General Practice Health of the Nation 2020

Thank you and hello everyone

I acknowledge the traditional owners of the land on which I record this message the Wurundjeri people. I pay my respects to their elders past present and those who are emerging as leaders.

It is an honor to officially launch this year's General Practice Health of the Nation report. The last 12 months have once again highlighted that communities rely on their GPs in times of crisis. Throughout the COVID 19 pandemic our GPs, practice managers, nurses, receptionists and administrative workers have persevered and done an absolutely incredible job. At the time of recording practices have delivered over 16.7 million COVID 19 vaccines, more than half the national total, and probably by the time you're listening to this much more.

The general practice health of the nation 2021 report underscores that GPs are more important now than ever and that we need greater support to help communities manage the fallout and the long tail of the pandemic.

The vaccine rollout. Well, GPs are the backbone of the vaccine rollout. We are a ready-made mass vaccination center. However, it has not been smooth sailing. Our survey found that almost three out of five GPs reported managing patient expectations about vaccinations to be one of the most challenging issues arising from the pandemic. Changes to vaccine eligibility requirements left many people confused and unfortunately some patients took out their frustrations on general practice staff.

Similarly, the fact that different jurisdictions across Australia have different eligibility requirements and different rules applying in state-run vaccine hubs compared to practices and commonwealth vaccination clinics has resulted in confusion and frustration for patients. And general practice bore the brunt of that frustration.

Government can alleviate this additional pressure on practices by ensuring that practices are kept in the loop by government. General practice must be front of mind in all major public health decisions including changes to the vaccine rollout. This was a national pandemic and needed a national response. The need for a one health system was never more stark. The vaccine rollout will have twists and turns ahead still to come and GPs must be properly consulted so that we can best perform our very critical role.

My message to all practices is that even through the difficulties you are doing a remarkable job. You are the unheralded heroes getting on with the job in the community and I am extremely grateful for your work.

Boosting the future GP workforce. We are in danger of running out of general practitioners. We can't just focus on the here and now the vaccine rollout we must also look ahead and be clear-eyed about the future of our profession. Not enough future doctors are opting for general practice. The GP workforce is aging with the proportion of GPs over the age of 65 increasing each year from 11.6% in 2015 to 13.3% in 2019. Almost 20 percent of GPs surveyed report they intend to retire within the next five years. This figure has increased from 14% in 2017. And at the same time not enough medical graduates want to become GPs. The proportion of final year medical students listing general practice as their first preference specialty for future practice has fallen to just 15.2 percent. That's the lowest since 2012.

So, we know what the challenges are and your RACGP is here to present solutions. I will advocate strongly and fearlessly for the progressive changes we need to serve our communities even better. Firstly, let me say international medical graduates will continue to play a crucial role in bolstering the GP workforce. However, we must also focus on encouraging more future doctors in Australia to take up a career in general practice especially in rural areas.

Secondly and just as important is highlighting how rewarding this career path can be. However, it's also important to address what is holding back more future doctors from a career as a GP. And a great place to start would be putting general practice on a more sustainable long-term financial footing. Because funding for primary care as a proportion of total government healthcare spend is in decline. It is less than eight percent of total health expenditure, yet we provide more than twice the number of episodes of care a year than hospitals, at only one-sixth of the cost. As we revealed last year in the pricewaterhousecoopers costed economic benefits of the vision for general practice and a sustainable health system, it's estimated that implementing the RACGP's vision and boosting primary care funding could provide benefits of 5.6 billion dollars over the next five years.

It's not the first time that evidence has pointed to primary care as the most cost-efficient part of the health system. More than half of GP surveyed said that they would recommend general practice as a career to their junior colleagues. But a staggering 48% indicated they are much less likely to do so now compared to a decade ago. Those who would not recommend general practice as a career point to remuneration, recognition and billing requirements.

