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29 Jan 2019

Transcript: AMA President, Dr Tony Bartone, ABC Radio Melbourne with Jacinta Parsons and Sami Shah, Tuesday 29 January 2019

Subject: AMA Pre-Budget Submission; My Health Record


JACINTA PARSONS: We are going to be talking about health funds, Sami Shah, actually because the Government is promising money left, right and centre.

SAMI SHAH: Well, the Government is going to be announcing or at least they're prepping to announce their pre-election budget; and the Australian Medical Association has got their list of things that they would like to see prioritised, ready and raring to go. Dr Tony Bartone is the President of the Australian Medical Association. Good morning, doctor.

TONY BARTONE:   Good morning.

SAMI SHAH: What would you like to see the money spent on right away?

TONY BARTONE:   Essentially, the core of what we would regard as our Australian healthcare system - so we would like to see money spent on public hospitals; we want to see an improvement in general practice funding in the primary care space; and of course, we also want to see the - it's quite topical at the moment - the shortfall of funding that is in the aged care space that has really caused a lot of consternation to the average person worrying about their elderly loved ones in a retirement place.

JACINTA PARSONS: The other aspect that we've been talking about in this State, particularly, is around mental health and spending in that sector. Is that a focus of yours as well?

TONY BARTONE:   When we really look at the whole of the health portfolio, of course, mental health is a key component of that and that will figure heavily in our pre-Election document that we will put out between the Budget and when the election is called. But in focusing on the Budget itself, we've focussed on these four core areas, the five core areas in particular at the outset. Mental health is obviously a core part of the Health Budget. It's a core part of the wish list, and it obviously figures in our pre-Budget submission.

SAMI SHAH:            How much are you asking for, for all of this?

TONY BARTONE:   Well, this is the problem. We really don't have a vision [in Australia]. We don't have a strategy that looks long-term into the future. What we do know is that our population is ageing and is subject to increasing number of chronic diseases and complexity. We know that medical technology is becoming increasingly more expensive, and we know that when you've taken money out of the system, as we have with the Medicare freeze which is money for patient rebates, essentially, over the last nearly four, five years, that something has got to give. And we're talking about re-putting at least that money back in and more to cope with the growing population and the growing complexity and demands of illnesses in our population. So it's not a small sum. It's going to run into a significant amount of money, and this is part of the conversation that we're having with the Minister and the Government as we lead into the Budget.

SAMI SHAH: [Talks over] In your conversations with the Minister and the Government, overall, have you found any appetite for this kind of expenditure? As you said, they have- previously, the money has been taken out of certain areas. Would they be willing to put, not just money back, but also larger amounts of money that were previously there?

TONY BARTONE:   Certainly, the Minister is understanding of the significant complexity and demand that the- the Minister is well aware of the burden of mental health disease in our community. He's well aware of the general practice and primary care space, at the lack of funding that has been commensurate over the last decade or more, in particular. And so he certainly has an appetite for those particular areas, but we can try to also increase the awareness when it comes to the aged care funding, in particular, as well as home care packages in that space, but also right across the board. We’ve got the issue of public hospitals, which really, if you look at the performance data, largely over the last four or five years, it shows performances which are really sort of standing still when you look at things like the time spent to be seen in emergency departments or the waiting list for elective surgery across the nation in the various hospitals.

JACINTA PARSONS:  You've got specifics here as well, looking at general practice - a request to have longer visit times for patients. Is that going to come though, at an extra cost for patients? Or is this hoping to actually roll this into currently what is seemingly a pretty expensive experience to have?

TONY BARTONE:   What we need to understand is the MBS rebates underpin a lot of the activity in that space - be it in terms of a patient rebate or in terms of the bulk-billing moiety that's paid back to the doctor when the patient is bulk-billed. So unless you address the MBS rebate, you're not going to address the cost of providing those longer consultations, which we know form the crux of good, mainstream, 21st century primary care and will lead to a decrease in unnecessary outcomes down the track; keep patients out of hospital and keep them more for longer.

JACINTA PARSONS:  Now, Kerryn Phelps came out yet again, she's been a- I guess, has had lots of criticisms around the My Health Program. The AMA has been support- the questions have been around security for that. Have you seen the Government shifting in making the sort of changes that more of the population would be comfortable with?

TONY BARTONE:   Right through the back end of 2018, both parts of the Houses of Parliament, including the Government, have worked together to increase and improve the legislation and the security around the My Health Record. I feel that what we've now ended up with is a far better product than what we started the year with; and really, Australians can be assured that it's as good as possible, and it is going to aid in the clinical outcomes of a vast number of Australians, and prevent unnecessary medication errors, unnecessary hospital re-admissions. It's going to help with the mapping out the journey that is very complex through the whole health system, and hopefully become that backbone that improves the communications and connectivity that is sadly lacking in our health system at the moment.

SAMI SHAH:  We are speaking with Dr Tony Bartone, President of the Australian Medical Association. 1300-222-774. If there's money going to be thrown at the Health Budget, what would you like it to be spent on? Where would you like some priorities to be?

Doctor, with this kind of thing, it's usually a negotiation, and negotiations mean you go in with the list, you get some of them, you don't get others. The Government might see it that way as well. What are the ones that, for you, are just you have to have those, and they are no-budge areas?

TONY BARTONE:   Well, clearly, primary care, which is the cornerstone of the health system in Australia which has been completely disinvested in, as I say, over the last decade, has to be our number one priority. This has been an area, a time where we really have the opportunity. We've got all the reviews. We've got all the consultation. All the various groups have come together, and we clearly have a strategy for trying to communicate what are the building blocks necessary to improve general practice.

Public hospitals is the other thing that Australians really depend upon. They love their hospitals and they want to see that the investment in that hospital continue, to allow the access that we regard as first class right across the world; and we want to see that enshrined going forward.

SAMI SHAH:  Well, let's see how the Government decides to spend that money. Thank you so much, Dr Tony Bartone, President of the AMA.


29 January 2019

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Published: 29 Jan 2019