Doctors take action

November 6, 1996
Issue 

By Kamala Emanuel

Interns in the Hunter Area Health Service struck on November 1, and other hospital medical staff around the country participated in symbolic actions to "mourn the death of medical care".

The national day of action was called by the Australian Medical Association to protest against the government's budget proposal to restrict new doctors' access to Medicare provider numbers.

Patients are only able to receive a rebate from Medicare, or be bulk-billed, if the doctor they are treated by has a Medicare provider number. Under the new proposal, new doctors will only be eligible to receive provider numbers if they are specialists, vocationally registered GPs, or in recognised training schemes. There are an estimated 950 training places available each year (550 specialist and 400 GP), but about 1450 newly qualified doctors seeking positions. So each year about 500 junior doctors miss out on training positions, and from November 1, will miss out on provider numbers as well.

The provider number restriction is estimated to cut over $500 million from the Medicare budget and has been justified on the grounds that there are too many doctors. Even if this were true, it won't reduce the number of doctors able to practise, but only those able to provide Medicare rebates.

In reality, there is a shortage of doctors in rural areas and hospitals. Doctors not on formal training schemes make up a significant proportion of the relief pool that rural GPs draw on. The restrictions will make it harder for GPs to find locums with provider numbers. Particularly in rural areas, they may have to employ locums without provider numbers. People living in rural areas may have to pay full fees for service, with no Medicare rebate.

Meanwhile, hospital funding grants to states have been cut by about $300 million over the next four years and, in NSW, hospital interns and residents have already been asked for suggestions for "streamlining" their jobs in the face of plans to reduce the intake of interns by 20% by 2000. Restriction of Medicare provider numbers will increase competition for fewer jobs and lead to the erosion of already appalling conditions. (In NSW, for example, the award maximum shift length is 34 hours.)

Stop-work meetings of hospital medical officers across NSW will be held on November 6 to consider further action.

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