A recent news GP poll of more than 1200 members also found 79% nominated increased remuneration for the profession as the best way to attract more medical graduates. Similarly, the most common challenge reported by GP surveyed found that 71 percent thought fair remuneration for skills with 58% suggesting managing fatigue and burnout. 50% of practice owners report they are concerned about the long-term viability of their practice. This is an increase from 37% in 2020. We know a lack of reward for work and declining autonomy are both risk factors for burnout. The picture is very very clear. Therefore remuneration, physician burnout and viability of small business we know what needs to be done If the government is serious about boosting the general practice workforce of the future and ensuring all patients can access high quality general practice care no matter where they live, then long-term funding arrangements must reflect this. The task of luring more future doctors into general practice will be made that much easier and the savings for the entire health system would be immense. Attitudes at a fiscal political and electoral level must change. There is no point training world-class students into world-class doctors to offer merely a system-induced secondary career path.

But there is some cause for optimism. Interest amongst medical graduates in entering the Australian general practice training program, the largest single training pathway to a career in general practice, has been in decline. But yet this year's application round saw the highest number of applicants since 2017. Similarly interest in joining the college's practice experience pathway or pep used by international medical graduates is growing with the number of new enrolments increasing by more than 42% since 2019.

Furthermore, GPs in training report high rates of satisfaction with their training position and workplace compared to their peers in non-GP specialist training. That should really bring a smile to our face. We know we are collegiate people. When we know we can train and mentor the next generation's wealth to ensure a strong future GP workforce.

We must also pay close attention to the mental health and well-being of GPs not just the patients they care for. This is an essential part of the quadruple aim of health system reform. There has never been a more salient time to address this issue with more than 50 per cent of respondents to our survey reporting at least one negative impact to their well-being because of COVID 19. Including 28% who nominated mental health.

Government should address this by removing all mandatory notification laws so that GPs don't hesitate to reach out for help if they need it. The western Australian model is working to respect both practitioner and the public's rights to safety in medical care. We need to reduce the stigma of talking about our very human needs for support and the way this supports the delivery of healthcare. And now managing the fallout from the pandemic in the years ahead will be critical.

Ask any GP and the likelihood is they will report more and more patients presenting with mental health concerns. Individual mental health and wellbeing are intertwined with community and cultural health. This is a part of a longer-term trend. Our culture is showing its troubles. For the fifth year in a row psychological conditions including sleep disturbance and depression were the most reported reasons for patient presentations. Eighty percent of GPs report that they have patients with mental health conditions that are mostly managed within general practice.

The scale of the parallel pandemic has only grown over the last 12 months. Unsurprisingly the COVID 19 pandemic, including measures needed to contain the spread of the virus such as lockdowns, and economic effects leading to loss of employment, loss of choice, loss of joy, and connecting, and often a loss of hope. These have impacted the mental health and well-being of many patients. Helpline such as lifeline and beyond blue have reported increases in phone calls compared to previous years. The rate of mental health distress in the Australian community prior to the pandemic was sitting at 10%. In April 2020 it was at 22% but by November 2020 it was at 24 percent. This rate is more than double the rate of mental distress that we began the pandemic with.

In my home state of Victoria which has endured the most days under lockdown the rate of Medicare supported mental health services was higher than any other state or territory. There is no guarantee that mental health concerns will dissipate as communities increasingly open up. I suspect the effects of the pandemic will linger for some time and GPs are perfectly positioned to help patients with mental health concerns with greater support. We can do even more.

Noting too that the figures concerning Medicare supported mental health specific care are likely an under representation of the true magnitude of GP mental health presentations as longer mental health consultations in general practice are often billed as general consultation rather than a specific mental health item number. And I personally do this frequently to help these patients. We need new Medicare item numbers for longer mental health consultations so that we can really get to the bottom of what's going on and spend the time that we need with our patients.

Aged care and multi-morbidities are another concern. The true measure of any society can be found in how it treats its most vulnerable members. The last 12 months has seen an increased focus on aged care. This could not have come soon enough. GPs play a vital and often and unrecognised role in caring for older people receiving aged care including those in residential aged care facilities. People aged 65 and over represent 16% of the Australian population but represent nearly 30% of all general practice consultations. Noting that 92% of all aged care occurs in the community outside of residential aged care facilities.

