Media Releases

“The DRS supports the National Health and Hospitals Reform Commission’s criticism of the current method of payment of GPs,” said Dr Tim Woodruff, President, Doctors Reform Society. “Paying doctors on a walk in walk out basis is only useful for a minority of illness in primary care. It discourages professionalism, encourages doctors to work alone rather than with health teams, and in a perfunctory manner i.e. time is money and an emphasis on quick consultations and fast throughput,” said Dr Woodruff.

“Fee for service (FFS) is not a good way to pay for the doctor to manage chronic illness or community care such as house visits and taking care of the elderly, seriously ill, those with disability or mental illness or those needing home care, palliative care etc.”

“In addition, FFS means patients who live in areas of workforce shortage, who are usually the most needy, get less care than those who live in richer urban areas, because funding goes to doctors, not to areas of need”

“We support calls for a mixed payment system for GPs that could combine FFS for acute care and part salary and part incentive payments for meeting broad targets and voluntary enrolments etc. It is crucial however, that incentive payments have no negative effects such as disadvantaging doctors working in areas of increased health burden, or encouraging doctors to cherry pick patiens with certain diseases.”

“However, we would stress that the important aim should be to get away from wholesale dependence on FFS payments,” said Dr Woodruff. “This would encourage doctors’ professionalism and a team approach to primary care, but it also must be done in a way which does not lead to frustratingly complicated and regulated payment systems.”

“But while reform of the system itself is important, it must be recognised that reform costs money but it is an investment in the future and in the midst of our current economic crisis it is crucial to make that investment,” said Dr Woodruff. “The current health system is under funded and under strain. Prime Minister Rudd’s promise to fund the system properly if elected should be implemented immediately and even while reform is being discussed. Otherwise doctors and patients may not take the reform process seriously or get the wrong idea – that the federal government’s reform process is really about privatising the health system or introducing US style managed care. And this would be the wrong signal to be giving at this time”. said Dr Woodruff.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

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Reports today that Treasury has repeatedly told the Rudd Government that the Private Health Insurance (PHI) rebate is inefficient is hardly surprising news, said Dr Tim Woodruff, President, Doctors Reform Society.

It’s very obvious to us as doctors and to patients and relatives across the country that the private/ public divide is inequitable, said Dr Woodruff. Public patients wait years on crutches or in wheelchairs for their hip replacements whilst private patients are treated within weeks. The PHI rebate encourages queue jumping of public waiting lists by those who, with taxpayer support, can afford PHI. The rebate has also funded the growth of the private sector, taking doctors out of the short staffed public sector.

The Government’s National Health and Hospitals Reform Commission claims principles of efficiency and equity. They didn’t address the PHI rebate.

We call on the Prime Minister to fulfil his promises of a root and branch analysis of the health system and evidence based policy and include the PHI rebate in the current review of the health system, said Dr Woodruff. Without such inclusion the review is badly flawed from the beginning.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

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“The Doctors Reform Society welcomes the many positive ideas presented in the interim report from the National Health and Hospitals Reform Commission,” said Dr Tim Woodruff, President, Doctors Reform Society, “but we wonder how their stated commitment to the principles of equity and efficiency has allowed them to ignore the inequitable and inefficient Private Health Insurance (PHI) rebate. Is choice more important than equity?”

“The belated recognition that dental care should be universally available is a huge step forward for many Australians who until now have had no choice but to live in pain, unable to eat properly, waiting years for treatment,” said Dr Woodruff. “The disappointment is that, even if the Government took the advice, those in rural and remote Australia will continue without dental care because fee for service funding will not get dentists into such areas. Denticare also guarantees that those who have the money for private insurance can get faster access. That’s choice before equity. It should be the opposite.”

“It is encouraging to see that primary health care, care in the community, is given such a high priority in this report, and that the funding for this care will no longer be spread between local, State, and Commonwealth authorities, thus potentially improving the integration of care in this sector. It is disappointing however, that there is no clear vision of how the recommended Comprehensive Primary Health Care Centres would be funded, governed, and staffed.”

