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Hope on prescription bugbear following Dutton talks

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The widely-loathed PBS authority prescription system will be brought into focus by the change of Government following a wide-ranging meeting between AMA President Dr Steve Hambleton and freshly-elected Health Minister Peter Dutton.

While the new Minister stopped well short of promising to scrap the system, under which doctors are required to seek approval from a Department of Human Services bureaucrat before they can prescribe certain medications,  Dr Hambleton said Mr Dutton made enough encouraging remarks at the meeting to suggest it is likely to come under scrutiny.

“I pointed out there was a need for a reduction in red tape, and scrapping the system would save six million phone calls a year, something the Minister was very interested in investigating,” the AMA President said.

The issue was among several pressing concerns discussed by Dr Hambleton and Mr Dutton during their first major consultation since the Federal election.

During the 9 October meeting, which was also attended by AMA Secretary General Anne Trimmer, Dr Hambleton flagged the AMA’s preparedness to contribute to improvements in the design and delivery of health services, as well as raising concerns about inadequate Medicare rebates, increasing education expenses, Government red tape and training shortfalls during extensive talks with

While it is still early days for the Abbott Government, its actions so far reflect the approach it outlined before the election in which it eschewed any plans for major health reform, instead focussing on achieving greater efficiency in spending and setting new priorities that are likely to see some health agencies and programs axed or merged.

In keeping with this focus, at the meeting Mr Dutton reiterated the Coalition’s intention to review the Medicare Locals program and the Personally Controlled Electronic Health Record System, as well as taking a closer look at the functions of Health Workforce Australia (HWA).

Dr Hambleton said the AMA welcomed the Medicare Locals review, which is to be conducted according to terms of reference similar to those recommended by the AMA.

He said the AMA was also keen to contribute to the PCEHR review, which is seen as an important opportunity to improve the system and make it much more useful for both patients and doctors.

“The AMA will be making submissions to that review and we would like to see a re-focus on clinical usability and utility for all participants [as a result],” Dr Hambleton said.

Among the other organisations and programs under examination is HWA, which has completed a series of significant reports that have provided information critical to assessing current and future need for medical skills and guiding workforce planning.

Dr Hambleton said that at the meeting with the Minister he and Ms Trimmer emphasised the important contribution the HWA had made to improved workforce planning, and the need for such work to continue.

The AMA President said medical workforce planning and the training pipeline was one of the top issues in health, and extended far beyond the current issues regarding a training bottleneck at the internship level.

“We stressed that the pipeline planning aspect of HWA’s work was critical,” he said.

Consistent with his emphasis on the importance of GPs, Mr Dutton was also intrigued at the meeting by work around the idea of a “medical home” and the potential for improved care through the creation of chronic disease items on the MBS.

Dr Hambleton said that, in this vein, he used the meeting to alert the Minister for the potential for fragmentation of care as various groups including pharmacists, optometrists and psychologists sought to increase the scope of their practise, such as by acquiring prescribing rights.

“Potential fragmentation of health care is not the solution for helping people, or tackling issues raised by an ageing population or increasing chronic disease,” the AMA President said.

But, while Mr Dutton appeared alert to many issues of concern to doctors, he also put the profession on notice that the Government was likely to look closely at medical fees.

In a warning shot for the profession, Dr Hambleton said, Mr Dutton “raised some caution that we need to think about” patient out of pocket costs and gap payments.

Adrian Rollins