MEDIA RELEASE

 

 

Friday 26 August 2005

 

Bulk-billing Rate Good News…But a
Rural Complexity Loading Still Essential

 

While the increased rural bulk-billing rate is a welcome sign that more rural doctors may be able to care for their most needy patients while also keeping their practices financially viable, the introduction of a Medicare complexity loading for rural medical practice remains essential in attracting more doctors to the bush, the Rural Doctors Association of Australia (RDAA) has argued.

 

“It is encouraging to see bulk-billing rates increasing in rural and remote Australia, particularly in times of drought and rural depression, since those living in the bush tend to have much lower incomes and yet have higher rates of chronic disease requiring medical attention than those in the cities” RDAA President, Dr Sue Page, said.

 

“Rural doctors are not working in the bush to become rich and they have always wanted to assist those patients who are struggling financially, however they have been caught between a rock and a hard place—if they were bulk-billing patients, they made their medical practices less financially viable.

 

“The costs of running a medical practice are higher in rural areas for many reasons, including differential staff awards, expensive rates for petrol and other consumables, long distance phone calls, greater equipment requirements like resuscitation gear (where there is no local ambulance station) and smaller sized practices with fewer doctors to share the costs. Research undertaken by RDAA and Monash University in 2003 found that approximately 20% of rural medical practices were not operating sustainably, and the figure was projected to reach 55% by 2008.

 

“Ultimately, many rural doctors had to charge their patients a gap fee just to ensure their practice could stay above water and not have to close down, which would then leave their community with no doctor at all.

 

“Federal Government initiatives such as the 100% Medicare rebate for consultations, the rural differential incentive of $7.50 for certain bulk-billed consultations, the introduction of practice nurse items and the Practice Incentive Payments rural loadings have clearly enabled some rural and remote practices to increase their bulk-billing rates and still get over the line financially at the end of each month.

 

“But these hard market forces are not the only ones that leave rural towns struggling to recruit and retain their doctors. The same doctors that have tried to provide healthcare at a price that has been unrealistic, for the communities they care about so passionately, have also been struggling to fit complex patient care into a pattern of consultation items better suited to encounters that are short and simple.

 

“The introduction by the Federal Government of a Medicare loading that specifically recognises the increased complexity of providing a comprehensive medical service in rural and remote areas would greatly assist many of Australia’s most vulnerable medical practices.

 

It would enable rural patients with complicated problems to receive a higher rebate that reflects the expanded service and skill level of their doctor, who is working largely isolated from specialist and other multidisciplinary team back-up.

 

“Any measure that recognises the unique role that rural doctors with advanced skills play in the Australian healthcare system will improve both the viability and the attractiveness of rural medical practice and encourage more doctors to consider moving to the bush.

 

“The advice we have been giving government has clearly worked for bulk-billing rates, and we strongly urge the Federal Government to consider introducing this loading as well.”

 

 

 

RDAA President, Dr Sue Page, is available for interview on tel: 0414 878 385.

Media contact: Patrick Daley on tel: (02) 6273 9303 bh or (0408) 004 890.