“The report clearly identifies inequities in funding and recommends regional block funding for rural and remote areas, based on need,” said Dr Woodruff, “but the report ignores this issue for inner and outer regional areas where many more Australians regularly miss out on their fair share of Government spending. They have no choice.”

“Our public hospitals are struggling, burdened by inadequate Commonwealth funding. The drift of doctors from public to private hospitals and the inequity of access to public hospitals is clearly identified in the report but the contribution of the PHI rebate to this inequity is ignored. Choice remains a taxpayer subsidised option for the minority of Australians who can afford PHI and can queue jump public hospital waiting lists, whilst the most needy just wait. They have no choice. Vested interests remain untouched.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

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“The scare tactics of the Australian Medical Association (AMA) about the decrease in private health insurance cover fails to mention that any decrease in private hospital work for its members means less money for them. Perhaps that underlies their tactics but it also clearly demonstrates that the AMA believes a safety net is all that most Australians deserve if they aren’t ‘good enough’ to have sufficient money to afford private health insurance (PHI),” said Dr Tim Woodruff, President, Doctors Reform Society.

“The AMA’s scaremongering tactics, suggesting that eg patients may not get radiation therapy for their cancer treatment, is unconscionable for an organisation which claims to be interested in patients but is in fact primarily interested in the profits for its private specialist members,” said Dr Woodruff. ‘If public patients cannot access public services but private patients can, it indicates a basic flaw in our health system which the AMA supports, ie that private health should be subsidised so that rich people can have better care than the rest of the population.”

“Public health insurance is what Medicare is based on: everyone pays through taxes and the Medicare Levy, and everyone has the right to access the care in public hospitals. The AMA wants a return to the past when public hospitals were for the desperate, private care was for the rich, and those in the middle went bankrupt trying to afford private care”, said Dr Woodruff.

“It also ignores the reality that when you are put in an ambulance, you will almost certainly finish your journey in a public hospital. Destroy the public system by spending much needed taxes supporting private hospitals, and your journey could well be an avoidable fatal trip. It’s worth remembering,” said Dr Woodruff, “that the victims of the Bali bombing, many of whom had PHI cover, were saved in public hospitals.”

What is the AMA interested in, the profits of its members and their rich patients, or the interests of all patients, even the 56% of Australians who can’t afford to see private specialists in private hospitals?”

The AMA wants second rate care in public hospitals for the desperate, first rate expensive private care for the rich, a continual struggle for those in between, and plenty of private work for its members.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

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“The response of the Australian Medical Association (AMA) to the increase in the Medicare Levy Surcharge threshold demonstrates clearly that it believes only those Australians able to pay their doctors privately deserve decent health care. The AMA’s President today became more desperate suggesting that patients may not get radiation therapy for their cancer treatment if they drop out of PHI, is self interested scaremongering at its worst,” said Dr Woodruff. “The reality is actually the other way around. When you are put in an ambulance, you will inevitably end up at a public hospital. This is no different if you are a member of the Packer family or a victim of the Bali bombing.”

“The first Rudd budget is a move in the right direction for the public health system. It partially addresses the need for increased funding and support for our valuable public system. It also acknowledges the reality that all Australians depend on the public health system which provides a high standard of care at much more efficient levels than the private system and a step towards rekindling confidence of the public, nurses and doctors in our great public health system.”

“What is probably NOT surprising is the venom coming from the private vested interests and their false moral imperative that people who do not take out PHI or use the inefficient, expensive private system, are bludging on the public system. People have every right to pick which system they prefer without being penalised for NOT picking the system which most rewards the doctors” said Dr Woodruff. “The government is to be congratulated in its early show of sound economic decision making on health and meeting the needs of the public, rather than those of the vested interests

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

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“Suggestions that there will be further money for public hospitals in today’s budget on top of the $1 billion already promised will go some way to restoring the 50/50 Federal/State split of funding which the previous Coalition Government allowed to degenerate to a 42/58 split,” said Dr Tim Woodruff, President, Doctors Reform Society.