Ensuring adequate access to general practice care can make an enormous difference. We know that people with dementia entering the aged care system are less likely to experience an increase in prescriptions for medications such as antipsychotics if they retain a relationship with their usual GP.

When asked what would make GPs more likely to work in aged care 67% of respondents said that better remuneration by Medicare items, more than fifty percent of GP selected fewer administrative burdens and more clinical staff in aged care setting as key drivers. Helping GPs get on with the job of helping older people in aged care is essential. Let us not have GPs sitting on their hands in aged care.

And now onto complexity. It is also important to remember that GPs are the only medical practitioners that specialise in managing patients with multiple health conditions. We have a broad knowledge base and adopt a whole of person approach to care. Almost 75 percent of GPs surveyed report that more than 50% of their patients have multiple medical conditions.

Australia has an aging population and that means that multi-morbidity is increasing, and more patients require complex care. The Medicare data shows that between 2010 and 2019 billing of long consultations lasting 20 to 40 minutes, and prolonged consultations lasting more than 40 minutes, have increased by 104 percent and 125% respectively. This is such an important contributor to workforce sustainability. There are therefore less hours available, less remuneration for complex care and lowered morale as the system struggles with the demographic shifts.

Almost three-quarters of surveyed GPs reported that more than half their patients have multiple medical conditions. This problem is particularly pronounced in the bush with GPs in rural and regional areas reporting that the majority of their patients have multi-morbidity. As things stand Medicare discourages GPs from treating more than one condition especially in the same consultation. Even the medical software has an inbuilt informatics error of only recognizing one condition for one consultation. Medicare billing also has this systemic error in managing general practice care. For example, many mental health items are unable to be claimed on the same day as a standard consultation or equivalent physical health item.

This must change. Community general practice is a lifetime of interventions not a single task-focused episodic model of healthcare. GPs provide comprehensive holistic patient-centered care taking into consideration the life circumstances of each and every patient to better help patients with multiple conditions who are at risk of ending up in hospital.

We must change how we structure Medicare items. It is vital that we incentivise longer consultation items to support more comprehensive care by general practitioners.

And so, in conclusion the RACGP will continue fighting for general practices across Australia. Only when the vital role performed by general practice is properly recognised and properly supported with resources given to our hard-working practices can we truly say that we are committed to improving the health of the nation. We cannot have the nation's GPs sitting on their hands wanting to work to the fullest of their abilities and their training. That is wasting the talented people that the country has trained to care for them. The people want it. The GPs want it. And it's time for the leaders of the country to work with us to deliver a vision of health care that is sustainable, that is evidence-based and fiscally responsible. Needs to be delivered in the communities where people live where they love and where they work.

To all practices and to the GPs of Australia I say keep up the great work. Your communities need you now more than ever before and I salute your exceptional work at such an exceptional time when your community needed you.

Thank you

Well welcome everybody and I want to acknowledge the Royal Australian College of GPs for their extraordinary work during the course of the pandemic under Karen Price's leadership. They've struck a partnership with the government which has been absolutely fundamental to saving lives and protecting lives, to supporting Australians. So, to all of our doctors our practice managers our nurses those who are assisting in the work of the practice, I want to say thank you.

It's my view and I think without any doubt in the government's eyes, the RACGP under Karen’s leadership and through the course of the pandemic partnership has emerged as the preeminent and leading medical group in Australia.

As a college it both represents the interest of doctors but above all else maintains the training standards, the educational standards and the practice standards for general practice. And so, Karen thank you to you you've elevated the status of the RACGP to paramount status. And most importantly the Australian GPs during the greatest health challenge we've seen since the second world war, have stood up. It's been difficult and stressful it's been challenging but you've stayed at your post you've continued to protect Australians.

All of these things have been fundamental as part of that pandemic response. There are a number of things we've done together.

Firstly telehealth. As we're speaking approximately 80 million telehealth consultations have been carried out since the start of the pandemic. This was a 10-year reform was part of our long-term plan and together we introduced it in 10 days. And yes, it's been iterative, but that work has helped keep practices safe, patients safe, kept the work going. And it's continued throughout. 83 percent of all of the telehealth consultations have been by GPs. And I think that speaks immensely to the dedication. Many of those are after hours, they're with patients who are homebound.

