 Health plan calls for bypass of GPs Adam Cresswell, Health editor 19jan06 MEDICARE could be thrown open to health workers such as nurses, physiotherapists and speech pathologists to ease pressures on the health system. A landmark report out today, commissioned by the federal Government, proposes allowing more patients to bypass their GP and go straight to the relevant health worker for a Medicare-funded consultation. Doctors should also be allowed to refer patients to a wider range of health workers under Medicare than they can now. Rebates for these consultations would be lower than for seeing a doctor, reflecting the lower level of the health worker's qualifications. But the proposals in the 450-page Productivity Commission report on the health workforce drew anger from the doctors' lobby, which said the proposals were "unacceptable". "Australians ... want quick and affordable access to a doctor, not a doctor-substitute," said AMA vice-president Choong-Siew Yong. "The key is to train and retain more local doctors." The report also seeks to fix problems with access to healthcare in the bush, by exploring new ways to combine state and federal funds for hospital, GP and other services. Waste and duplication would also be cut, for example by merging Australia's 90 existing registration boards for health professionals into one national entity. A single national accreditation board would also take over responsibility for doctors' and health workers' education and training, and responsibility for overseas-trained doctors. Nurses and allied health groups such as physiotherapists greeted the findings with jubilation. The Australian Physiotherapy Association said that if implemented, the report would "lead to better use of the health workforce and better access for all Australians". The Productivity Commission's Mike Woods, who chaired the study, said in five to 10 years "we would be looking at patients being able to go to a wider range of health professionals". Exactly which health workers could join doctors under the Medicare banner should be decided by a new permanent advisory committee, qualified to say which services were cost-efficient, he said. Replacing two existing bodies, the new committee would report publicly to the federal health minister on what services should be added to or cut from Medicare, and what rebates should apply. "But the evidence has been put to us that you could have quality care delivered directly by professionals who might be physios, occupational therapists, speech pathologists or nurse practitioners," he said. "We already spend 9.7 per cent of GDP on healthcare. That will rise (no matter what). But ... we need to use the health workforce more efficiently." Expanding full Medicare recognition to more health workers would end the "medical merry-go-round" under present arrangements. For example, a physiotherapist would be able to refer a patient straight to a specialist, without the patient having first to return to a GP for a referral in order for the consultation with the specialist to attract the maximum rebate. College of Nursing executive director Judy Lumby said the commission had "shown courage" in its recommendations. A spokesman for Acting Health Minister Julie Bishop said John Howard would take the report to next month's Council of Australian Governments meeting for discussion. Have your say, email The Forum [EMAIL PROTECTED] |
