While numbers can be manipulated (lies, damn lies, and statistics), raw numbers can tell a story. On January 31, the Productivity Commission reported “…total government recurrent expenditure for health services for the latest years covered in this report was $150.9 billion.” Public hospitals cost $90 billion in 2021-22, with primary and community health a mere $55.4 billion.
In 2022, there were 38,881 GPs – 29,921 full-time equivalent (FTE), equating to 115.2 per 100,000 people – a decrease from 120.9 in 2021. In WA, the number of services per person fell to 5.8 in 2022-23 reversing a three-year upward trend and consistent with national trends.
The decrease in GP numbers will not surprise anyone except perhaps the Federal Health Minister who advised patients to “shop around” for the cheapest appointment. Most of us will look for the best holiday deal or price on a new kitchen appliance but also know that cheapest is not necessarily the best value.
There is the adage that an economist knows the cost of everything but the value of nothing. This may be unfair to economists and is more aptly applied to politicians and bureaucrats.
Laws of supply and demand make “shopping around” less viable when demand exceeds supply. The numbers of young doctors electing to go into general practice has shrunk from around 50% to 15%. There is also a demographic cliff looming as “baby boomer doctors” retire over the next decade further reducing the head count and even more potently the FTE numbers. And there is that pesky demand side demographic trend of an ageing population.
There is the adage that an economist knows the cost of everything but the value of nothing. This may be unfair to economists and is more aptly applied to politicians and bureaucrats.
Aside advising “shopping around”, what else is the government offering? MyMedicare bears an uncanny resemblance to the defunct Healthcare Homes, which were going to “revolutionise” primary care. Nobody seems to know how it will work. Ultimately it is a form of financial risk transference whereby the financial risk of health services is transferred from the government to GPs, who will be provided a fixed amount of money to provide services versus the current open-ended system.
And surveys show that the new CPD regime gets a massive thumbs down from doctors as a tick-box waste of time – hardly adding to allure of general practice.
Milton Friedman wrote that if the government was in charge of the Sahara Desert, in five years there would be a shortage of sand. The government has been in charge of the health system for a lot longer. There is an increasing shortage of health services.