“The raising of the Medicare Levy Surcharge threshold is also a small signal that the grossly inefficient private health insurance (PHI) industry will not have everything it demands as it sucks the heart out of the public system,” said Dr Woodruff.

“It’s a tiny step in the right direction. It will take a maximum of $120 million in taxes from the PHI industry. That leaves them with an extraordinary sum of about $3 billion, and the vested interests are still whinging.”

“Ten years age we predicted that this taxpayer support for PHI would fail to decrease premiums, fail to unload the public system, and lead to a decline in public hospital access. We were correct.”

We now predict that this minor change will lead to the industry demanding approval for higher premiums, however unjustified, and that there will be no obvious increased burden on public hospitals because those who drop out will be low users of hospital care”.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

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“The proposed increase in the threshold for avoiding the Medicare Levy Surcharge may well mean a decline in private health insurance (PHI) cover,” said Dr Tim Woodruff, President, Doctors Reform Society. “This will mean less tax support for the private health insurance industry and perhaps less work for private specialists in private hospitals.”

“It’s no wonder then that the PHI industry and the Australian Medical Association are complaining,” said Dr Woodruff. “They both have a vested interest in taxpayer support for the private health system which has been helping to tear the heart out of the public health system for a decade.”

“Whilst more people may now say ‘PHI is not worth it’, that’s the PHI industry’s problem. If they can’t make it a worthwhile and affordable product, even with the Federal Government’s annual 3 billion dollar subsidy of PHI, and its neglect of the public system for the last decade, they should be on their own”

“Whilst the Government’s decision appears to be based on correcting the threshold because of inflation, it really should be asking why the rich can avoid paying the Medicare Levy Surcharge just because they are rich enough to afford PHI,” said Dr Woodruff.

“Indeed, one has to ask why the Federal Government’s support for PHI which was called ‘a monumental waste of money’ by the then Labor leader 10 years ago is any less wasteful now,” said Dr Woodruff. “It has failed to put downward pressure on premiums, and failed dismally to help correct the appalling waiting times for elective surgery in public hospitals. It is so unfair on working families and on the 56% of Australians who cannot afford PHI. It’s time to do more than fiddle with thresholds.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

“The report in today’s British Medical Journal suggesting that a pharmaceutical company can get a university to discourage its academics from commenting adversely on one of their products is very concerning,” said Dr Tim Woodruff, President, Doctors Reform Society.

“The company, CSL, is said to have complained to the University of Queensland about a senior lecturer’s comments on radio regarding the marketing of Gardasil, the new purported cervical cancer vaccine”, said Dr Woodruff.

“The lecturer, Dr Andrew Gunn, received a letter from the Secretary and Registrar of the University of Queensland saying it was highly likely he had misled listeners into thinking his comments were officially endorsed by the University, and that an apology to CSL was required, amounted to harassment”, said Dr Woodruff.

“The call for an apology appears to stem from the University of Queensland’s commercial relationship with CSL, said to be at least several million dollars annually, and it seems to ignore the University’s own policies on academic freedom” said Dr Woodruff.

“The suggestion that identification of one’s academic position would lead people to believe that the comments are endorsed by an institution as large and diverse as a university is laughable at best,” said Dr Woodruff. “Different views on economics, law, climate change, and almost everything else are frequently expressed in the media by academics with no suggestion that the views are endorsed by their university, The only difference in this case would appear to be the determination by the university to override its own principles of academic freedom in the face of commercial concerns.”

“The pharmaceutical industry already heavily promotes its drugs to doctors and the community through many channels including so called “educational events”,” said Dr Woodruff, “But if an institute of learning’s need for cash from the private sector influences its independence and its promotion and encouragement of open debate, it is a sign of the level to which the profession and our institutes of science have fallen. Should we be surprised given that the average budget of the Pharmaceutical companies is now more than that of many small countries?”

Dr Andrew Gunn is also National Treasurer of the Doctors Reform Society of Australia

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

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