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The ghosts of Budgets past

While listening to the Secretary of the Department of Health in the Health Budget lock-up in Canberra on Tuesday night, I was more than a little surprised that the sales pitch to Australia’s health leaders was that the centrepiece of the 2015 Health Budget was the Review of the Medicare Benefits Schedule (MBS) – a measure that had been announced some months earlier with supposedly no Budget revenue implications.

I was even more surprised when the Secretary inferred that the MBS Review would deliver further considerable savings to the Government. Health Minister, Susan Ley, has since clarified that this was not the Government’s intention.

It is not purely about a savings measure, it is about making sure that we have a modern MBS that actually reflects modern medical practice, and it actually maintains access for patient services.

Nevertheless, given the damage caused to the Government from last year’s Budget co-payment proposals and public hospital funding cuts – misguided measures that brought misery to the Government for the best part of a year – the general expectation was that the Government would play some strong suits in health policy.

That was not the case. Instead, we saw a range of modest (but welcome) announcements that remain completely overshadowed by the lingering negative effects of the Medicare patient rebate freeze and public hospital funding cuts – the ghosts of Budgets past.

The Budget unfortunately does not go anywhere near addressing the concerns of the AMA from last year’s Budget.

There is no indication that the public hospital cuts are going to be restored. Nor is there any indication about the required changes for the indexation freeze that we are seeing for GP and specialist patient rebates.

People need to remember that the indexation freeze is a freeze for the patient’s rebate. It is not about the doctor’s income. It is actually about the patient’s rebate and their access to services. There is no indication that those freezes are going to be lifted any earlier than 2018.

There have also been cuts of nearly $150 million taken out of general practice from changes to the child health checks, apparently because of ‘duplication’. It is very unclear where the so-called duplication occurs.  Such a change would have been better dealt with as part of the MBS Review, rather than as a hastily conceived Budget saving measure.

There is also a lack of clarity around some of the announced cuts. There was a mystery package of $1.7 billion in cuts that was claimed to cover child health assessments, a number of dental programs, and ‘flexible funds’ for NGOs in the health sector. A big number, but little detail. The end result is a number of small organisations that do very good work looking after vulnerable people left wondering about their funding and their future.

The focus should have been on positives.

The AMA welcomed a range of other measures, including:

  • e-health changes, including the myHealth Record, particularly the opt-out component;
  • mental health plan;
  • support for the National Critical Care and Trauma Response Centre;
  • funding for Aboriginal Community Controlled health organisations;
  • organ donation programs; and
  • the Ice Action strategy.

The AMA has been invited by the Minister for briefing and clarification of issues such as Indigenous health program funding, after hours care, and preventive health.