General Topics

That 7:30 Report

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In mid October the ABC 7:30 Report ran an article suggesting very high levels of  “leakage” from Medicare. The ABC news site article of 17 October states:

Doctors are abusing the $28 billion Medicare system, at times putting patients at risk, billing dead people and falsifying patient records, all to boost profits.

A joint investigation by ABC’s 7.30 program, The Sydney Morning Herald and The Age has uncovered flaws in Medicare’s systems that make it easy to rort and almost impossible to detect fraud, incorrect payments and errors.

The leakage is estimated to represent nearly 30 per cent of Medicare’s annual budget, or about $8 billion a year.

Unsurprisingly the reaction from GPs was one of outrage and denial.

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Practice Principals are a bit like Ducks

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GP practice owners are a bit like ducks, says Dr Jared Dart,  a GP Practice Owner and director of the Australian General Practice Alliance (AGPA) in an interview with Francis Wilkins of Medical Republic.

“They look like they’re floating, but under the surface they’re paddling fiercely,” he said in the interview . “And the biggest problem is practice principals have nowhere to go. A GP can retrain or go on sick leave, but principals only have one option: to sell, and unfortunately, many are doing just that.”

Inflation is now one of the toughest challenges facing owners. “Medical inflation over the past two years has been particularly high,” says Dr Dart. “Our costs are at least 10% higher in our practice, and that’s across the board – from electricity, wages and consumables to cleaning and rent.”

“Add into the mix things like payroll tax, which could bankrupt a practice principal, and you can understand why the stress is significant.”

The full article and podcast are available here

Queensland Joins the Payroll Tax of GP

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Following the precedents set in Victoria and NSW it is now appears  that the Queensland State Revenue office has  commenced levying retrospective payroll taxes on GP Practices and that medicare and professional fees paid to independent  GPs are considered to be be payments to “employees” for the purpose of determining payroll tax liability.

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General Practice is on the Edge of a Cliff

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General Practice is on the edge of a cliff and has been put there by the actions of Successive Governments.

There are three key components to a high quality primary healthcare system

  • Professionals- Sufficient well trained and appropriately remunerated staff including GPs, Nurses, Allied Health Professionals and  Administration staff,
  • Practices – High quality infrastructure provided by GP Practices with up to date standards and facilities, and
  • Patient Access- Ease of patient access which is impacted by  cost of access,  timeliness of access, and the transportability of access (competition between GP Practices)

Most GPs work in Principal led (GP Owned) Practices, small businesses that are the backbone of Australia’s primary health care system.  These General Practice businesses are under extreme pressure.  The Australian GP Alliance (AGPA ) is the representative body for GP owned practices which account for over 2/3 of General Practices (ref HON 2022).

We call on the Federal Health Minister to act in this time of crisis to for Primary Health Care in Australia.

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Transition to Private Billing

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Transition to Private Billing

Presented by: AGPA

Speakers:

Dr Trish Baker, Dr Bernard Shiu, Dr Mukesh Haikerwal, and Dr Richard Barker

Tuesday 9 August 2022

 

Since 2010 health costs have increased at about 5% per year. MBS funding has increased by about 0.5%. This has put significant pressure on Practice viability.

Many Practices that were traditionally bulk billing or mixed billing Practices have started or are considering moving away from their previous billing model.  We  asked four Practice owners to participate in a panel discussion to discuss how they approached the key components of the transition.

  • Conversations with/ information for patients
  • Conversations with and information and support for contract GPs
  • Support for reception staff and practice managers
  • Support for practice nurses and allied health team members

The webinar was recorded, with a link available here

Meet the Candidates 2022

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The candidates:

Dr Julian Fidge

Dr Charlotte Hespe

Dr Nicole Higgins

Dr Chris Irwin

Professor Brad Murphy

Dr Chris Ogonowski

Dr Kate Wylie

Primary health care in Australia is led by Practice Principals who work in the Practices they own, providing clinical leadership and facilities to deliver a high quality, community based, primary healthcare system.

The RACGP council elections will take place in September 2022.

The College has significant influence on government policy regarding General Practice and therefore its policies impact on General Practice Principals as the owners of the practices.

The 2022 candidates for President of the RACGP were invited to address an AGPA forum so that GPs and Practice Principals can hear their views on matters which impact on General Practice.

View webinar recording here

Monkey Pox Declared a Notifiable Disease of National Significance

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On 28 July 2022 the Australian Government Chief Medical Officer, Professor Paul Kelly declared Monkeypox (MPX) to be a Communicable Disease of National Significance . The Chief Medical Officer’s statement is here

Monkeypox, also known as MPX, is a disease caused by the Monkeypox virus or MPXV. It is part of the same family of viruses as variola virus which causes smallpox. MPX symptoms are similar to smallpox symptoms, but milder and rarely fatal. Most people will recover in 2-4 weeks.

More severe cases, while rare, can occur among children and people with compromised immunity.

A DoH fact sheet  is here

The Department of Health and Aging have developed a resources page here

ATAGI clinical guidance on vaccination  is available here

Expanded Eligibility Criteria for COVID-19 Antiviral Treatments

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The Pharmaceutical Benefits Advisory Committee has expanded the eligibility criteria for COVID-19 oral antiviral treatments, Paxlovid (nirmatrelvir and ritonavir) and molnupiravir (Lagevrio) effective from 11 July 2022.

It is important that primary care providers familiarise themselves with the updated criteria and pre-identify potential patients before they test positive for COVID-19 so medication options can be explored and included in their care plan to expediate treatment within that critical 5-day window from symptom onset (noting those over 70 years may commence treatment while asymptomatic following a positive test).

This decision is in response to the latest evidence on the effectiveness and safety of the medicines, the rate of uptake since they were made available on the PBS and the changing epidemiology of the virus.

Eligibility has been broadened to include people who have chronic respiratory issues due to conditions such as COPD, moderate or severe asthma and there is also greater access for adults living with disability who have multiple medical conditions.

Not being vaccinated has been removed as a risk factor from the criteria for prescription under the PBS.

The new eligibility includes updated age limits and risk factors summarised below.

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ATAGI Updates – COVID-19 Vaccinations

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Vaccinations for Children aged 6 Months to 5 Years.

Following the Therapeutic Goods Administration’s (TGA) approval of the Spikvax (Moderna) vaccine for children aged 6mths to 5 years, the Australian Technical Advisory Group on Immunisation (ATAGI) has provided recommendations in on the use of Moderna in children aged 6mths to under 5 years in certain at risk populations groups.

3 August DoH Provider Bulletin is here

ATAGI Recommendations are here

Fourth  Vaccine Dose Eligibility

The Australian Technical Advisory Group on Immunisation (ATAGI) has updated its recommendations for an additional
booster dose (also known as a fourth dose) for selected population groups (below) who are at greatest risk of severe illness
from COVID-19 and who have received their primary vaccination course and first booster dose.

Prevention of severe illness from COVID-19 is now the primary goal of the ongoing COVID-19 vaccination program, with the
secondary aim of the COVID-19 vaccination program being the prevention of infection and transmission of the virus.

The ATAGI Fourth Dose Eligibility bulletin is here