to the way mental health policy and mental health planning should be occurring. But I think the absence of a really clear overarching strategy that encompasses both workforce, community programs, and the importance of general practice and the general practice environment, the consulting room, in that mental health care delivery was clearly not really drawn together.

It was very encouraging to hear that one of the first tasks for the Health Reform Commission under an elected Labor government would be to look at the integration of primary health care in the lead up, and especially with a focus on mental health care.

So there was some really good take outs from today, but clearly some more areas which we'd love to have some more detail on as we run into what is t-minus 17 days to the election.

STACEY LEE:         Yeah, the countdown is certainly on. You mentioned general practitioners there briefly. There was a lot of talk about GPs and about the out of pocket costs that some people have to pay. Do you think that's been addressed adequately by either party?

TONY BARTONE:  Clearly, when you're talking about out of pocket costs when seeing a general practitioner, you need to acknowledge one thing, and that is that the cost of- the Medicare rebate schedule has not kept pace with the cost of providing that care. Not just with the freeze over the last best part of five years, but right through the last few decades and beyond. Consistently timed, year after year, lack of appropriate indexation and funding of that MBS schedule has led to the out of pockets. And it's the people who are not being bulk billed, who are actually inheriting that out of pocket cost, that are wearing the consequences of that. And that clearly needs to be addressed in a much more robust general practice funding envelope.

There was a commitment by both sides to continue the reforms that have been notably announced in the Budget by the current Minister and the work of the review committee in that respect. But clearly, more needs to be done. And it was pleasing to hear that commitment to continue that on both sides.

STACEY LEE:         Let's talk about cancer funding now. It's a huge part of Labor's campaign. They've promised $2.3 billion to reduce the out of pocket costs for cancer patients. Health Minister Greg Hunt was arguing against that, saying they haven't done the appropriate modelling and costings. It's pretty hard to argue with more funding for cancer patients. Do you think it was a good move to go after that?

TONY BARTONE:  Look, what we need to realise is that obviously cancer is a very, very serious and a very, very challenging condition affecting countless numbers of Australians. And we all know someone, or are closely touched by someone afflicted by cancer. So their journey is a very important one, and a very, very emotional one. And a very, very seriously confronting one. Two point three billion dollars is a significant- a very significant amount of money. Now, we'll work with an incoming Labor government - should they be elected - in terms of the detail and the implementation, and the process to rolling that out. But clearly, there are more details to come out on that space.

But the key point that I'll make in all of that is that it's really important to note that part of that $2.3 billion acknowledges a bulk billing item number that will be paid for specialist consults, which roughly approximates the AMA's schedule of fees and is significantly, by a factor of double or more, the current MBS schedule. That is the clearest - to me, the clearest undertaking that the MBS schedule is out of step with the cost of providing good health care. And, hopefully, that is a sign of an approach right through the MBS schedule that I'll be taking up should an incoming Labor government be voted in.

STACEY LEE:         I mean, as you mentioned, everybody is touched by cancer in one way or another. I guess that's why this has been considered a good policy by Labor; $2.3 billion in funding. Like I said, it's tough to argue with. But is it appropriate to be spending that much money in one place? Would it be better spent in other areas?

TONY BARTONE:  Look, what I will say is that yes, it's really a very important initiative and a very, very significant amount of money. Yes, the Health budget is more than just cancer. But we need to recognise that, at this stage, we do need an overarching, all encompassing, robust health vision for all Australians not just for the current and immediate future, but for the long term, for the impending challenges that are coming with a growing population, an ageing population, and a population that's increasingly afflicted by chronic disease and morbidity. We need to have a strong robust plan that connects all parts of the health system together to reduce duplication, reduce inefficiency, improve the journey through the system, but also prevention.

And prevention is- we welcome the Opposition's announcement on prevention today. It is a significant step in improvement in what was currently available. But prevention and primary care form the backbone of what we're going to do to manage and deal with the future load on the system. So we need to look at the whole health system in its entirety.

STACEY LEE:         Okay - Tony, we do have to leave it there. But appreciate your time today. Thanks for coming on the program.

TONY BARTONE:  My pleasure. Have a good afternoon.

2 May 2019

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