Guy Barnett (Tasmania, Liberal Party) Share this | Hansard source

The federal budget, handed down by the Treasurer, the Hon. Peter Costello, on 8 May this year, provided $291.3 million over the next four years for the inclusion of two new attendance items in the Medicare Benefits Schedule. These are to commence from 1 November 2007. They will provide for lengthier consultations between patients with chronic and complex health conditions and the consultant physicians or paediatricians to whom they are referred than has previously been the case.

Patients with chronic and complex conditions have two or more serious medical conditions simultaneously and with combined effect—for example, they have cardiovascular disease and diabetes, they have osteoarthritis and chronic respiratory disease, or they are children who are not thriving for any number of reasons. People with chronic and complex conditions are among the sickest people in our community. The number of Australians with chronic and complex conditions is steadily increasing as our population ages, but it is also due to the growing incidence of serious diseases among young Australians.

Consultant physicians and paediatricians are the specialist medical consultants to whom patients with chronic and complex conditions are referred for specialist attention. They advise the referring general practitioner, surgeon or other specialist on the patient’s diagnosis and management. Consultant physicians and paediatricians undertake many years of postgraduate training and have specialised knowledge, understanding and skill plus broad holistic understanding. They are particularly qualified to treat the diseases which have been identified by the Council of Australian Governments as national health priorities, which often feature in chronic and complex conditions.

Compared with the needs of other patients, the needs of patients with chronic and complex health conditions typically take longer for consultant physicians and paediatricians to investigate, consider and address. Until now, this difference has not been reflected in the Medicare Benefits Schedule. The new items 132 and 133 will go a long way towards remedying this longstanding and anomalous situation. These two new attendance items will provide Australians with chronic and complex conditions unprecedented access to the highly specialised medical care they need for optimum health outcomes. The implications are positive and wide ranging for patients with chronic and complex conditions, for the patients’ families and carers, and, not least, for consultant physicians and paediatricians.

In recent years the growth of Australia’s consultant physician and paediatrician workforce has not kept pace with the demand for its services. The supply and distribution of consultant physicians practising general medicine is a matter of growing concern, while many specialist appointments and training positions for consultative subspecialties are empty. Considering the duration and intensity of training followed by the skill, responsibility and complexity required to practise as a consultant physician or paediatrician, these subspecialities—including geriatrics, general medicine, renal medicine, rheumatology, haematology, endocrinology and diabetes, respiratory medicine, rehabilitation and cancer medicine—have become financially unattractive, particularly to potential trainees. For example, in my home state of Tasmania, the Launceston General Hospital has been underfunded by the state Labor government to the tune of $22 million a year. In terms of consultant medical staff, the Launceston General Hospital, I am advised by the relevant staff, needs one interventional cardiologist, one endocrinologist, two medical oncologists, one neurologist, one haematologist and an emergency medicine consultant. It is a great relief that our local federal member, Michael Ferguson, is standing up for the local community.