But it's not just been a pandemic response it's a structural change to the way in which medicine is delivered in Australia. In my view it's an improvement. We have to make sure that there is the maintenance of quality so face to face is critical, video conferencing. We want to work with the RACGP to encourage that as a greater proportion of telehealth consultation. So not just telephone.

But all up it's allowed patients who are immobile, patients who may be contagious, to get the care they need in a way that works for them.

Couple that with e-prescriptions. With real-time prescription monitoring, with the capacity for home delivery which we've done on the pharmacy side. It's quite a revolution in the delivery of services and it's permanent. That's the critical thing, it's a permanent change and that will improve the lives of patients and improve the work and the outcome for our magnificent GPs.

Equally what we've also seen is your role in vaccinations. We said at the outset that the GPs would be the cornerstones of the vaccination program. They're the cornerstone of our health system and we've had over 5000 practices participating in the vaccine rollout. As we speak 18 million vaccinations have been delivered in the primary care setting. You've done the bulk of the work, the heavy lifting for Australia.

And the point is that you cover the length and breadth of the land, and you know your patients. And so those things together have meant we've been able to drive to that first dose mark of well above 80 percent in New South Wales. Well above 90 Victoria, approaching 90, and in other states and territories driving towards those critical markers. So, this wouldn't have happened without you.

We've worked in particular with Karen and others on the indemnity and we're able to achieve that indemnity outcome to protect doctors, protect patients, and to give everybody confidence.

The next big thing of course is mental health and aged care. Together we've worked on that in terms of mental health up through the MBS. We've been able to put on Medicare critical changes. The changes to eating disorders you know the profound importance of that extra support for patients. Equally we have doubled the better access scheme which has been so important for patients.

And then finally we've allowed family consultations and you know that's a 100-million-dollar investment. And that will primarily go through our GP. So, all of these things are so important.

At the same time structural reform to the delivery of mental health in Australia. The GP has been, is, and will continue to be, the front line. But more funding to support our GPs in their training so as they can progress what they're doing.

Equally we're putting in place through the 2.3-billion-dollar mental health package and plan a very simple concept of children, youth, adults specialised mental health treatment, to give you a pathway for referral. To give you that additional capacity to support beautiful young kids through the Head to Health kids’ hubs. Teenagers through Headspace, and adults who have in so many ways been overlooked with specialised services. So, Head to Health for adults. All of these networks being established together.

In aged care one of the fundamental things we've done is to provide funding for general practice visits to aged care not just for vaccination but more generally. And this is a real revolution in care. We've worked on those funding items, and we've put them all together with you.

 

Now let's turn to the future and the Health of the Nation report focuses on that. And to everybody at the RACGP who's been involved I want to congratulate you.

 

Right now, we are building that next wave for the future through the 10-year primary care plan. And that plan will be focusing on three big things. Firstly, there's the relationship between the patient and the doctor and the voluntary patient registration program. The continuation of telehealth in perpetuity but building the relationship so as to emphasise quality of care and all of the wrap around supports which come with that. That is a fundamental task, and it fits very nicely with what the Health of the Nation report is focusing on.

And emphasising secondly that training colleges ultimately are about training. It's in the name. And in that component, we are transferring training responsibility for our GPs to the Royal Australian College of General Practitioners and to the Australian College of Rural and Remote Medicine. And so, the RACGP has long sought this we made the commitment to do it and now we're doing it on track on time.

I’m pleased to have been able to work with Karen and her counterparts at ACRRM to deliver that outcome. And you are the colleges, and you will be fulfilling the role of being true colleges. The teachers teaching, the trainers training, coming direct from GPs to GPs, or our future GPs as it were. So, I think that that's restoring the natural order of things.

And then finally there's the rural workforce focus. And that's a big part of the next three months for me working on the incentives in particular, looking at what will help provide longevity and bring people into the bush to practice. We have the rural clinical schools through the Murray Darling Basin network but there's more to be done on that front. There are the attraction incentives and there are the retention incentives. And so that's our next piece of work which we're focusing on and designing with the RACGP as we speak.

