BULK-BILLING would come under threat in the Hunter if a $20 cut to rebates for consultations less than 10 minutes passed the Senate, the chairman of the region’s new GP association has warned.
The Hunter General Practitioners Association was launched this week to act as an “independent and local” voice for GPs at an uncertain time for Australian primary healthcare.
Chairman of the group Kotara GP Dr Tony Isaac said Hunter doctors felt “insulted” and “devalued” by last-minute federal government changes to Medicare that would ultimately make bulk-billing “unviable” for shorter consultations.
In the first change set to take effect on January 19, the Medicare rebate for most consultations lasting up to 10 minutes will drop from $37.05 to $16.95, meaning if a doctor bulk-bills they will earn $20.10 less for the consultation.
If the doctor charges a private fee the patient would be out of pocket an extra $20.10.
The move will require the Parliament’s endorsement when it meets in February.
However there are signs it could be struck down in the Senate because Jacqui Lambie, Ricky Muir and Nick Xenophon are strongly opposed to the changes.
If Labor joins the Greens in also opposing the rebate cut, just one more crossbencher would be needed to unwind the policy.
“The cuts to the rebate ... will be so much it will be impossible for the practice to bulk-bill,” Dr Isaac said.
“We have to pass those costs on; we can’t absorb them, they’re too great. That will basically mean the end of bulk-billing or I fear that practices will be unviable.”
Last financial year 26per cent of consultations billed to Medicare were less than 10 minutes.
The federal government says it is implementing the change to make Medicare more sustainable and to stop doctors rushing patients through their rooms to increase their revenue.
But Dr Isaac said the vast majority of GPs in the Hunter were not rorting the system.
“Most doctors would see four patients an hour, maybe with a nurse-assisted consultation,” he said. “We’re not churners. The majority of us are really good, well-qualified doctors who worry about our patients.”
To create more savings, the government will also freeze the indexation of rebates until 2018. Doctors are concerned about income not staying in line with rising costs like rent, electricity and wages.
Then on July 1 there will be a further $5 cut to all Medicare rebates for GP consultations for non-concession patients (that is everyone except pensioners, concession cardholders and children under 16).
“That will really hurt the working poor,” Dr Isaac said. “The triple whammy is undermining Medicare – I think it’s an ideological attack on Medicare by the federal government.
“And this is all coming on the back of a whole series of cuts over the last few years by both sides of government that have undermined general practice.”
Dr Isaac said that local doctors decided to form the Hunter General Practitioners Association so there would be a strong and united voice on local GP issues.
The group’s formation comes at a time when Hunter Medicare Local – the region’s primary healthcare organisation which runs GP Access After Hours – is moving to a Primary Health Network, meaning it will stretch from Taree in the north to Gosford in the south and west to Tamworth and Qurinidi.
“The problem is we probably just don’t know what they [Primary Health Networks] are going to look like because the government has been so slow in telling us,” Dr Isaac said.
“What’s going to happen to GP Access After Hours?
“At the moment it’s only funded until the end of June – the community deserves better than that.”
From January 19:
For six to 10 minute consultations the rebate will drop from $37.05 to $16.95. This means if the doctor bulk bills they will lose $20.10 for the consultation. If they charge a private fee, you will receive $20.10 less back from Medicare.
From July 1:
Medicare rebates for all GP consultations will be cut by a further $5 for non-concessional patients (meaning pensioners, concession card holders and people under 16 will not be affected)
This means for consultations between six and 10 minutes the rebate will be brought down to $11.95; $32.05 for 10 to 19 minutes; $66.70 for 20 to 39 minutes; and $100.55 for more than 40 minutes.