BY RODNEY CHRISTOPHER
Nobody can deny that the Medicare system is in need of resuscitation. However, nobody can deny that our most vulnerable citizens, the elderly, are the pawns in the latest debate between doctors and the federal government over bulk billing for GP services.
Since the inception of SMARTS (Support Medicare and Retain Total bulk billing Services) in September 2000 in the Hunter area, committee members and concerned residents have undertaken direct action by staging two public meetings and 18 rallies, protests and pickets outside doctors' offices and Newcastle Liberal Senator John Tierney's office, all in the name of gaining some equity for the frail and disadvantaged citizens of our community.
There are 10 of us in the SMARTS committee, most of us pensioners, with the oldest being 84 years old. We are taking direct action because the political system has failed to deliver justice in this issue so far.
Medicare is a universal health care system and yet, our elderly citizens are suffering financially each time they access this system. It is not their fault that they have reached their twilight years, nor is it their fault that they only have a fixed fortnightly pension to live on. More importantly, it is not their fault that it is inevitable that they will succumb to more chronic ailments or reside in a nursing home requiring GP visitation.
While the federal health minister, Dr Michael Wooldridge, asserts that doctors can set their own fees, he also asserts that the government relies on the goodwill and co-operation of individual doctors to ensure that patients receive adequate medical care without financial hardship.
Wooldridge must reside in "fairyland" or he knows very little about the Hunter. It should be incumbent upon any government to provide alternative arrangements when patients can no longer afford to visit their GP.
In more recent times, we have been bombarded by media reports as to how GPs have embraced technology by having access to the internet and installing software to help monitor patients with health problems. There have even been courses provided for GPs to become methadone providers. This all sounds so innovative, but just what advantage is this technology to the patient who simply cannot afford to visit their GP?
One of the most intriguing innovations has been the Maitland After-Hours GP Trial with a submission under way for more of these services to be extended throughout the Hunter. Under the trial, GPs are to be paid up to $120 per hour, even if they only see one patient and for a home visit, it is up to $200. Again, nobody denies that after-hours GP care is in crisis and solutions need to be sought pronto.
As bulk billing is evaporating on an almost monthly basis in the Hunter, does this not suggest that people might wait until after-hours and then romp up to the hospital casualty department to see a GP for a complaint that could have been better dealt with in normal hours?
With the escalating cost of GP consultations, it should come as no surprise if these after-hours GP services become an attractive option or even a substitute for normal-hours' GP care. Of course, this is not what they are designed for.
It must be borne in mind that many local doctors deny bulk billing to even the disadvantaged in normal hours, but they are willing to work after-hours and treat anybody with no cost whatsoever to the patient.
There appears to be no shortage of GPs willing to staff the Maitland trial. Just what is the attraction at Maitland? As the Hunter Area Health Service panders to the federal government for additional funding for after-hours services, struggling pensioners, single mothers with sick children, low-income families, and university students with HECS fees, must all be wondering what relief they can expect when it comes to receiving basic in-hours GP care.
The latest buzzword to infect our health care system is "corporatisation". As we read more about corporatisation and the impact that it could have on our health care system, the more nervous our most vulnerable citizens become. The Hunter Urban Division of General Practice (the local doctor's union) has received a $200,000 grant from the federal government to fund a study into a plan for a GP's "co-operative". Only time will tell if a GP's co-operative will be better than a corporate system.
If a co-operative does not deliver bulk billing to the elderly and disadvantaged, then it is really no better than corporatisation, and so one must question the justification of a $200,000 grant.
The various players in this debate appear to point the finger at each other. Under our two-tier health care system, those people who cannot afford to pay must really feel like stray dogs - nobody wants them.
As health consumers, we are personally concerned that our health care system is haemorrhaging to the point of no return. We are also concerned that the day will come when our parents or relatives will be faced with the prospect of not being able to afford to visit their GP, notwithstanding the purchasing of prescription medicines. Before this sad day arrives, let us hope that the current federal government adheres to its own rhetoric about listening to the people.
Australians strongly support the ideal of access to affordable basic health care being a right for everyone, not just for a privileged few.
[For more info contact SMARTS, PO Box 3039, Blacksmiths NSW 2281. Ph: 0407 102950. Email: