Sunday, December 21, 2014

Has Anyone Else Noticed Just How Political The Political Leadership Of General Practice Is? The Good - They Have Now Actually Listened And Toughened Up Big Time!

This week we have seen the most amazing set of political turn-arounds I have seen in quite a while.
Let’s start with the AMA.
When the Medicare Co-Payment Plan B was announced the view was that the plan was a ‘mixed bag’. After a week and a few (the most ever) angry e-mails from those in the trenches we get:
“Last week I wrote to you outlining the details of the Government's latest co-payment proposal and asked for your feedback to help inform our ongoing advocacy.
Many members took the opportunity to respond, and I really value the constructive input you have provided.
As I said in my email, the AMA does not oppose co-payments for people with adequate means.
The AMA does not support measures that take billions of dollars out of general practice, undermine the viability of individual practices, and ultimately disadvantage our patients.
I write to make it clear to you that the AMA is strongly opposed to all three measures in the Government’s package that attack general practice, these being:
·         the $5 cut to Medicare patient rebates for general patients;
·         the non-indexation of rebates until July 2018; and
·         the introduction of time-based changes to level B consultations.
This is a triple blow that will hit general practice like a wrecking ball. The AMA will do all it can to stop these destructive changes.”
Full letter to Members here:
Suddenly the mixed bag is a wrecking ball!
The AMA in WA is even more contrite:

AMA WA president Michael Gannon agrees to oppose GP co-payment

  • December 19, 2014 11:30PM
  • Perth Now
THE WA president of the Australian Medical Association has changed his mind on the federal government’s modified GP co-payment scheme after speaking to members.
Michael Gannon last week called for MPs to support the policy to charge patients an optional $5 co-payment that would be determined by doctors — putting him at odds with the national office.
But after speaking to GPs this week, Dr Gannon said he now believed the policy would have a major negative effect on the provision of health services in Australia.
 Lots more here:
With the RACGP we also saw a rather ‘limp wristed’ response. A week later we get:

General practice unfairly targeted in revised co-payment model: RACGP membership

18 December 2014
Following extensive consultation and dialogue with its membership, the Royal Australian College of General Practitioners (RACGP) has strengthened its position on the Government’s revised co-payment model announced last week and is calling for an immediate halt to any measure that jeopardises general practice services.
The RACGP is astounded and disappointed that the Government has targeted general practice in its pursuit to ‘save’ the health dollar by proposing a model that will equate to higher out-of-pocket costs for everyday Australians.
The RACGP is Australia’s peak body for general practice, representing over 28,500 GPs working in or towards a career in general practice.
Under the newly revised model, the Government has proposed a $5 cut in the GP patient rebate, a freeze to rebates until 2018 and an introduction of time-based changes to Level A consultations from 16 January 2015.
The RACGP labels these proposals as unacceptable.
Lots more is found here:
For more annoyance this has it all:

GP bodies defend co-pay policy response

GP bodies have defended their muted reaction to the new co-payment plan that will strip $3.5 billion from general practice, as they prepare to meet with the Federal Health Minister. 
Grass-roots GPs have blasted the AMA, RACGP and ACCRM for failing to hit out at the government for the savage cuts it plans to impose on general practice.
The overhaul, announced by Prime Minister Tony Abbott last Tuesday, saw the planned $7 co-payment for all patients axed.
But instead GPs will see $5 cut from rebates for non-concessional patients over 16, a freeze on all GP items until 2018 and an extension to the consult time for a level B item to a minimum of 10 minutes.
In their initial responses to the news, all three organisations welcomed the revised plan saying it was a win for vulnerable patients - with the AMA and the RACGP adding that they were "disappointed" by the cuts to general practice. 
ACCRM President Dr Lucie Walters (pictured), however, went as far as to praise Mr Dutton for his "courage in taking a stand for quality and value for taxpayers’ money".
Later in the week the RACGP came out in support of the proposed changes to the level B rebate, saying in a statement it had "merit" because less than 10% of all consultations were six minutes long.
The college would "progress this initiative with government,  which will come into force in a months time, it added.
Hundreds of doctors responded angrily on the Australian Doctor website, accusing the organisations of lacking bite and letting the profession down.
"This is purely an attack on GPs. The AMA are a non-representative GP mouth-piece, historically aligned with the Coalition. Where is the RACGP voice?" Dr David Moss wrote.
"The RACGP and its president has sold us out and the PM has insulted us by calling us 'sausage factory' medical practitioners after years of hard work and sacrifice," wrote a commentator known as Athanasius.
"I think enough is enough! The talk is over. Action is needed like never before. Proposal: Mass resignation from the college, and let them know why."
Lots more here:
Note the huge number if comments….
The lesson in all this is that medical politicians are like other politicians and can become rather disconnected with the interests of their members.
What offers hope is that the grassroots were listened to and appropriate responses emerged.
Make no mistake this is an ideological attack on the core concept and intent of Medicare as well as an outrageous attack on General Practice - and needs to be named as such and resisted.
I hear the AMA are preparing a campaign to run in all the practices around the country. If that is true and I was the Government I would be very, very worried.
If only it was as obvious just what a crock of an idea the PCEHR is!
Back to holidays!
David.

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