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12 January 2015
by Dan Harrison

Last-minute Medicare change evidence of Abbott government bungling, says Australian Medical Association

AMA President Brian Owler talks to media at Parliament House in Canberra.

The Australian Medical Association predicts many doctors will be caught out by a change quietly made by the Abbott government two days before Christmas that will cut the Medicare rebates which apply for short consultations for one class of doctors.

AMA president Brian Owler said the last-minute change, which will take effect on January 19, is proof that the government's second attempt at overhauling Medicare was "rushed" and "poorly thought out".

The fact that there has been no announcement about these changes, it's been snuck in on a website somewhere, that's a terrible way of putting forward these changes.

On December 9, Prime Minister Tony Abbott and then-health minister Peter Dutton announced the government would abandon its original budget plan for a $7 fee to see the doctor and unveiled a replacement proposal which included cuts to Medicare rebates for visits of between five and 10 minutes.

A fact sheet distributed to explain the proposals said the change would not apply to the Medicare items used by non-vocationally registered medical practitioners, who are doctors who have not completed GP specialisation.

This would have meant some visits to a doctor without GP specialisation would have attracted a higher rebate than a visit of the same duration to a specialist GP.

To correct this anomaly, on December 23, 12 days after the original regulations were made, Governor-General Sir Peter Cosgrove signed into law regulations that brought the definition of Medicare items for non-specialist GPs into line with the equivalent items used by specialist GPs.

Associate Professor Owler said the government was "trying to play catch up" on the consequences of its changes because it had failed to consult with doctors when designing the package.

Associate Professor Owler said the changes were due to take effect at a time when many doctors and practice managers were away.

"The fact that there has been no announcement about these changes, it's been snuck in on a website somewhere, that's a terrible way of putting forward these changes, and I suspect ... many non-VR doctors are going to be caught out by these changes because basically they're unaware of them."

Associate Professor Owler said he felt for new Health Minister Sussan Ley, who was sworn in on the day the latest regulations were made. The regulations were prepared by her predecessor, Mr Dutton.

"To lump an incoming health minister with someone else's very poor policy ... puts a potentially very good minister on the back foot right from the beginning," he said.

A spokesman for Ms Ley, who is on leave, said the minister had already met with the AMA and would continue to consult with the organisation, doctors and the broader community about Medicare reform.

The spokesman said the issue had been discovered early and been promptly addressed prior to Ms Ley being sworn in as minister.

The changes, which will cut the rebate for a visit by a non-concessional patient of between five and 10 minutes from $37.05 to $16.95 for a specialist GP, and from $21 to $11 for a non-specialist GP, have been framed by the government as a quality control measure designed to deter the "six-minute medicine" practised by some clinics, which seek to maximise their revenue by churning patients through quickly. They are expected to save about $1.3 billion over four years.

Ms Ley's spokesman said Associate Professor Owler's criticism of the changes was at odds with his calls last year for reform to address the "competitive drive towards six-minute medicine."

Labor's health spokeswoman Catherine King said the late change was "further evidence of the complete chaos that is the hallmark of this government's handling of health policy".

"It's further proof, if it was needed, of why Minister Ley should scrap the policies she inherited from her failed predecessor, and start afresh by scrapping her GP tax."