So let me finish where I started by thanking our amazing Australian GPs. You've saved lives you have saved lives through the pandemic, through your diagnosis, through your treatment, through the fact that you've continued care. It has been difficult and challenging but it's been I think the most extraordinary two years, are the most incredibly productive two years in the work of our general practitioners in peace time.

And so, thank you I honor you I wish you all the best and with that I am delighted to officially launch the RACGP’s Health of the Nation report for 2021.

Thank you for the opportunity to say a few words on behalf of the Federal Labor opposition on the occasion of the launch of this year's Health of the Nation report. Before I do so though can I particularly thank Karen Price the federal President, and all of the other officers of the college at a federal state and local level, for the contribution you all make to the important public debate about health policy. It is enormously important, and we understand that you do that on top of your day jobs as important general practitioners in your own community too.

I also obviously acknowledge the extraordinary contribution that general practitioners Fellows and members of the college have made to keeping our nation safe through this extraordinary pandemic, this extraordinary time in history, that we are still living through. At the time of recording this message we're still seeing incredibly alarming case numbers in those states that are living through this disastrous third wave and in those states who are currently COVID free. We're contemplating a position when the virus becomes endemic across the country, and we know that you and your staff have been on the front line.

The Health of the Nation report this year bears out the amazing contribution general practitioners have made to keeping our nation as healthy as possible through this pandemic, but also to the vaccination program as well, with GPs contributing more than half of the effort across the country.

The Health of the Nation report every year is an incredibly important source document for policy makers and for the general community to understand the work of general practice in keeping our community safe. For an opposition that doesn't have access to the advice, the briefing notes of agencies like the Department of Health, it's a particularly important document even in the best of times and these, as you know, are far from the best of times.

I’ve really appreciated the frank and honest engagement I’ve been able to have with the college since returning to the health portfolio in January this year. As members might know I spent four years in different forms in the health portfolio back under Prime Minister Rudd and then under Prime Minister Gillard and it has been an extraordinary joy to be back in this incredibly important part of government policy. It has been obviously a tumultuous time when there are pressures across the health system at all different levels, but can I say and I think I’ve reported this to the college at different levels, that perhaps my deepest impression over the course of this year aside obviously from the impact of the pandemic is the power state of general practice across Australia.

I mean no disrespect obviously to the work the general practitioners do every single day it is extraordinary work, but you are operating under enormous pressure and those pressures are borne out. They're illustrated in black and white in this year's Health of the Nation report. Aside from the obvious and very severe impacts and pressures arising from COVID, those pressures I think are illustrated through your report in three main areas.

The first obviously is the financial pressures particularly those that continue to linger from the several years of MBS rebates which are still effectively, even though they've been lifted, stripping about half a billion dollars each year out of the Medicare system that would otherwise be there. I think one of the really stark illustrations out of this year's report is the degree to which the gap between primary care government funding and hospital government funding has grown from about 10 years ago to now. That tells you a lot about the efforts and the priorities of government over the course of that decade.

The other pressure that's borne out in this report is the structure of the MBS and the degree to which the MBS items reflect the current health demand in the population. Of particular note I think is the data from your report around long consults whether that's complex chronic disease, mental health or often a combination of the two. This is something I know the college has advocated very strongly as an area of priority reform.

And the third pressure that's borne out and illustrated in this report I think are workforce trends in your profession. There is some good news around clinical training places over the course of the year, but the background trends are not just concerning I think they are deeply alarming. Background trends around the aging of the GP workforce and the frankly precipitous decline in the preference of medical graduates as they reach the end of their medical training to adopt general practice as their preferred profession. All of this in some parts of the country has been aggravated by the introduction of the Modified Monash Model that has some has had some very perverse impacts I think in regional communities and some of our outer suburbs of major cities.

On top of all those structural pressures obviously is the impact of a once-in-a-century pandemic. Again, the insights from the Health of the Nation report this year are perhaps not particularly surprising but the granular detail set out in the report is incredibly important, because we still as you understand better than I do, have a long way to go through this pandemic.

