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MEDIA
RELEASE |
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040909
Bulk-billing
—
Don’t Focus on a Symptom and Miss the Disease
The focus on bulk-billing is missing
the point in rural and remote communities—they are more concerned about whether
they have access to a doctor at all!” President of the Rural Doctors
Association of
“Bulk-billing
incentives do not address the core issue, which is that the schedule fee does
not represent the true cost of the service. Put simply, if the schedule fee was
realistic and matched the costs of providing the service, bulk-billing incentives
would not be necessary” Dr Page said.
“Rural practice
is simply undervalued and under-funded. No matter which part of the health
workforce is involved, rural patients are more likely to have chronic and
complex diseases which are more likely to be more advanced and more complicated
at the time of presentation. This demands a higher level of skill from the
healthcare professional, who is also required to work with inadequate resources
and without the full range of backup. The hours of work are longer, and the
holidays few and far between.
“GPs in rural
areas must provide a range of specialty, emergency and hospital services
including surgery and obstetrics, and they end up performing a role that looks
very much like that of a Specialist. Yet through the current MBS system, they are
paid less than half as much per unit time for a consultation. To add to it all,
the costs of running the practice business are higher, including transport costs,
phone calls and indemnity.
“The few
Specialists we have in rural areas are also working harder, and without the
usual registrar and administrative supports. Without access to private hospital
income, they are further financially disadvantaged compared to their urban
colleagues.
”RDAA is concerned that a continued focus on bulk-billing means a focus on
delivering rural services at a financially unsustainable level, so we get a
smaller and smaller workforce in the long run. Feeling undervalued is also not
good for the morale of the workforce that remains.
"The evidence that GPs genuinely care
about their patient’s ability to access affordable healthcare is clear from
Australian Bureau of Statistics reports that national GP incomes declined from
2000 to 2002. How many other occupations have taken a pay cut recently?
“However, the evidence is also there to show
that bulk-billed consultations are shorter, as the doctor strives to provide a
discounted service to an impoverished community while still meeting the costs
of paying staff. There are insufficient incentives for longer consultations
which would support better quality medical care for the community (this would
be provided by the ‘7 tier’ reforms), and there are insufficient incentives for
rural consultations of all types.
“Joint research by RDAA and
”Different Medicare loadings for doctors in RRMAs 3-7, which reflect the
greater complexity of providing both specialist and GP medical services in the
bush, already have the support of rural communities. RDAA stands ready to
assist the political parties in further developing the details, to help ensure
the provision of sustainable medical services in rural and remote communities.”
RDAA
President, Dr Sue Page, is available for interview on tel: (0414) 878 385.
RDAA
Vice President, Dr Graham Slaney, is available on tel: (03) 5775 2166 or (0418)
540 223.
Media
contact: Patrick Daley on tel: (02) 6273 9303 or (0408) 004 890.
The Presidents of the State and Territory Rural Doctors Associations are
also available for interview (mobile phone numbers can be provided by Patrick
Daley):
RDA NSW, Dr Peter
McInerney, 02 6545 1600 * RDA Victoria,
Dr Mike Moynihan, 03 5033 1711 *
RDA SA, Dr James McLennan, 08 8842
2100 * RDA Tasmania, (Past-president)
Dr Myrle Gray,
03 6254 5030 *
RDA NT, Dr Denis Chew, 08 8987 3044.