29 May 2017

Mental health plans, management plans for chronic diseases are of no importance under according to the budget. Is this for real?

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Devil in the detail: 23 million GP services delayed in Turnbull's Medicare thaw
By Adam Gartrell

The Medicare rebate freeze will remain in place for tens of millions of GP services – including mental health plans and chronic disease management – for another three years under little-known details of the Turnbull government's budget.

A gradual thaw in the deeply unpopular indexation freeze, which doctors claim has forced them to increase prices and in some cases abandon bulk-billing, was the centrepiece of the government's health budget earlier this month. But doctors and the federal opposition are now accusing the Coalition of trying to sneak out details that show the thaw will be slower than advertised.

Under Health Minister Greg Hunt's agreements with doctors' groups, indexation will be reapplied to bulk-billing incentives, visits to the doctor, allied health services and a small number of diagnostic imaging services over four years.

Mr Hunt has in particular trumpeted the thaw for GP consultations from July 2018.

But Health Department figures released subsequent to the budget show indexation on 113 GP benefit items, which add up to about 24 million services a year, will remain frozen until July 2020.

The delay, which was not detailed in the budget papers or in the government's "compacts" with the Australian Medical Association and the Royal Australian College of GPs, applies to common services such as mental health plans, management plans for chronic diseases, pregnancy support, prolonged and after-hours consultations and residential management.

Brad Frankum, the president of the NSW AMA, said the arrangement was news to him.

"I think it is something they have tried to push through very quietly," he said. "The problem with this arrangement is that it's basically saying let's not reward this type of quality care service. The message it sends is that these items are not important."

But a spokesman for Mr Hunt said 78 per cent of GP services by volume would be indexed in 2018.

"This is exactly what was agreed with, announced by and welcomed by the RACGP as part of a broader partnership set out in written compacts," the spokesman said. "We have a rock-solid commitment to Medicare. Bill Shorten on the other hand has become so desperate for a health policy he's turned to attacking the nation's doctors."

Mr Shorten told the AMA's national conference on Friday the government's thaw was "cash for no comment", which has been interpreted as an attack on the AMA for accepting the government's staged approach.

Speaking at the conference in Melbourne on Saturday, Prime Minister Malcolm Turnbull said: "Our approach to lifting the freeze is responsible. It targets those services that matter to Australians the most."

But Labor's health spokeswoman, Catherine King, called the delay on non-standard GP services an "unbelievable insult" to patients and doctors.

"This is the secret the Turnbull government hid from the Australian people on budget night – their GP freeze won't be fully lifted until 2020," she said. "This is proof that this was a health budget of smoke and mirrors."

The rebate GPs receive on a standard consultation has been frozen at $37.05 since December 2014. Out-of-pocket costs under Medicare have increased by 34 per cent in the past three and half-years.

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