After serving as Minister for Mental Health and Ageing in the Gillard Government a decade ago, Mark Butler now has the challenging health and aged care portfolios to sort in the Albanese Government.
Here he talks to Medical Forum about his top priority to reform Medicare, and fix primary care which he argues is “in worse shape than it’s been in the entire Medicare era.”
MF: Minister Butler, you have said primary health care is in crisis in Australia. What has got it to that point?
MB: What we’re seeing today is the unfortunate result of nine years of neglect. Primary care is in its worst shape since Medicare began. Across the country we hear stories of Australians not being able to get in to see a bulk-billing doctor or GPs changing from bulk billing to mixed billing. It’s never been harder or more expensive for Australians to see a GP.
The former government froze the Medicare rebate for six years, ripping billions of dollars out of primary care and causing gap fees to skyrocket.
MF: How will the outcome of the Strengthening Medicare Taskforce differ from the former government’s 10-Year Primary Health Care Plan and not become just another report?
MB: The Strengthening Medicare Taskforce is backed by genuine investment to support its work. It will provide recommendations to the government on the highest priority investments in primary care by the end of 2022.
We have committed to the $750 million Strengthening Medicare Fund from 2023-24 to to support the priorities identified by the taskforce and the government will respond to its recommendations in the 2023-24 Budget.
MF: Only about 15% of medical graduates are choosing general practice (in Western Australia, this has fallen from about 40% in the early 2000s). What can be done to make this career path more appealing?
MB: I have already brought together representatives from across Australia’s health workforce, including unions, employers and other stakeholders to discuss how best to grow and support this vital sector.
Over the next two months I will continue to meet with frontline health care workers, including students and those who have recently left their positions, to understand their issues and what governments can do better.
This work will inform and advise our new Health Workforce Taskforce as well as the Jobs and Skills Summit process.
The Government is working towards the transition of the Australian General Practice Training program to a college-led model by 1 February 2023. The transition will provide the GP colleges with direct responsibility for the delivery of training including marketing of the program. As part of the marketing and delivery of the program, the GP colleges will play a central role in making a career in general practice more attractive to junior doctors.
The Government is progressing a program of work to further support junior doctors to consider a career in general practice.
Significant incentives are also in place to support GPs and GP practices – such as the workforce incentive program. How these are shaped and targeted is to be considered as part of the Strengthening Medicare Taskforce.
MF: Many GPs are finding it economically unviable to bulk bill their patients and patients are facing higher out-of-pocket costs. Can you ease financial pressure for both GPs and their patients?
MB: The Government has committed to new investments of more than $1 billion in general practice and primary care.
This includes:
- the $750m Strengthening Medicare Fund
- $220 million for Strengthening Medicare GP grants of up to $50,000 per practice (see below)
- $146 million in support of rural community access to primary care.
The Strengthening Medicare Taskforce is made up of a diverse group of health experts and consumer representatives who will provide practical advice to help us start fixing our health care and make it easier for Australians to see a doctor.
It will identify the best ways to boost affordability, improve access, and deliver better support for patients with ongoing and chronic illness.
MF: The government’s reforms to Medicare include $220 million for a GP grants program. How will that help practices in real terms?
MB: The $220 million Strengthening Medicare GP grants program will support general practices through one-off grants of up to $50,000 to:
- enhance digital health capability;
- upgrade infection prevention and control arrangements to ensure infectious respiratory disease (e.g. COVID, influenza) patients can be safely seen face-to-face; and/or
- support practices to maintain and/or achieve accreditation against the Royal Australian College of General Practitioners Standards for General Practice, under the General Practice Accreditation Scheme – to promote quality and safety in general practice.
Further detail is expected to be announced in the context of the October 2022 Budget.
MF: With almost half of Australians having at least one chronic health condition and needing continuity of care, does the current funding model for general practice need to change – i.e. moving to a blended funding model or an annual budget for a patient’s care from their GP?
MB: The Strengthening Medicare Taskforce is considering the sustainability of general practice and in that context possible changes to funding models to support quality of care and better outcomes for patients.