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June 18, 2008
I see that the AMA has come out fighting against the proposed extension by the Rudd Government of Medicare to nurses and allied health professionals (such as psychologists and physiotherapists) in response to the shortage of GPs. It is another plank in their resistance to reform as can be seen in campaigning against the government's GP Super Clinics and the doubling of the Medicare surcharge levy threshold.
The core bit in their latest media release, in association with other doctor organizations, states that the Government’s proposed National Primary Care Strategy should ensure that:
- Australians continue to have access to high-quality general practice services;
- General practices are given additional support to allow them to deliver more preventative health care services and tackle the growing burden of chronic disease;
- General practice is the gateway to allow patients enhanced access to other health professionals - including general practice nurses and allied health service providers such as physiotherapists and dieticians;
- Primary health care services in workforce shortage areas such as rural Australia are improved through incentives and assistance to get more general practitioners and primary health care teams in these parts of the country;
- General practice training opportunities and incentives are enhanced so that many of the new medical school graduates choose to enter general practice over the next few years.
Australians, it says, have confidence in their general practitioners having overall responsibility for their primary care needs and that the future of primary health care in Australia should build on this system not undermine it.
I've listed these points in the media release to show how much the AMA is in flight from reality. Two points show this. First, the AMA 's only solution to the lack of GP's in rural and regional Australia is for the commonwealth and state Government to provide incentives and assistance to GP's to get more general practitioners and primary health care teams in these parts of the country. But here already are health professionals there delivering primary care. So why not utilize them? Why not extend Medicare in these parts of Australia to help those who are sick and unwell. Why cannot patients be able to access Medicare-subsidised care without a referral from a GP?
So what does the AMA say in response?:
Reforms that do not support the important role of general practice will progressively erode the health system’s function, patients will experience more fragmented and uncoordinated health care, and primary health system costs will inexorably rise.
Note the phrase--'erode the health systems function'. It has already has been eroded. The reforms are addressing it.
Secondly, the AMA says:
General practice is the gateway to allow patients enhanced access to other health professionals - including general practice nurses and allied health service providers such as physiotherapists and dieticians
Why should the GP be the gateway for a consumer to see a dietician, psychologist or a chiropractor? Why cannot we see them direct?
These two points highlight how the AMA is simply protecting its turf --a demarcation dispute hidden by the rhetoric of public safety and quality health care.
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Hawk: Pilots union.
Howard: wharfies.
Rudd: Doctors Union.
And life goes on.