There has over recent days been much attention on the need to reinforce the safety and the strength of our hospital system as we move to the next phases of the national cabinet plan. As we see inevitably COVID start to spread to those jurisdictions that are currently COVID free.

But I think importantly also your report highlights some of the longer-term impacts and challenges that the nation will face for months and even years. The deferred care that we only saw several days ago through the Cancer Australia report around diagnostic imaging. The deferred care is again borne out in the Health of the Nation data in very stark detail. We will see higher acuity as other jurisdictions have seen, we will see long-term mental health impacts and general practitioners will be at the front line of that.

Can I say congratulations again on this important report. This has been an incredibly busy time for the college and for the college's Fellows and members, so your ability to bring together this comprehensive report will be an important addition to the critical public debate that will play out over the coming weeks and months about how we keep our community healthy and how we keep our community safe.

I really look forward to continuing to engage with the college in the period between now and the next election and hopefully beyond.

[Acknowledge traditional owners.]

Hello, thank you for the opportunity to address the Royal Australian College of GPs.

Thank you for your advocacy. People trust doctors. As a begrudging member of the least trusted profession speaking to the most trusted, can I just say how grateful I am for your contributions to the big issues in public debate. They are really important. 

Your efforts in speaking out around the health impacts of the climate emergency have been powerful, and adding your voice to the importance of phasing out coal, oil and gas will be so crucial in what climate scientists have called the critical decade for climate action. 

They’ve said we have until 2030 to halve global pollution or we risk losing control of our climate system and all that this would mean for our health. The expansion of tropical diseases southward, rising saltwater and storm surges infiltrating our drinking water and sewerage networks, and an unleashing of the silent killer of heat waves. 

Historically, Brisbane has had 12 days a year over 35 degrees. But on current pollution trends, then within our children’s lifetime, there will be between 37 and 80 days a year. 

So thank you for using your position to speak up for a safe climate. And thank you for fighting for people seeking asylum in helping us pass the Medevac bill in the last Parliament. 

And thank you for all you have done to support our communities through the pandemic. We have saved thousands of lives. It’s been tough, but we owe a tremendous debt of gratitude to our public health system, for the clear advice, the willingness to stand up and speak out, and the public confidence you rightly hold. 

And I want to thank you for inviting me as Greens Leader to address my first RCAGPs conference. 

Because the Greens aren’t just key to determining whether legislation that’s bad for our health system gets stopped in the Senate, like when we helped stop the government introducing a $7 GP co-payment to visit your practices back in their first budget in 2014. 

If history and current polling are any guide, the Greens are also likely to be in balance of power in a minority Parliament after the next election. 

The outcome of the next election will be closer than you think. Scott Morrison holds on to majority government by the barest of margins. If just a few hundred people changed their vote at the last election, the Greens would be in balance of power in both houses right now. For Labor to win in its own right, they’d need a swing only seen once in the last 20 years, so unless the current Leader proves to be as popular as Kevin Rudd, we’re heading for a power-sharing Parliament. 

The Greens believe in growing the public health system and expanding Medicare. Last time we were in balance of power back in 2010, part of our signed agreement was to bring dental into Medicare for children. Over 3 million families have been able to get free dental care for their children because of the Greens.

And right now it has never been made more stark that quality public healthcare is a human right. So I give you a sense of what we’ll be fighting for. 

Your report illustrates what many of us have been hearing for a while. There is a massive mental health concern in our country. When psychological conditions are the most common reason for presentation for 5 years running, something is deeply wrong in our country. 

The Greens have already announced our plan to bring mental health fully into Medicare, by Expand the Better Access Initiative to unlimited psychology or psychiatric therapy sessions and raise their Medicare Benefits Schedule (MBS) rebates for patients with a diagnosed mental illness. We’d deliver free and unlimited mental health care as part of Medicare. 

The Greens also understand that there’s a lot doctors deal with every day that many people haven’t got to because they've been stuck in lockdowns, caused by a federal government failure to give you and others enough vaccines early enough, so now we’re lagging behind in the vaccine race at 31st out of 38st OECD countries. 

Your report being launched today highlighted that managing vaccines and patient expectations was the hardest part of GP’s work during this pandemic. 

