Speeches and Transcripts

Transcript - Dr Bartone - Radio National - AMA Presidency

Transcript:   AMA President, Dr Tony Bartone, RN, Drive with Patricia Karvelas, Monday 28 May 2018

Subject:  AMA Presidency


PATRICIA KARVELAS:   Australia's peak medical group, the Australian Medical Association, has elected a new President. Dr Tony Bartone was the Vice President of the AMA. He's also a Melbourne-based GP and he has plans to push for an injection of funding into general practice services in Australia.

Welcome to RN Drive and congratulations.

TONY BARTONE:   Good evening. Thank you.

PATRICIA KARVELAS:   What are the AMA's priorities? What will they be under your leadership?

TONY BARTONE:   The delegates on the weekend heard my message, and endorsed my message, that was one of a significant investment in the health system altogether, but in particular in the areas that address access to services - be they in public hospitals, in waiting lists for outpatients or elective surgery; be that in access to mental health care for our patients with mental illness; be that for access to quality aged care service provision, both in facilities and in home care packages; or be that in that variable service that is rural and regional Australia has been experiencing.

But, particularly, one of the key areas will be a significant investment in general practice because of a decade-long series of systemic and sustained cuts and underfunding, which has seen, really, the squeeze put on that part of what we call primary care, the cornerstone of primary care, because we believe it's really essential, it's really crucial, and really underpins our whole health system, both in the terms of long-term quality of care and keeping patients fit and healthy, and out of hospital altogether.

PATRICIA KARVELAS:   You've signalled that this is a critical time for the AMA, the Australian Medical Association. Why is it such a critical time?

TONY BARTONE:   It's a critical time because we've seen – we’re at an inflection point, really, after coming out of a series, a long time of indexation freeze - an indexation freeze which has been sustained for almost five years and really has put pressure on the viability of practices around the country.

But also because what we do know is that out-of-pockets have gone up for patients during that time, especially underpinned by that freeze in rebates, but a longstanding lack of investment in the rebate structure. So clearly, we need to have a really sustained and long-term discussion about reform and a vision for our health system, especially in face of a growing need and a growing demand and a growing change in both the delivery, and also the ageing population and its increased issues with increased illness and co-morbidity.

PATRICIA KARVELAS:   Your predecessor was very critical during the last election campaign of the Labor Party for the so-called Mediscare campaign, as it's become known. Were you also critical of that?

TONY BARTONE:   Yeah, so that was entirely an issue that was really predicated on misinformation at the time, and clearly had the intention of seeking to focus on health, but for areas of misinformation. That Mediscare was about back office technology solutions to the running of Medicare offices, essentially, to put it simply. And that was really never envisaged, using that as a target to attract attention to an area that's obviously the focus of what we're talking here tonight.

PATRICIA KARVELAS:   Will the AMA be actively campaigning in the Federal Election that we could see by the end of the year, or at least early next year?

TONY BARTONE:   What we'll definitely be sure about progressing in the lead-up to the election campaign, whenever it's called, is to make very clear our priorities and our need to communicate the investment that's required, the attention to health service delivery, and understanding that the problem of demand and the resourcing of that demand has to have a long-term structured solution for all of our community, so that we can address the issues of access and timeliness of care and equity across the entire Australian population.

PATRICIA KARVELAS:   A Melbourne medical practice received a lot of attention on social media this week for appearing to charge patients more to see female GPs, allegedly because women's issues take longer. Now, the Health Minister has called the practice offensive and potentially discriminatory. Do you agree?

TONY BARTONE:   No. Look, this is a really interesting point here. It's not that women's issues take longer, but it's really to understand that our consultation is driven by the personalities involved in that consultation, and by the number of problems that are brought to a consultation. Obviously, a significant number of women patients prefer to see a female practitioner, and they do want to have longer consultations. So that in itself shows clearly that female practitioners care significantly about their patients and want to invest the time, and that consultation fee, which really has to reflect the cost of provision of that service. We know that, from research and from studies, women GPs actually earn less per hour than their male counterparts, and that's because they tend to spend a lot more time for the same unit of Medicare billing.

Medicare billing is a time-based billing as a general rule, and they're in bands. So if you were to go to your solicitor, for example, lawyer, whatever, they usually charge on increments of five minutes. Those five-minute increments don't occur in our practice. They're much more larger increments. That's merely a reflection of what I would imagine was underpinning the decision of that practice to charge the variable amount.

PATRICIA KARVELAS:   So you're saying women want longer consultations and they should pay for it?

TONY BARTONE:   No, no, I'm not saying that they should pay for it. What I'm saying is, if you look at a female GP, in this case, was obviously feeling that she was looking at the cost of running her practice. That's an entirely appropriate situation to be in. Now, when running your practice you need to take into account your overheads, and you need to take into account how much you should charge to cover that.

Clearly, if that GP was feeling that she was seeing less consultations per hour, it's entirely appropriate that that be reflected back into that. It's not that she was trying to charge more or take opportunistic advantage of her position as being a female GP for female patients. It's looking at the cost of running a quality practice. You need to look at both sides of the equation, your inputs and your outputs, as does any other person in small business, which is exactly what we're talking about here.

PATRICIA KARVELAS:   Is there actually any data that you can point to, saying that women want longer consultations?

TONY BARTONE:   What I can show you is that there is significantly good research, evidence, and studies that I’ve read on many areas, including articles just as recently as last weekend, that will show that female GPs earn less per hour, and overall, than their male counterparts.

PATRICIA KARVELAS:   But in terms of the demand from female patients?

TONY BARTONE:   Well look, I've been running and involved in general practice for over 30 years at a number of clinics in that time – a fairly detailed participation in the industry. The economics of running a practice are what they are. And we know from fact that women consultations run longer than the male GP consultations. As BEACH data that we will look at - which is no longer collected but used to be collected under previous governments and was disbanded in 2014-2015 as part of one of the first Abbott Budgets - will show that data, will show that we actually as a profession, we're spending longer with our patients than ever before. In each consultation, we're dealing with more problems than ever before. Obviously, in that situation, we're seeing that this female GP was making an entirely appropriate, independent assessment of what she felt that she- with the inputs and outputs of the costs to try and obtain the same …

PATRICIA KARVELAS:   So the Minister is wrong to be concerned?

TONY BARTONE:   The Minister- I’ll be meeting with the Minister, we'll address this issue and try and clarify the misunderstanding in this place.

PATRICIA KARVELAS:   Dr Bartone, congratulations and thanks for joining us tonight.

TONY BARTONE:   My pleasure. Have a good evening.

PATRICIA KARVELAS:   Dr Tony Bartone is the incoming President of the Australian Medical Association.


29 May 2018

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761
                          Maria Hawthorne                02 6270 5478 / 0427 209 753

 

 

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