THE Rural Doctors Association of Australia (RDAA) says the federal government’s announced investment in Medicare and GP training will assist more rural patients to access affordable care.
RDAA president Raymond Lewandowski said that any investment in health was welcome, including investment in primary care, and that he hoped to see an increase in the number of rural patients able to be bulk billed after November.
“All rural doctors want to provide affordable health care to our patients” Dr Lewandowski said.
“Unfortunately, the reality of providing the complex care needed to patients in rural and remote communities, who simply do not have easy or affordable access to other health care professionals, means that rural GPs have to provide advanced and complex care that is outside the scope of most urban GP practices."
Dr Lewandowski said longer consultations and increased services, such as surgical and mental health care, added significant cost to the running of a rural GP practice.
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"These practices are more often than not small family-owned businesses, that already bulk bill as many disadvantaged patients as they possibly can."
He said the expansion of the bulk bulling incentive to include all patients and not just children under 16 and concession card holders, means that for some practices bulk billing will be able to be extended to more patients in need.
“It will be particularly helpful for doctors who already bulk bill patients who do not qualify for the incentive but are struggling to afford appointments.
"Additional funding for these patients will be extremely welcome for the doctors who otherwise provide this care at a reduced rate."
Dr Lewandowski said 'tiering' of incentive for rural and remote settings had also helped address the additional costs of providing health care in the bush, and praised the RDAA for its advocacy to make this a key principle built into the bulk billing incentive.
"It has already enabled many rural and remote practices to provide some bulk billed services, but to go to full bulk billing would require further consideration by individual practices.
“The additional 12.5% incentive for practices that only bulk bill will likely be out of the reach of many rural practices.
"The cost of providing the advanced level of care needed within rural communities, the shortage of health professionals, and the smaller patient cohorts are limiting factors that result in most rural practices having to mixed-bill in order to survive."
Dr Lewandowski said the RDAA was having active discussions with its members across a range of rural and remote medical practices to better understand how the incentive could be applied.
He said the changes would present welcome additional investment for practices that do bulk bill or have a significantly high rate of bulk billing and that Aboriginal Medical Services in particular will benefit due to the exclusive bulk billing model they have adopted.
RDAA has been a long-time advocate for broader reform of health funding and Dr Lewandowski said there had been many reform recommendations sitting with the Department of Health to put forward to Government.
“To really address the issues plaguing our health system, particularly in rural and remote areas, practices need to have other models of funding available to them – not just fee-for-service (and) the changes to bulk billing are a continuation of the same funding framework that we know is no longer fit for purpose.
"We worry that the current suite of reform recommendations already on the table will be overshadowed by the bulk billing changes and will result in a missed opportunity for longer lasting and more effective reform.”
With the federal opposition matching the Medicare announcement, the new policy will come into effect in November regardless of which party wins government at the next election.
RDAA said it would continue to work with all parties to advocate for election commitments that will make a difference 'on the ground' in rural communities.
“RDAA’s election priorities include initiatives like increased rural training places, accessible childcare for rural health workers, better access to specialist care and a national rural health strategy," Dr Lewandowski said.
“We look forward to seeing more policies aimed at improving health outcomes for rural patients over the coming months in the lead-up to the federal election.”
