Wednesday, 19 September 2018
Questions without Notice
My question is to the Minister representing the Minister for Health, Senator Scullion. Prior to 1 July this year, vocationally registered and non-vocationally registered doctors were paid the same amount for GP mental health services. Non-VR doctors have the same patient responsibilities and the same university qualifications as VR doctors, so it made sense that there was no difference in their Medicare rebate for mental health services. Can the minister confirm that the government has now reduced by $25 the reimbursement amount for non-VR general practitioners who provide mental health treatment, and the reason for doing this?
Thank you for the question. It is an important one. It is probably important to make the distinction between a vocationally registered doctor and one who is not vocationally registered. A vocationally registered doctor is someone who is not only qualified as a doctor but has the prerequisite training and experience in a particular field to be actually examined or assessed by either of the colleges of general practice.
It is the case that the new schedules indicate that there is 20 per cent less you get on that schedule if you are not a vocationally registered doctor than if you are. Just for the basis of information: fully qualified specialist general practitioners who belong to either of the colleges of general practice are able to continue to access the same MBS item they had before in recognition of their qualifications and their skills. As you have indicated, Senator, the reduction only applies to the non-VR medical practitioners.
We have provided funding, through the general practice colleges, for a fellowship support program to ensure that we can support those individuals who haven't had the experience in that area. We've actually had, for a very long time, since the late 1980s, differential approaches to some of the Medicare rebates. The mischief we are trying to resolve is that a number of people who are non-vocationally registered are now in circumstances where they're getting full VR access but they're making absolutely no effort to get the experience that is required by others. This is a disincentive to that happening, and we think it's an important initiative.
The system changed in 1996, when there were grandfathering options, which meant that at that particular point all doctors who were full-time working doctors were actually considered to be vocationally registered. The people who actually missed out primarily were, in many cases, women who took time out to raise kids or perhaps were overseas or working in hospitals at the time. Would the minister consider grandfathering existing doctors? (Time expired)
(—) (): I have been informed that the demographic is principally overseas doctors who have come from or were trained overseas. I have been informed this is the principle demographic. I haven't said it doesn't involve women at all, but it's not a gender issue. They sit in places where they're unable to get the experience that one of the two colleges would be able to provide them. We think that those particular people in regional and remote Australia should be getting access to a practitioner who has the very best level of experience. We are providing additional funds, as I have just indicated, to ensure they can get access to the training to do that. On the question about whether or not I'll be able to grandfather particular doctors, can I take that on notice? In fact, can we provide you a brief on that particular matter as I am unaware of those matters? (Time expired)I
Minister, I imagine you'd be aware, particularly given what you just said, that the majority of mental health consultations are provided to low-income Australians who access these as bulk-billed services. These cuts will erode their access, and doctors in all likelihood will need to charge a gap in order to continue providing the service. How does this meet the government's plans to maintain and improve bulk-billing for mental health services?
The response we desire is obviously not to put the price up and pay a gap; it's simply to take the offer we have to further your professional qualifications so that you can charge at everybody else's rate. That is our intention, Senator. We think that this is an incentive. It is a disincentive in some ways, but we have provided all the funds from both colleges of general practice to enable people to get the same qualifications as everyone else in Australia.
We think there's a bit of disincentive, but we also think there's an awful lot of incentive to ensure that people are able to deliver. We don't think this is suddenly someone saying, 'That creates a gap. Let's do this.' Our intention is to ensure that everyone has access to the same level of qualifications, and those people receiving treatment, therefore, are treated by people with the highest level of qualification. I'll make sure I get a brief to you, Senator.