You can call me stupid or ignorant. I just found out that there are two different kinds of GPs in Australia. I didn’t know about it until now. And they are treated by government differently even their job is exactly the same.
I don’t have any more brain power left today to give you clear view what I am talking about. Maybe, someone who knows Australian system very well would leave educational comment for me.
There were Google search results made me aware of the fact. They are submissions made to parliament few years ago regarding to Medicare Plus Inquiry and Fairer Medicare Inquiry, and they gave me some idea how Non Vocationally Registered GP are unfairly treated by government even though they do exactly the same job Vocationally Registered GP does.
I became aware that my wonderful doctor is Non Vocationally Registered GP. I do not pay anything because I am covered by bulk bill system. But it hurts me to know that how little he is being paid for his work. On the other hand, one of my previous GPs charged me $65 when he was typing and printing out few documents while I was desperately explaining my doubts about fatigue was coming from depression. Well, he even managed to sign off those documents while I was talking to him. I am sure he is Vocationally Registered GP.
If I compare those two doctors, I will clearly tell anybody that my Non Vocationally Registered GP has much better skill and knowledge than the Vocationally Registered GP I had before. And government is allowing that he would receive less than hair dresser’s wage? (No offence to hair dressers. They are respectful career, but I hope you understand the points I am trying to make.)
I also heard rumours that Bulk Bill Medical Centres are particularly struggling financially. And sometimes, doctors do not receive their pay cheque on time because Medicare delays its payments to those Medical Centres. How can it be acceptable?
If my wonderful doctor is working under this condition, how can I be sure that he will keep struggling but keep dedicating to help patients who desperately need him? How can he keep his compassion to help others? How where can he get job satisfaction from?
I am really really hoping that situation has improved since those documents I found on Google were written. Especially after some foreign trained doctor murdered many Australian patients and run away, government would pay little more attention and respect to Australian doctors now. (Once again, I have no objection to foreign trained doctors and I know there are many compassionate and skilled foreign trained doctors.)
Parliament of Australia: Submission Inquiry to Medicare Plus
(Note: I removed contact reference from here, however, if you click on the above government site, you can view the full information.)
SUBMISSION NO. 02
Thomas Lyons [thomas.lyons@ ]
Dear Mr. Curtis,
Thank you for inviting me to make a submission regarding Medicare Plus proposals. The $5 incentive payment to bulk-bill pensioners, concession card holders and children is close to what I am doing now anyway. I have been taking a $5 co-payment and my patients have been trying to bring in the cheques. We are $20000 behind in lost cheques so this idea is very interesting for me. But please see me within my context. I am Non-VR on $17.85 per patient.so with $5 that is $22.85. I work in a practice with three bulk-billing VER GPs. They . Two are over 70 years old and only working as a hobby. They have no interest in fussing with the complexities of private billing. The third is loyal to his long term patients. The Practice I work at is just holding on financially. We know that if we all charged privately things would be smoother. There are practices nearby that have closed their doors. If I charged privately here at this point in time I would sit behind my desk and see no-one. The extra $5 would keep me where I am which is treading water. Next year with the creep of CPI taking over and height interest rates making an impression I will move away from $17.85 + $5 per patient. I will not be able to afford a modest suburban lifestyle on $22.85 per patient.
On a larger scale there are a few GPs who have a grass roots commitment to bulk-billing and are financially secure enough to not really care about the short falls. They will bulk-bill with or without the $5. And then there are the others who feel the financial squeeze as I do and the $5 is too small to make bulk-billing attractive. Practices that charge privately have lower overheads. Generally they see fewer patients so the need fewer reception staff, they go through less stock in their treatment rooms. GPs cannot charge patients to recoup this cost. It is illegal. Bulk-billing practices have smaller margins, more staff are required, go through more stock…experience more stress as the fewer receptionists become outnumbered by the anxious agitated patients who are waiting hours for their turn to see their GP. Privately charging places are more relaxed, the wait is shorter, the stress level much lower, and the patients happier…this is worth more to these GPs than $5.
the Government has failed to identify the cohort of the swinging Bulk-billing GP. Some GPs will never bulk-bill and some will always bulk-bill. You need to identify the variables that affect those uncommitted. Having a happy efficient practice generally means more money but ther are other issues as well.
Dr. Thomas Lyons
SANCTUARY COVE. QLD 4212
Submission – Senate Select Committee on Medicare – First Inquiry
(I got this information as a result of Google search. When I try to retrieve this from government website, it denied my access. So I leave the link from Google search result. Once again, I removed his contact number, but you will see it when you click the link below.)
5000 GPs ON DISCOUNT RATES A THREAT TO BULK BILLING
The AMA and the Health Department are deceiving the Australian Public because 5000 GPs on 1989 rebates are being forced out of bulk billing. This is 20-25% of the Australian GP workforce. They are classified as Non-Vocationally Registered (Non-VR) - meaning that in 1989 they had not been GPs for the 5-year requirement to become Vocationally Registered (VR). The Non-VR GPs are still working on 1989 rebates of $17.85 per patient for a standard consultation, so as most of us work as contractors we receive 50% (approx. $8.90). Less than a hairdresser!! The rebate is the amount of money the government contributes to the consultation. There is a major incentive here to abandon bulk billing, abandon general practice, or abandon medicine. If the Non-VR GPs abandon bulk billing, it is their patients who are the ones out of pocket because they only receive $17.85 (the patients of VR GPs currently receive $25.05). The government knows the Non-VR GPs are under great pressure, but they still deceive the public with their fake determination to maintain bulk billing. This two-tier system is derived from a cabinet decision in 1989. Having two rates of pay for the same work is in breach of the UN Charter of Human Rights. The AMA is ignoring the issue of the Non-VR rebates because they are pushing loudly for the majority VR GPs to be given $48 per patient. The AMA knows that if the Non-VR rebate remains frozen, this huge increase for the VR GPs will be easier to reach. Non-VR GP hardships are a leg up for the AMA. Kay Patterson is comfortable that 5000 GPs are working at a discount rate. There is a cozy collusion here between the AMA and Kay Patterson.
In November last year a public servant working in policy development for the Commonwealth Department of Health confided to me that they do not expect Non-VR GPs to bulk-bill anyway. They know it is impossible. Emma Handyside, advisor on GP matters to Kay Patterson informs me that the Non- VR issue will never be on the agenda. Ian Mcrae, a senior bureaucrat in the department of health has told me that in his opinion Non-VR GPs should not be working anyway. In his view we are all luck to have jobs.
Dr Thomas Lyons
Once again, I have no power to change the situation. But I am hoping that my wonderful GP will not abandon his career and will keep helping desperate patients like me. Personally, I don’t mind pay him the same fee as I used to pay for the GPs who did not want to help me. It is much more important to me if my GP is willing to help me or not, and has skill and knowledge to help me, rather than if my GP is VR or NVR.