Fed budget: GP co-payments, Medicare Locals future "uncertain"

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AHHA: The future of organisations established to address gaps in primary care access is "under threat".
AHHA: The future of organisations established to address gaps in primary care access is "under threat".

The federal government's first budget due out next month (May 2014) will include a six dollar co-payment for bulk-billed GP visits and could mean an uncertain future for Medicare Locals, according to reports.

The government's Expenditure Review Committee will go ahead with the co-payment – which includes capping it at 12 visits – where a maximum extra cost of $72 per year will be incurred for patients.

The savings from the measure will be put back into health, and is intended to reduce the unnecessary number of GP visits.

"I think it will stay true to all of the principles that we've got, and that we want to make sure that people that can't afford services are taken care of and provided for," Health Minister Peter Dutton told reporters on The World Today last week.

"We need to make sure that people like you and I, on higher incomes, when we go to the doctor, should we expect it for free? When we go and have a blood test, should we expect not to pay one cent?"

The Palmer United Party (PUP) said it would be "open" to the idea, but would need to see the bill first in order to properly decide its position.

"If we are going to make structural changes to health care, this is something that has to be looked at," PUP's leader Clive Palmer told reporters.

However Labor's health spokeswoman Catherine King said a co-payment wouldn't make the system sustainable, rather it would signal the "end of bulk-billing".

Further, she asserted, it would stunt GPs' capacity to make decisions about whether people are in circumstances where they can't afford to pay, whether they can actually waive those fees or not.

The future also looks shaky for some Medicare Locals, set up by the former Rudd government at a cost of $1.8 billion, with plans to shut down the current system.

A number of Medicare Local chief executives held a series of talks last week to the discuss the government's plans for the scheme. Some of the government's proposals under serious consideration include establishing larger statutory agencies to funnel state and federal funding; putting more focus on GP involvement; and putting more services out to public tender.

Health groups have spoken out against the proposals, among them the Australian Healthcare and Hospitals Association (AHHA) who described the coordination of primary care as a "critical" part of an effective healthy system, in statement on Tuesday (April 22).

"The future of the organisations and structures established to address gaps in primary care access and to improve the integration of the primary and acute care sectors are under threat," said Alison Verhoeven, Chief Executive of the AHHA.

"There is strong international evidence that supports investment and coordination of primary care and general practice to take pressure off the health system and keeping people out of hospital.

"Any changes that arise from the May budget must ensure that the critical roles of service coordination and access support are retained.

"Anything less will result in a service vacuum which will have significant negative impacts on patient outcomes, and service costs and efficiency."

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