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Tuesday, 19 August 1980
Page: 458


Mr Hayden asked the Minister for Health, upon notice, on 16 October 1979:

(   1 ) What was the (a) doctor, (b) general practitioner, (c) surgeon/anaesthetist, (d) pathologist, (e) radiologist and (f) specialist to population ratio and rate of increase on the previous year for the years (i) 1960-61, (ii) 1964-65, (iii) 1969-70, (iv) 1970-71, (v) 1971-72, (vi) 1972-73, (vii) 1973-74, (viii) 1974-75, (ix) 1975-76, (x) 1976-77, (xi) 1 977-78 and (xii) 1978-79.

(2)   What were the per capita services utilised and rate of increase on the previous year for each category referred to in part(l).

(3)   What was the average cost of each service referred to in part (2) (a) in current value and (b) in constant prices.

(4)   Can he state what were the movements in average weekly earnings and the Consumer Price Index for those years referred to in part (1).

(5)   In providing the statistics for parts (2) and (3) will he make any appropriate adjustment for the cost of the excessive over-run from 1974-75 into 1975-76 for medical services incurred in the earlier year and also make suitable adjustment to the total number of services because of that over-run.


Mr MacKellar - The answer to the honourable member's question is as follows:

(1)   Data on the year by year size and composition of the medical workforce have not been published by official Government agencies (e.g. Medical Registration Boards and State health authorities).

The only source of which I am aware which provides comparable data on the number of medical practitioners over the whole period sought, is the commercial mailing agency, Permail. Data from this source, using the classifications adopted by Permail, have been used to produce the ratios set out below. For the purpose of calculating these ratios, the number of practitioners was that obtained at a date (which is shown in brackets) as near as is available to 31 December; the population estimates are as at 31 December each year (the midpoint of the financial year).

NUMBER OF MEDICAL PRACTITIONERS PER 1,000,000 OF POPULATION AND PERCENTAGE CHANGE

Australia

Date of Population Estimate (Date of Data from Permail)

General practitioners

Surgeons Anaesthetists

Pathologists

Radiologists

All Specialists

All medical practitioners percent change from previous No. period percent change from previous No. period percent change from previous No. period

No. percent change from previous period per cent change from previous No. period percent

No. from previous period

(11.1.79)

(a)   'n.a.' means not available.

(b)   The classifications above are those adopted by Permail. 'Surgeons/Anaesthetists' above refers to Permail classification 'Eyes', 'ENT, 'Surgery', 'Paediatrics', 'Orthopaedies', 'Heart', 'Neurosurgery', 'T.B. and Chest', 'Urology' and 'Anaesthetics'.

(c)   Permail revised its statistics at various limes.

(2)   The answer to part (2) of this Question is divided into two parts - Part A and Part B.

PART A

Table A below shows the particulars for total medical services for the years requested from 1960-61 . As there is a break in the series of statistics available, two series have been supplied for the years for which each is available. Both series are available for the years 1969-70 to 1974-75. The different series reflect the changes in the prime interests of the time in relation to health insurance. The technical differences are outlined in the Footnotes to the Table.

Table A

NUMBER OF SERVICES PER PERSON COVERED

Series (I) Series (2)

Percentage Percentage increase increase from previous from previous

Year Number period Number year

1960-61 1964-65

1969- 70

1970- 71

1971- 72

1972- 73

1973- 74

1974- 75

1975- 76

1976- 77

1977- 78

1978- 79

n.a. denotes information is not available. FOOTNOTES

(   1 ) Series ( 1 ) is derived from annual reports of the Departments of Health and Social Security for services on which a Schedule medical benefit was paid for fee-for-service organisations only (Le. it excludes contract organisations), and includes ancillary services (e.g., physiotherapy services). The number of persons covered, however, includes those covered by contract organisations.

(2)   Series (2) is similar to Series (1) except that all contract and ancillary statistics have been excluded. The statistics are more up to date and take account of revisions to statistics as advised by organisations.

