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Doctors want more Medicare changes. -

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ELEANOR HALL: Australia's doctors say the Federal Health Minister has not quite given them the
Christmas present they were hoping for in the form of a simplified Medicare system.

The Minster, Nicola Roxon, announced changes to the Medicare rebate structure this morning.

But the Australian Medical Association and the College of GPs say that while they welcome the
simplification, the Government has missed an opportunity to do more, as Kirsten Aiken reports.

KIRSTEN AIKEN: Doctors don't want to appear ungracious but say the simplifications to Medicare have
been a long time coming.

ROD PEARCE: This was an '07 promise, that we discussed in '08 and they've announced in '09, to
bring through in 0-10. So it's a slow process for stuff that we thought was essential.

KIRSTEN AIKEN: Dr Rod Pearce is the chairman of the AMA Council of General Practice. He says the
principal change to the Medicare structure will make life easier for doctors and he believes
patients too will notice the difference.

Could you give me an example of how these so-called simplifications will actually work in the
consulting room? What will patients notice when they go to see their doctor?

ROD PEARCE: In the past we've been told that if a person and we know over 65, 85 per cent of our
patients have five conditions or multiple morbidities, so if they brought a question about each of
those five different complaints and the time was more than 20 minutes, the old interpretation was -
well sorry it's only five simple problems so therefore it's not a complex consultation and it's not
eligible for a higher rebate.

If the doctor then charged an appropriate fee the patient was going to receive a lower rebate. Now
there's clarification around that so there's no pressure on the doctor or the patient to either
misinterpret it or to misunderstand that it is okay to bring in a list of problems if you've got
multiple issues you want to talk with your doctor.

KIRSTEN AIKEN: The president of the Royal Australian College of GPs also welcomes the Government's
reforms.

Dr Chris Mitchell.

CHRIS MITCHELL: There's also been some clarity and simplification in terms of home assessments and
what is called in general practice, GP management plans, and team care arrangements. Now they're
where GPs work with allied health providers to provide a sort of basket of care for our patients.

And there has been some simplification for the review of those. Again that simplification is always
appreciated.

I guess one of the small disappointments that general practice has is that we really were hoping to
see general practice better recognised for the role it has in terms of disease prevention.

KIRSTEN AIKEN: The organisations representing Australia's doctors admit they had expected more from
today's announcement.

Dr Pearce from the AMA is hopeful it's the start of a longer process of reform.

ROD PEARCE: Also the simplification of Medicare that was promised was um, we thought was going to
be all about Medicare whereas it was eventually narrowed down to only GP items and then it had to
be cost neutral with some major restrictions on the restructure.

So an opportunity to simplify Medicare for a whole lot of reasons and it's a small change that
we've welcomed. It's a bit late, but it's a good start.

KIRSTEN AIKEN: According to the Royal Australian College of GPs' president Dr Chris Mitchell, the
Government must now focus on the reason why doctors are choosing to leave general practice in
favour of moving into specialty medicine.

Dr Mitchell says the basis of the GP shortage also lies within the structure of Medicare.

CHRIS MITCHELL: The community is aware there is a major general practice workforce shortage. Since
2000 GP supply has actually fallen by 2 per cent. In that time specialists or other specialist
supply increased by 17 per cent.

And part of the problem is the mismatch between rebates for generalist consultations, for GP
consultations and for consultations by specialists.

So I think going forward, the college would certainly like to see some work towards better equity
between the rebates for GPs and specialists.

KIRSTEN AIKEN: Health Minister Nicola Roxon says she is open to discussing further changes.

ELEANOR HALL: Kirsten Aiken reporting.