Lack of funding risks Australia’s world-class health system

U Ethical was delighted to host President of the Australian Medical Association (AMA), Dr Tony Bartone, at a forum on 18 June where he outlined what the recent federal election result will mean for the health sector. The event drew over 80 attendees from across the health spectrum with interests ranging from the climate crisis to aged care, mental health, private health and primary care.

Dr Bartone delved into the pre-election priority issues put forward by the AMA and reiterated its call for the federal government to support the points below.

A future-proofed Medicare

Extend Level B of the MBS to allow longer consultations between GPs and their patients. This is particularly important as doctors manage increasing loads where patients (particularly the elderly) present with multiple reasons for each visit.

Because it diverts patients away from more expensive hospital care, general practice is the most cost-effective sector of the health system.

Climate change and health

Although the federal election was touted as ‘the climate election’, there hasn’t been enough focus on the myriad linkages between rapidly changing climate patterns and human health. The public health system will be put under increasing strain from impacts like heat stress, extreme weather events, the spread of vector-borne diseases and food insecurity.

With an ‘economy’ similar in size to South Australia’s, the healthcare sector has an enormous environmental footprint and therefore has a responsibility to urgently reduce its emissions. The AMA calls on the federal government to develop and fund a national climate change strategy and set up an Australian Sustainable Development Unit to coordinate efforts across the sector.

Aged care

Dr Bartone’s evidence to the Royal Commission into Aged Care Quality and Safety highlighted that the acute shortage of registered nurses is compromising the handover process for patients.

Elderly patients are being moved into care facilities which are often a long distance from their existing GP and familiar surroundings. This could be addressed through increase funding for the Aged Care Access Incentive to allow patients to see their GP of choice in the care facility, ensuring continuity of care and decreasing the pressure on the hospital system.

Supporting GP training

Even with 3,700 medical students graduating each year, GP training is hugely undersubscribed mainly because GP registrars earn significantly less than their hospital-based doctors. The disparity is particularly felt by doctors with family commitments. Increasing funding to address this gap would be an efficient use of resources as it builds the long-term capacity of the primary health part of the system.

Public hospitals

While activity-based funding has helped deliver efficiencies, it is now forcing hospitals into a spiral of cost minimisation and patient churn to survive. If this continues, it will undermine our standing as having one of the best health systems in the world, if not the very best. The AMA’s 2018 Public Hospital Report Card was referenced continually by the media and politicians prior to the election so it remains to be seen if funding will be committed to this area.

Elective surgery is a crucial preventative measure that saves significant costs in the long-term. Public hospitals are increasingly cancelling affordable elective surgeries due to the strain of providing more serious complex care with fewer resources.

Private health

The AMA supported the government’s reforms private health insurance to simplify the 70,000+ variations on insurance policies. However, further reform is needed. Rising premium costs are still outstripping inflation and wage growth such that coverage has dropped to 44 per cent (at 40 per cent, the entire system ceases to be viable).

Australians do not want a US-style corporatised system and medical decisions must be left to qualified and experienced professionals without interference from insurers.

Dr Bartone acknowledged that the time limitations meant he couldn’t address all the priority issues but the common thread through all of them is that the sector is severely underfunded. Therefore, the AMA will work closely with the new the new federal Minister for Health, Greg Hunt MP, to secure “increased funding so the sector can be better tomorrow than it is today”.

In thanking Dr Bartone, CEO Mat Browning, underscored the alignment between AMA’s advocacy work and U Ethical’s values: “we invest in healthcare because it is part of striving for a better world”.