SWSLHN and Bowral's Health - 8

May Budget expected to bring long-awaited GP MRI rebates

3rd May 2011 - Medical Observer

Byron Kaye   all articles by this author

GP REFERRALS for MRIs could finally be granted MBS rebates as the Federal Government confirms it is “reviewing” funding arrangements for radiology ahead of the release of next week’s Federal Budget.

The widely anticipated measures, long advocated by doctors’ groups, would see MRIs subsidised for children under 16.

The changes would mean young patients could more easily recoup most of the cost of the radiation-free, higher-accuracy alternative to CT scans, now seen by experts as the standard for examinations of several spinal, knee, brain and abdominal conditions.

Currently, patients of all ages can receive a rebate of $350–$430, but only when ordered by a non-GP specialist. GPs have been agitating for years to have the rebates available directly from their referrals, arguing the system is inequitable because it discourages lower-income patients from having the investigation.

When questioned about speculation the Government will offer the rebates for GP-ordered MRIs for children, a spokesperson for Health Minister Nicola Roxon declined to comment directly but said the Department of Health was “currently reviewing diagnostic imaging arrangements”.

RACGP vice-president Dr Elizabeth Marles said she would be “very pleased” by any measure to cut children’s exposure to even the low levels of ionising radiation in a CT scan. She predicted that rather than risking a “budget blowout”, the rebate would save taxpayer money by reducing specialist visits.

“It’s not going to be a commonplace investigation,” Dr Marles said.

“If you had significant neurological concerns about a child, you’d get a specialist anyway. By giving them the ability to have an MRI, you’d be able to determine if there were any brain tumours or things like that. You’ve got a better idea from the outset.”

The change may require additional CPD training on appropriate and safe ordering of MRIs and the college would work with Government to develop a program, Dr Marles said.

“We would support some sort of education for GPs so they would be comfortable to be able to use MRIs appropriately.”

GP Dr Brian Morton, chair of the AMA’s Council of General Practice, said it would make “the right test for the right reason” more easily available and would speed up treatments.

GPs could “initiate the management rather than having to wait for the specialist”, he said.

However, Dr Morton called for any rebate for GP-initiated MRI to be extended to include non-child examinations best done with MRI, including for spinal radiculopathy, knee injuries and multiple sclerosis.

Dr Ron Shnier, president of the Australian Diagnostic Imaging Association, said although radiation levels in CT were low, making MRI more accessible to children would improve safety.

Comments:

bubbles
3rd May 2011
5:12pm

Finally! I also hope they are going to consider the CT Coronary Angiogram having some form of rebate as well.

SSWAHS = SWSLHN + SLHN and the Medicare Locals - 34

At last, there is something more substantial in the way of the every-growing backlash against the Federal government's Super Clinics and Medicare Locals. Socrates notes that this survey of GPs is of just a small sample, but it does seem to confirm the anecdotal view that there is mass confusion amongst the general practitioners of just what will be the business of the Medicare Locals and of the Super Clinics and how either will in any way change the delivery of health services in the Australian community.

Secondly, it confirms what seems to have been evident in this blog, and elsewhere, that there has been very little information provided to local communities about how the Medicare Locals will operate to improve their local health services. The big exception has been the Bankstown GP Division and their SWS Health Coalition.

Let's hope that the Federal Government budget focusses on what works and what does not when it comes to making cuts in health spending.

GPs: Axe Medicare locals to free up health funding

19th Apr 2011

Byron Kaye all articles by this author

JUST weeks out from what is predicted to be a tight Budget, GPs have pointed the way for the Gillard Government to reach its all-important surplus: freeze the rollout of super clinics and scrap Medicare Locals altogether.

Winding back incentive payments for pharmacists to dispense generic drugs also rated a high mention in MO’s latest national poll of 150 GPs.

Asked where health spending should be cut in the May Budget, 77% of GPs nominated the super clinics program – now $630.4 million deep in promised Commonwealth funding.

Nearly 40% recommended Medicare Locals for the chopping block, freeing up at least some of the $416 million that has so far been committed to their rollout, which begins on 1 July.

“If you took the super clinics money from Canberra, the leverage that you would get would train five times as many students and doctors,” AMA vice-president Dr Steve Hambleton said.

“Nobody can understand anything about whether super clinics are any benefit to the health system at all.”

Health economist Professor Gavin Mooney said the super clinics program was too advanced to be stopped, but “what could be possible and a good thing would be if Medicare Locals were delayed”.

The survey, conducted by Cegedim Strategic Data, also found 45% of GPs wanted to see a reduction in the $1.50 payment that pharmacists receive each time they substitute branded medicines with generic ones.

One area where some GPs and the Government appear to agree is the chronic disease dental scheme, which the Gillard Government claims is costing close to $63 million a month.

Nearly a quarter of those surveyed would be happy to see the scheme axed.

The poll comes as medical researchers held a series of rallies protesting widely tipped budget cuts to the sector of $400 million.

GPs were not short of ideas for where to spend the savings. Two-thirds nominated indexing MBS rebates to inflation as a priority.

Dr Hambleton said the rebates had been “systematically underdone” for years, making out-of-pocket expenses harder for patients to meet.

A quarter of GPs wanted MBS rebates for point-of-care testing (PoCT).

Robert Wells, director of the Menzies Centre for Health Policy at the ANU, said Government support for PoCT was inevitable, but a rebate now could undermine the new funding deal with pathologists. But given PoCT was both safe and convenient, he said, rebates for this should be supported.

This poll was conducted for Medical Observer by Cegedim Strategic Data research company.

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SSWAHS = SWSLHN + SLHN and the Medicare Locals - 31

It seems that there have been almost as many leaks from Canberra about our pending May 2011 Federal Budget, as there have been with a cup of water in a sieve! Most attention has been on the scientific Research and Development grants which are expected to be chopped by the Federal government.

Most recent news has been the means testing for family allowances and child care, and health and education projects.

Let's make the suggestion now that, if health cuts are required, the Federal Government should, first of all as a matter of priority, consider stopping the roll out of the Medicare Locals ($500,000,000 savings) and the funding for the Local Health/Hospital Networks (LHNs) which are incorporated in the Federal-State governments funding agreement.

In NSW, which is the only State that may have implemented the LHNs since 1st January this year, it appears to have rolled them out on the promise of the funding. However, all the previous NSW government seems to have done is add another bureaucratic layer to an already over-corporatised health system.

As reported in this blog previously it would seem that the Federal government has already told the previous NSW state government to get rid of the LHNs that they have rushed to implement.

Obviously, if the Federal-State health budgets are going to be impacted by the soon to be announced Federal Budget cuts, then the funding for the not wanted LHNs will be top of the list.

If these obvious cuts are, in fact, brought into reality it would be up to the new coalition NSW State government to decide whether their State Budget can maintain the additional funds needed to support the LHNs and the state's Medicare Locals. Socrates's hope is that they recognise that the NSW population can do without the additional mis-management that such poorly run and poorly considered projects can introduce.

It would be hoped that both the Federal and NSW governments will see that some of the current applications for Medicare Locals from NSW are very short on the necessary community consultation and colloboration with other public and private healthcare providers. The latter is best exampled by the recent application by the Macarthur-Southern Highlands Division of General Practice consortium. The contrast has been the very extensive consultation and collaboration done by the Bankstown GP Division and their SWS Health Coalition.