Have your say

Wouldn't it be great if you actually supported doctors working in Aboriginal Health.
Your silence at a federal level and despite many requests for support about the abuse of staff at Derbarl Yerrigan Health Service meant a considerable loss of GP members of the AMA.
The appropriateness of providing locums for a Health service in contempt of HREOC should be a matter for ethical debate at a federal AMA level - where is your leadership on this matter?

What is wrong with this plan? Just think how it can and therefore will be gamed.

Suppose the enrollment is with a single GP.
If that GP works in a group practice it will maximise profits if all except the minimum diabetic care is given by one of his colleagues and billed IOS. That is what I would try to arrange to happen if I were a senior director of Healthscope.

If the enrollment is with a practice.
Then none of the GPs with the practice will have any incentive to see the patient at all, not even for the bare minimum that will enable the practice to claim the annual enrollment fee. As an associate on a percentage of IOS rather than partner, I would be working for free if I saw such a patient.

Lastly, look at the long term direction the government wants to go with this: away from IOS to capitation, a model they believe can further screw down the amount medicare pays for GP services. This is already planned with the abolition of nursing MBS items which is going to be disastrous both for patient care and the stability of many smaller practices.

The proposed changes to a sort of capitation system both for CDM patients and for practice nurses is lead-in to a totally non fee-for-service pay structure. It is the necessary precursor to further screwing down the medicare costs of paying for primary care. It might be wrapped up in the fig leaf of "improved patient care" but the bottom line is how to pay GPs less.

Robert Dawborn's point seems to have been missed: to achieve accreditation requires much investment in time, money and infrastructure that is totally irrelevant to the delivery of the special interest. I am a solo GP in a regional city. I have an accredited practice and a special interest in mental health. I could not make an adequate income in such circumstances if I pursued only my special interest. For example, what has an oxygen supply, a height adjustable examination table and a spirometer got to do with mental health. All these are either current or future accreditation standards, not to mention the administrative burden of managing the plethora of CDM item numbers, no simpler since the latest changes.

Totally agree that there needs to be more financial support for general practice to employ practice nurses. They are the future of support for our over worked doctors and can assist in so many ways. Higher fees for nurse item numbers & more nurse items as well as PIP type payments would assist with this.