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Shadow Minister believes government is overseeing the demise of bulk billing; Minister says rate of decline is disappointing but is working to solve the problem.

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Monday 10 February 2003



LINDA MOTTRAM: The federal government was warned more than a year ago that if it didn’t act the rate of bulk billing by doctors, a keystone of Medicare, could continue to fall significantly, according to internal Health Department documents, and the federal opposition says that it is proof that the government has been breaking down Medicare by the back door by ignoring its decay. The Australian newspaper has obtained the documents and the federal Health Minister concedes that the rate of decline in bulk billing is disappointing. Matt Brown reports.


MATT BROWN: The government says it is concerned that an increasing number of doctors are turning away from bulk billing their patients, but the Shadow Health Minister, Stephen Smith, says he now has proof—in the form of internal Health Department documents—that the government has been twiddling its thumbs while Medicare has been crumbling.


STEPHEN SMITH: John Howard couldn’t destroy Medicare and bulk billing through the front door in the 1980s when he was Opposition Leader because he couldn’t get public support. Now he is happy, by process of stealth and attrition, to see that occur through the back door, and that’s what these documents prove.


MATT BROWN: According to Stephen Smith, the documents, obtained by the Australian newspaper under freedom of information laws, prove that the government was warned more than a year ago that Medicare was faltering and that those warnings have come true.


STEPHEN SMITH: What the government was told as early as December 2001, a month after it was re-elected, was that without doing something, without intervention, bulk billing would continue to decline, would decline rapidly, and might decline as high as a percentage point a month. And if you look at the official release statistics in the September quarter figures which were released last year, there is a 2.7 percentage decline since June. So that is 2.7 over three months; that’s getting close.


MATT BROWN: But it is not like health has been forgotten by the voting public. During the last election, academics from the Australian National University surveyed thousands of Australians about their key concerns. That research will be detailed later today, and one of those involved, Doctor Shaun Wilson, says voters have kept their eyes firmly on the issues the opposition is trying to pursue.


SHAUN WILSON: Concern for declining standards in public health care, Medicare, was quite across the board. There was a very large number of Liberal voters who were also concerned about this, and this seems to be the number one policy issue in Australia that is currently contributing to the big shift away from preferring tax cuts and the shift across to preferring high social spending.


MATT BROWN: Labor’s Stephen Smith claims the government’s been ducking the decline in bulk billing for too long to be sincere about finding a solution.


STEPHEN SMITH: People might recall, on the last day that parliament sat last year, John Howard saying that it wasn’t factually correct that bulk billing was in trouble. The Health Minister has been out there saying the figures are disappointing. We say it is a catastrophe. The release of these documents prove that and the government has known that and the Health Minister has known that since one month after they were re-elected in November 2001.


LINDA MOTTRAM: Labor’s health spokesman, Stephen Smith; Matt Brown with that report.


The federal government denies that it is trying to dismantle Medicare, with the Health Minister, Senator Kay Patterson, saying that she is trying to find a solution to the decline in bulk billing. Matt Brown has been speaking to the Minister.


KAY PATTERSON: I have said it is disappointing. We are looking at the issue of access and affordability. It is no good just hiding behind and building up bulk billing rates which you could do and get them back up to the levels they were when we first came in, last year and the year before. But what that did was hide inequalities. It hid the fact that there were people in areas where there were fewer doctors not being bulk billed and there were people in city areas and areas where there were a large number of doctors being bulk billed.


MATT BROWN: But presumably you are not admitting that this is a deliberate policy of running down bulk billing to expose those inequities?


KAY PATTERSON: No, it is not a deliberate policy to run down bulk billing. What I want to do is to make sure we have fairness, we have equity, and we have reasonable access.


MATT BROWN: You were advised in December 2001 that, without intervention, bulk billing could continue to fall and fall significantly. That is a year ago.


KAY PATTERSON: I wasn’t advised. I believe there is a departmental document; but I was concerned when I got the first figures. I have been looking at it. I am working on it.


MATT BROWN: It is year gone by, Minister. What’s been going on?


KAY PATTERSON: I will work on the way that increases access and equity, and one of those is by increasing the number of doctors in rural areas. And we have about 14 programs to increase access in rural areas. Labor had a maldistribution of general practitioners which was one of the factors which has driven bulk billing down.


MATT BROWN: When you announced in November last year that the figures had fallen, you said then that you were examining ways to ensure the affordability of GP visits. Has there been any progress?


KAY PATTERSON: I am working on it. The department and I have been working very closely. These things always take time and of course they have to fit into budgetary cycles. There’s always bids with all the other departments.


MATT BROWN: Has it been hard for you to get up a solution given the way the budget is being managed now?


KAY PATTERSON: I am concerned about the issue but what I will do is ensure that we have a system which encourages equality and equity for people accessing general practitioners.


LINDA MOTTRAM: Federal Health Minister, Senator Kay Patterson, speaking to Matt Brown.