Houston – “We have a problem”

Recently, at a Labor Party National Health Policy summit, the Leader of the Opposition, the Honorable Bill Shorten asked me “What was the one thing punters in the Bush wanted from Health?”. My reply was simply that people wanted their own doctor and that they wanted to be able to afford to see them.

bill-shorten

That same day I spoke with an ABC Journalist about the lack of doctors in Apollo Bay, a coastal town that is a gateway to the scenic beauty of the Great Ocean Road and retirement area for many older Australians. The interview is one of many that I have had over the last 18 months since accepting the Job as President of the Rural Doctors Association of Australia.

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There are chronic, systemic and perpetual access issues for Rural Australians even in the most beautiful areas of Australia.

Last Saturday crisis talks were held at the Stamford Plaza Sydney Airport with over 80 GP practice owners (that is General practitioners who own their own practices) and a new entity born to the Australian Health Lobby, the Australian General Practice Alliance.

This group has coalesced over two issues the Practice Pathology Rental Subsidy Agreement and the Medicare Freeze, and is looking to cement (or perhaps renovate) the importance of General Practice operated by doctors (not corporate entities) as an important cog in the machinations of health service delivery.

agpa

This weekend Sean Parnell, a Journalist and Health Editor for the Australian, wrote of the issues facing Australians regards Private Health Insurance. Parnell describes a Public Health System starved of funds to the degree that they intentionally access patient’s, seeking public Hospital care, private insurance. This drives up costs and premiums for consumers and families.

That is not too say that the costs of private care are constrained with Australians having the highest out of pocket costs to patients in the world bar one other country (and it’s not the USofA). Private Specialist Services variance in gap fees is upwards of 400% in some parts of our country.

Mike Steketee followed up, further revealing a sick Health System, open to systematic rorting by public health systems and doctors. “Medicare should be protected” says Opposition Leader Shorten; yet the Federal Department of Health, turning a blind eye to its own compliance rules, allows cost shifting and double dipping to persist and grow (for accessing private funds Parnell quotes an average 20% growth each year).

bastian-seidel

Professor Bastian Seidel President of the Royal Australian College of General Practitioners gave a rousing speech at the AGPA Meeting “General practice is under assault”, “we must fight”.

Dr Michael Gannon, President of the Australian Medical Association, spoke about the importance of unity in approaching government, that General practice was the most efficient, cost effective and accessible part of out health system.

For my part, more and more I see problems, the future for private general practice in the bush, or even in a lovely coastal town in not bright. We have more Medical Schools, and more on the way, than ever before.

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We are graduating more medical students than ever in the history of the country, yet there are only two GPs left between Alice Springs and Darwin.

The National Party Assistance Minister for Health Dr David Gillespie predicts a Surplus of 7000 doctors in this country in 15 years (so much so that New Zealand has given up training its own, apparently, and is waiting on a whole bunch of unemployed Aussie Doctors).

Rural health care is unique and it deserves to be supported and protected, we need a properly trained medical, nursing and allied health workforce. We need to tackle maldistribution of health professionals and we need to ensure equity of access to care for our most needful. There are answers to be had and the recent successful passage of the Rural Health Commissioner Legislation is one opportunity.

However, fundamentally we need reform of a sick health system where Public Health is starving and Private Health is misused. Capping and rationing has only led to rorting and inventive abuse of systems and processes that were intended to ensure Universal Access to Care.

We must acknowledge that health care doesn’t happen in tertiary hospitals, it starts at home with wrap around support by a primary care team preventing or acting early when illness strikes, setting the priorities for a sustainable health system that cares for all Australians.

Our System is broke, its headed for a crash, it needs to be fixed. Spending is rampant, uncontrolled and misappropriated. Punters want their own GP and they want to be able to afford it.

Our Political Leaders must acknowledge that party politics has no place in health care, that we need a long-term view, a sustainable source of funding across all systems and services that produces positive health outcomes whether someone lives in Double Bay or Apollo Bay.

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