None of this was helped when the government let its MPs spread misinformation without consequence and let a billionaire donor to the Coalition, Clive Palmer, sabotage public health advice with billboards, newspaper ads and text messages, all of which made it harder for health professionals to do their job. 

We now have more people struggling to manage chronic illnesses, more people presenting with more complications and needing greater levels of integrated help. 

And waiting lists were already too long at public hospitals, but now our public hospitals are getting ready for the fight of their lives. 

Our public health system - whether it be inside our hospitals, our GP clinics, our universities and research labs - should be our absolute priority and we should fund every part of it properly. That is where the need is and that is where the best value is too. 

But it appears we have arrived at the ideological end point of a government that kept the Medicare rebate - the income of GPs - frozen for years. 

Your report makes the point starkly that 26% of members said Medicare rebates were your highest priority. The Greens hear you. 

And while the government keeps trying to push GPs to do more with less, the amount of money they give to their big corporate donors rises by the year, even as it skews our health priorities. 

There is a general rule in public policy to tax more of something you don’t want and fund more of what you do. But in our health system we have it all backwards. 

We first started subsidising private health insurance under John Howard’s Prime Ministership. Still no one wanted to use it, so they started taxing people for not having it. 

This has forced people to take out junk policies to avoid paying the Medicare surcharge. This is effectively a tax diverted away from the public good to go straight to the bottom line of private health corporations - who offer nothing in their product. 

But the only thing rising faster than the premiums are the policy exclusions, so even today, people really don’t want to take out private health insurance. 

But the Parliament keeps throwing good money after bad, bending over backwards to change the rules and allow premium increases and public handouts to keep these big corporations profitable. 

Each year, the public hands $6.7 billion to the private health sector, where 4 big corporations control 70% of the market and make large profits off the back of public largesse. 

To keep the $6.7b a year flowing, a small amount of that money flows back to the coffers of the Liberal and Labor Parties, with $2.73m in political donations being made since 2012. 

We have fallen a long way from when Labor health spokesperson Jenny Macklin rightly called it “the worst example of public policy ever seen in this Parliament”, and now both the government and opposition are captured by the industry. 

But the Greens are not. 

There are better ways of spending $7b a year than giving handouts to big corporations to put up the prices of a product people increasingly don’t want to buy. 

The Greens plan is simple. We want to stop giving handouts to the billionaire corporations in the private health industry, and put that money back into the public health system. 

The State Premiers have been pushing to make 50/50 Commonwealth/State hospital funding split permanent, beyond this pandemic. We’ve had a policy costed by the independent Parliamentary Budget Office as to what a 50/50 split in the growth of hospital funding would cost and it would require a boost in hospital funding of $8 billion over the next decade. 

Once the COVID-pressures on our hospital system starts to ease, then with targeted, one-off funding of $875 million to the States, we can get to work on clearing the built up backlog of people on waiting lists, prioritising those categories of clinical urgency. 

In balance of power, the Greens will push to make healthcare more accessible, slash out of pocket costs, wipe out waiting lists, build up staffing levels and ensure the public health system is there for everyone when they need it. 

According to the Parliamentary Budget Office, even after removing the taxes that the Medicare surcharge raises, cancelling these corporate handouts will free up $59 billion over the decade. 

We can use this money to fund GPs and provide the security your report demands, fund chronic health management, fund prevention, fund regional health, make telehealth permanent and make mental health care completely free through Medicare. 

We can do all this as well as lock in the 50/50 funding growth model and clear public waiting lists when the crisis has subsided. As you can see, $59 billion buys a lot of public services. 

Of course, it isn’t all about money, we want to improve the communications between GPs and hospitals and recognise that GPs have been forced to take up the load of other underfunded areas of our health sector. The Greens don’t want you to keep having to do more with less. 

And I am sure many of you have seen the effects of these publicly subsidised corporate behemoths first hand, with the context and economic model of delivering GP services having changed and becoming increasingly corporatised. 

We want to take the pressure off GPs, so you can do your job, keeping our community safe and healthy. 

Thanks again for everything that you do