Welcome to the Doctors Reform Society of Australia

The Doctors Reform Society (DRS) is an organisation of doctors and medical students promoting measures to improve health for all, in a socially just and equitable way. The Society was formed in 1973 to support a proposal for a publicly-funded universal health insurance system.  Medibank (now Medicare) was successfully created despite opposition from the Australian Medical Association.

All members’ views are valued, open debate on all health issues is encouraged both within and outside the organisation, and consensus decision making is the norm.  The DRS functions as a medico-political think tank, a lobby group and a public resource centre.

50 years Anniversary Doctors Reform Society Conference and AGM.

NSW Nurses and Midwives Association Building
50 O’Dea Ave Waterloo NSW

Face to face and zoom.

Saturday 9th November 9.30 am – 5.00 pm
AGM in after lunch session
Zoom attendance will be available.

Please email drs@drs.org.au for zoom link (available from 1 November)
The zoom link will be circulated to DRS mailing list.

If you are attending the conference in person, please advise us at drs@drs.org.au
Further program information to follow closer to the event.

There will be a Conference dinner held at a location in Surry Hills on the evening of November 9.

The location is close to Central Railway Station and will be advised at the AGM.
It will be in proximity to The Friendly Society Hall where our first meeting was held.

Please let us know if you will be attending for catering numbers.

Any queries to drs@drs.org.au

Feature Image

Join the DRS

Membership of the Doctors’ Reform Society is open to all medical practitioners and medical students who believe that everyone, regardless of their social or economic status, should have access to high quality healthcare.

Click here to find out more about membership
Feature Image

Report on National Conference October 2019, Brisbane

 

We started the day with a talk from Dr Beau Frigault from Doctors for the Environment, who gave an overview of the disaster we are heading for but then concentrated on the significant contribution of the health care system particularly hospitals, makes to greenhouse gas emissions. He then outlined (in between torrential Brisbane rain on the tin roof) a wide variety of measures that hospitals are implementing to address this, both in the design of new hospitals and in retrofitting older hospitals but also indicated relatively simple changes such as using different anaesthetic gases eg servoflurane instead of desflurane which can also help significantly. The emphasis however was that for change to happen in established hospitals a commitment to fund a dedicated person to the task is required.

We then had a fascinating and eclectic talk from Dr Andrew Gunn about how he manages to provide health care to about 500 patients who are mainly living in hostels, are all significantly disadvantaged, with a major contribution from mental illness. He referred also to two other examples of doctors who have set up systems to deal with the most disadvantaged and provide them with the health care they deserve and would seldom receive from standard GP practices, the first in Perth where the emphasis is on addressing homelessness as a major contributing cause of disadvantage, the second in Melbourne where, with the benefit of Community Health Centres carrying on from their beginnings as a Whitlam initiative, provide comprehensive care across many inner city Melbourne suburbs.

The afternoon started with a talk from Ben Cohn from the Australian Digital Health Agency, giving us an update on how it is progressing. The best we could establish from him was that the ADHA was continuing to play with the data they had, but had not really made much progress in terms of meaningful and useful engagement with either health care providers or patients to make My Health Record a particularly useful product. Nor was there any indication that the ADHA had understood the concerns regarding patient control of the information which we and others have raised previously.

The day ended with our AGM and reappointment of the previous committee unchanged, and we then proceeded to an excellent vegan meal nearby.

Next year we plan to meet in Western Australia

 

Read more here

Media Releases

21st May 2024

Health Care: A Disappointing Budget

By: Dr Peter Davoren

“Why has health care been almost ignored in this year’s budget”, asks Dr Peter Davoren, Secretary, Doctors Reform Society. In January last year Health Minister Butler said, “Frankly I think our general practice right now is in the worst shape it has been in the 40-year history of Medicare,” His Strengthening Medicare Taskforce made many recommendations and the Minister said at the time that ‘a comprehensive revamp’ was required, including addressing ‘structural issues’. Read more

Articles

15th Nov 2024

Putting the mouth back into Medicare

Pearls and Irritations
By: Dr Tim Woodruff

How would it be to walk into a general practice with a toothache and be triaged to see the oral health therapist, who assesses and then develops an oral health care plan? They are then qualified to provide dental treatment but may also involve a GP or dentist across the corridor for further assessment. It is time to dream this could become a reality if Labor is prepared to embrace the mouth, gently.

