CATHERINE KING MP
SHADOW MINISTER FOR HEALTH AND MEDICARE
MEMBER FOR BALLARAT
SPEECH TO RACGP GP18
FRIDAY, 12 OCTOBER 2018
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In my five years as Shadow Health Minister, there hasn’t been a dull moment in Australian health policy.
Since the 2013 election, and particularly since the 2014 Budget, we’ve had a series of difficult debates about Australia’s universal health care system – and general practice in particular.
In my previous speeches to this conference, I’ve looked back at those debates and thanked you for your advocacy in them.
But today, I want to look forward – to the opportunities and challenges that I think general practice will face in the next term of Parliament, and over the next decade.
We are no more than seven months from the next federal election. And while we don’t take anything for granted, it’s an election at which Bill Shorten and Labor hope to form Government, and I hope to become Health Minister.
We haven’t announced all of the policies we will take to the election, and like the Government we are still in active policy discussions with the College and others.
But Labor’s vision for general practice is clear:
- We want to live up to the promise of Medicare and ensure timely, affordable access to general practice for all Australians.
- And we want to empower you to practice in the way that you know is best for your patients.
In short, we want to work with GPs to ensure access and improve quality, and I want to touch on both of those in the 10 minutes I have today before taking as many questions as possible.
Last month, I joined Harry and Bill Shorten to help launch the College’s 2018 Health of the Nation report.
It includes the good news and the bad news on access to general practice.
The good news is that general practice remains the most accessed part of Australia’s health care system.
83 per cent of Australians have seen a GP in the last year – compared to 36 per cent who’ve seen another specialist and 14 per cent who’ve visited an emergency department, for example.
But the bad news is that access to general practice is far from universal.
One in four Australians has delayed or avoided seeing a GP in the last year. One in six of those has done so due to cost.
In recent years, our discussions on access have rightly focussed on the Medicare freeze.
Like you, I am relieved that most GP rebates were re-indexed in July, four years after they were last increased in 2014 – as the last Labor Government had budgeted.
But parts of the freeze remain in place, and will continue to impact your patients:
- Specialist procedures and allied health items remain frozen for another year, to July 2019.
- 100 GP items remain frozen for another two years, to July 2020 – meaning they will have been frozen for six years.
- And gradual re-indexation will not restore the more than $3 billion that has been cut from Medicare by the freeze.
That said, the pressure on general practice didn’t begin with the freeze and won’t end with indexation.
The Health of the Nation report shows that GPs still want the Government’s top focus to be Medicare rebates.
And of course, there are a range of barriers to access beyond cost:
- Women and young people are more likely to delay or avoid seeing a GP.
- There are still less GPs and therefore longer waits for patients in regional, rural and remote Australia.
- And Bill Shorten and I have spoken before about our particular concerns around poor access to general practice in residential aged care.
One way to address those challenges is by adjusting fee-for-service payments, which will always remain an important source of funding for general practice.
I look forward to the advice of the MBS Review Taskforce on that possibility.
But the College has actually led the call for new funding structures that both ensure access and reward GPs for practicing in a different way – which takes me to the question of improving quality.
You released your Vision for General Practice and a Sustainable Health Care System more than three years ago, in September 2015.
Two Prime Ministers and two Health Ministers later, I think it’s fair to say we haven’t made much progress.
I do acknowledge the Government’s Health Care Homes trial, and I do hope that the evaluation of the program offers lessons for the future.
But I think Bastian is probably right that Health Care Homes will be remembered as – and I quote – a “two year underfunded trial on the effects of inadequate capitation funding”.
In the absence of leadership from the current Government, the College has provided the principles that should guide reform in the next term of Parliament.
I agree wholeheartedly with you that GP care should be:
- Comprehensive, meaning that it meets most of a patient’s health care needs – and in some cases addresses the social determinants of health;
- Coordinated, meaning that where care is needed in other settings, it is managed holistically;
- Patient-centred, meaning that a patient’s needs and wants shape their care;
- Accessible, meaning care is available when and where it is needed; and
- Safe and high-quality, meaning that GPs are encouraged and rewarded for continuous quality improvement.
As I visit general practices around the country, I am reminded that we have a strong foundation on which to build, because many of you already practice in that way.
For example, when we talk about integration of care, we should remember that 91 per cent of practices already employ practice nurses, and 62 per cent already employ allied health professionals.
Similarly, when we talk about continuity of care and policies to encourage it, we should remember that 78 per cent of Australians already say they have a preferred GP.
And we should always remember that Aboriginal community-controlled health organisations have been providing comprehensive, integrated care for decades.
But clearly, we will not achieve the College’s vision unless and until Commonwealth policy and funding rewards GPs for practicing in a different way.
That’s what the last Labor Government did, for example through the introduction of the Coordinated Veterans Care program.
And I can assure you it’s what a Shorten Labor Government would do, because general practice and your patients depend on it.
Thank you and I’m happy to take as many questions as possible.
MEDIA CONTACT: ADAM GARTRELL – 0427 008 525