Dr Omar Khorshid on new AMA campaign to Modernise Medicare

OMAR KHORSHID:             Thank you for joining me. I'm here today to launch the AMA's Modernise Medicare campaign. And this is a campaign aimed very much at the Federal election to outline the urgent need for reform in the community care, in general practice and in primary care. Medicare is the bedrock of our primary care system, and a lack of attention to Medicare over decades has led to a situation where our primary care sector is really struggling, GP practices are struggling to deliver care that patients need, and patients with chronic conditions are ending up in hospitals, ramped outside hospitals in ambulances because we are unable to look after their care properly in the community. So, it is time to reform Medicare and to make Medicare fit for purpose, to deliver on the health needs of Australians.

To do that we need substantial reform. And, in fact, there has been a conversation around that for the last few years with the Government and with many stakeholders leading to the release of the Government's 10 Year Primary Health Care Plan at the last budget. Now, unfortunately, this plan has not been funded.  So, a plan that isn't funded is a plan that sits on the shelf and never gets implemented and the care of Australians won't change. So, it's time for action and we are asking all Australians to talk to their politicians about the need for reform.

Now in terms of our vision for the future, our vision for a modern Medicare, it is a vision around designing the system to look after the care of people. We're talking about more time for patients with their GPs. We're talking about more care leading to better health, more health. Those are the three main themes of our campaign. And when you look at what's actually going to change, we're talking about having a medical home, having a place where you will always go for your health care, a place that keeps your records, that knows who you are. And when you go to that medical home, you will not just receive care from a general practitioner, but from nurses, physios, from pharmacists, from dieticians, from a multidisciplinary team who can actually look after your health needs the way that you want and deliver that care under one roof, rather than requiring multiple referrals and resulting, I guess, in our fragmented health care system that we have at the moment.

Now, we also need to specifically fund some other good ideas that are supported not just by the AMA but by all players in the primary care space. Ideas such as keeping GPs’ hours open longer, so that you can see the GP when you need to see the GP rather than when it's convenient for the practice during office hours. It's not a major change to deliver that, but it's something that successive governments have failed to do.

Similarly, we've got suggestions around wound care. Right now, if you have a chronic wound and you require dressings weekly or every few days, you've actually got to go buy those things yourself from the pharmacist and then go to the general practitioner to go and have that applied. You pay a high retail price, and of course that reduces access to care; some people simply can't afford it. So, a scheme for Medicare to actually subsidise wound dressings, to allow GPs to provide those dressings to patients for free in the practice is something that we know will reduce healthcare costs overall, and of course will reduce out-of-pocket costs for patients.

So, these are just some of the ideas around modernised Medicare, but a key one is to address the workforce shortages that we have in general practice. We need to make general practice as a career attractive to young doctors. And right now, it simply isn't, partly because it's stuck in the past in terms of the funding system through Medicare, but also because young doctors that enter a career in general practice immediately lose their workplace entitlements like leave, maternity leave, sick leave. They lose money; they actually get paid less immediately the moment they step out of the hospital and into general practice. And we need to look at that to make sure that we are attracting the best and brightest of our medical graduates into general practice, because we know investment in general practice will lead to better health care outcomes for Australians and will lead to a reduced reliance on very expensive hospital care.

Now I'd like to just contrast this vision for Australia's future with what's been announced so far in the election campaign. We've heard today about the proposal from Labor for 50 urgent care clinics to be located around the country. This sounds a lot like the failed GP super clinic model from over a decade ago, one that led to practices being built that ended up competing with local practices, ended up making absolutely zero difference to hospital waiting lists, and zero difference to the quality of primary care delivery in the community. Ideas like this may sound good, they'll be superficially attractive. The idea of keeping people out of hospital makes a whole lot of sense. But in fact, when you scratch the surface, you see a model that is piecemeal, that fragments care even more, and does nothing to improve the average patient's experience in primary care. There are around 8000 general practices around the country, and a measure that allows 50 of them to open after hours is one that's going to make very little difference to the average Australian. 50 out of 8000 practices will be supported under this model, and it really is just another experiment, and it's an excuse to not look at these deeper reforms.

So right now we've got both parties that are failing the needs of Australians when it comes to health care. The Liberal Party and the Coalition Government have got a plan, they've got the 10 Year Primary Health Care Plan, but they've failed to fund it, and that plan will sit on the shelf unless the Coalition, during this election campaign, commits to actually funding this reform that they have worked so hard along with all the stakeholders to            develop.

And what we need from Labor is not piecemeal, ill-thought out ideas where they haven't consulted with general practitioners and emergency doctors. What they need is to address the deeper issues in our health system, such as the need for Medicare reform, to commit to the 10 Year Primary Health Care Plan, and of course, to address the urgent need for extra funding in our public hospital system. Without commitments like these from major parties, the health of Australians will deteriorate over the course of the next term and the term after that, because we've come to a point where both primary care and the hospital system are in crisis and it's time for a change -- and it's time for courage, not to try and appear to be a small target, or pretend that we've spent enough on health in the last few years and it's time to move on to other issues. Health is of critical interest to all Australians, we know that, and we're calling on Australians to remember that when it comes to voting day on 21 May.