It could be started immediately by listing oral health therapists as part of the primary care team (general practice and others), in the Government’s recently proposed most radical restructure of primary care funding since the introduction of Medicare. Such therapists could focus on oral disease prevention and health promotion. Dentists could be added later.

Currently the radical restructure ignores the mouth. This restructure was initiated by a taskforce chaired by Mark Butler, Health Minister. Further detail on the restructure was addressed by a committee chaired by the First Assistant Secretary for Primary Care. With such senior people driving the restructure one could reasonably expect that suggested changes or a variation of them will be implemented over time.

The Federal Government’s main funding for general practice is through fee for service i.e. you receive a service, and the Government provides a set rebate, the value of which depends on the service. The provider can charge a copayment of whatever value. If no copayment is charged it is called bulk billing. There are other Government payments to general practice for a variety of things which are not related to an individual service. These other payments currently make up less than 10% of Government funding for general practice.

Central to new changes is a move to increase the percentage of general practice funding through non fee for service payments from the current less than 10% to 40%, and adjust them for socio-economic status, rurality, and complexity. Funding will now aim to enable general practices to employ a variety of other health care providers in the practice to promote a comprehensive primary health care team, consisting of GPs, Allied health, nurses, Nurse Practitioners, Midwives, and social support services. Oral health therapists and Dentists are primary care providers. Put them in the list and finally, the mouth is into Medicare.

Importantly, it is suggested that the changes be introduced gradually, with an aim of reaching the 40% target by 2032. This is partly because the changes are quite complicated and cover much more than the above. In addition, the resistance of the medical profession needs to be carefully managed. Lastly, spending extra money on health, education, and welfare is not a priority of this Labor Government unless it has an immediate political impact.

There are a variety of proposals to get the mouth into Medicare. The Greens propose having a rebate system like Medicare to address the issue. There are three problems. Firstly, there is the cost. Labor leadership does not have a ‘crash or crash through’ Whitlamesque visionary who can see the political, economic, and social benefits of equitable access. Minister Butler’s comments reflect that reality. The second is that it would mean adopting a fee-for-service rebate system. That doesn’t work well with doctors’ visits because copayments decided by doctors mean patients can’t afford to go. The same would almost certainly happen with dentists. The Child Dental Benefits Schedule (a limited fee for service scheme introduced in 2014) relies on dentists to participate. Sixty percent don’t, most likely reflecting the fact that eligible patients would not be able to afford the copayments these dentists would charge. A recent review of that scheme concluded there is only a 40% take up of the scheme. The third problem is that it would lead to a federally subsidised dental profession which would then resist any change away from fee for service medicine. That change is precisely what the restructure is intending. It is resisted by doctors’ organisations because it affects their income and autonomy. We don’t need dentists as another adversary to patient centred care. Resistance from dentists was part of the reason Whitlam ignored the mouth in 1974. Doctors’ resistance was enough of a problem then.

Butler said on Q&A recently,

“It’s in our platform that we would one day move to incorporate dental care into Medicare, which conceptually makes sense……We don’t have the ability to [incorporate dental care into Medicare] right now”.

We do. Doing it slowly and carefully is so much better than ignoring it for another 50 years

The mouth has been largely forgotten by Federal Governments since dental care was left out of Whitlam’s Medibank and Hawke’s Medicare for financial and political reasons. The opportunity now exists to start putting the mouth back into the body to address the huge inequities in access to dental care across the country.

Read more