(3)   Both series include where applicable, services and coverage under the Pensioner Medical Scheme.

(4)   Both series are based on the year of processing, and the population covered is estimated as at 30 June in each year. It is emphasised that changes to Schemes, changes to eligibility and consequent changes in claims and processing patterns are likely to have an effect on base statistics for both series for any particular year with possible distortions to the statistics presented above.

PART B

Statistics by specialty groups are not available for years prior to 1975-76. From 1975-76, statistics are either incomplete or would require the diversion of substantial scarce resources to provide the detailed analysis for the periods for which information is available. However, estimates on a full year basis derived from a preliminary analysis of medical benefits claims processed in the March Quarter 1979 by the major medical benefits organisations and the direct billing payment system administered by my Department are as follows:

TABLE B

Average Per Capita Use of Services in a Full Year by Practitioners Providing Services on which Medical Benefits were Paid

Category of Practitioner

Surgeons and Anaesthetists

Pathologists.....

Other Specialists .... Practitioners Undefined*

Total all practitioners

Number of services per person covered

0.5 0.6 0.8 0.9 5.9

Category of Practitioner

Number of services per person covered

* Relates to services provided by practitioners where insufficient detail was available to determine whether the practitioner was an optometrist or a medical practitioner recognised as a specialist or as a consultant physician for the purposes of the Health Insurance Act 1973.

General Practitioners (including Participating Optometrists)........... 3.1

(3)   The answer to part (3) of this Question is divided into two parts - Part A and Part B.

PART A

The statistics in column (2) of Table A below are provided on the same basis as those referred to in Table A (Series 2) in the answer to Part A of (2) above.

There is no appropriate deflator available to adjust average costs at current prices to constant prices over the period. However, to provide a rough guide on the order of average costs at constant prices, the statistics in column (2) have been deflated by movements in the Consumer Price Index (using 1 969-70 as the base year) and represented in column (3) .

The statistics in column (3) are subject to further distortion because of a number of different factors, including changes to Schemes over the period, changes in 'carry-over' of services from one processing year to another, changes in benefit arrangements and changes to the periods over which medical fees were adjusted.

TABLE A

Average Cost Per Service at Current and Constant Prices

(1)   (2) (3)

Average cost Average cost at current at constant

Year prices prices

$ $

1969- 70....... 4.44 4.44

1970- 71....... 5.15 4.91

1971- 72....... 5.92 5.29

1972- 73....... 6.20 5.23

1973- 74....... 6.73 5.02

1974- 75....... 7.85 5.02

1975- 76....... 10.72 6.07

1976- 77....... 12.35 6.14

1977- 78....... 13.18 5.98

1978- 79....... 13.85 5.81

PART B

The following estimates have been derived on a basis similar to that for Table B in Part B of the answer to (2) above, which are based on medical benefits claims processed in the March Quarter 1979.

Average Cost per Service by Category of Practitioner for Services on which a Medical Benefit was Paid, March Quarter 1979 - Australia (Preliminary).

Average cost

Category of Practitioner per service*

General Practitioner (including Participating

Optometrists)......... 9.94

Surgeons and Anaesthetists...... 26.49

Pathologists........... 10.25

Radiologists........... 29.75

Other Specialties......... 24.85

Practitioners Undefinedf...... 11.71

Total All Practitioners....... 13.77

* Calculated from the amount shown as the fee charged on practitioners' accounts. t Relates to services provided by practitioners where insufficient detail was available to determine whether the practitioner was an optometrist or a medical practitioner recognised as a specialist or as a consultant physician for the purposes of the Health Insurance Act 1 973.

(4)   Set out below are the statistics on Average Weekly Earnings (per employed male unit) and the Consumer Price Index, and percentage movements from the previous period.

Average weekly earnings (per employed male unit) Consumer price index

Source: Publications by the Australian Bureau of Statistics.

(5)   To obtain reasonably based estimates, it would be necessary to obtain data on a date of service basis for a number of years so that a reasonably based picture of changes from year to year could be made: such data are not available.







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