Back-to-front and upside down – GP crisis oz-style

For years now, UK general practice has borne the brunt of government budget cuts and is facing a crisis. Many GPs, like myself, have chosen to leave the UK and move to Australia, for better weather and better working conditions. But it’s not all roses here. Recently, the Australian government announced that it is going to freeze the amount it pays for general practice consultations (known as the medicare rebate) until 2020. In practical terms, for full-time GPs, that equates to a loss of $100k per year, per GP. So how will GPs here manage with such large pay cuts?

Well most GPs will be relatively unaffected by this because the majority have said that they will have to raise their fees to cope with the loss. They have also educated their patients that their higher fees are due to the government for paying less for general practice consultations. Information about ‘the freeze’ has been printed on scripts given to every patient and posters put up in waiting rooms. The patients have been advised to contact their local MP if they are not happy. Consequently, the government has come under a huge amount of strain from this.

This has worked well for the majority of GP clinics in Australia, as most charge a ‘gap’ fee on top of the medicare rebate. The medicare rebate is $37.05, and most GPs charge $15 to $40 on top of this per consultation. Some clinics though, especially in the less well off suburbs, either fully bulk bill or choose to waive the gap fee for their patients to help make general practice more affordable. With a loss of $100k/yr per GP, this is going to be difficult for these doctors and practices to weather, thus many GPs in these areas are worried about their future. The budget cuts sadly disproportionately affect the poor.

That said, compared to the UK, Australian general practice is coping better in times of austerity because the GPs have more control over their individual practices. This is one of the attractive features that lure UK GPs over here. But Australia may not be accepting foreign GPs for much longer; RACGP applied this year to the government asking for general practice to be taken OFF the skilled migration shortage list, saying that the country has enough GPs! That is certainly not a cry that is being heard in the UK.

This article first appeared in The Sessional GP magazine.

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