The Health News – 21 March 2014

Overview

  • A review of the National Disability Insurance Scheme has said there are significant problems with the agency formed to manage the scheme.
  • The Australian Medical Asoc has said that a private health scheme which promises members access to prioritised bulk-billed healthcare goes against the spirit of Medicare laws that are intended to guarantee quality in access to healthcare.

Health News on HPR.

NDIS rollout may be delayed after review finds ‘significant problems’ with agency set up to run it – By Emma Griffiths
A review of the National Disability Insurance Scheme has said there are significant problems with the agency formed to manage the scheme. The review also compared the National Disability Insurance Agency to “a plane that took off before it had been fully built and is being completed while it is in the air”. The assistant minister for social services Mitch Fifield, who is in charge of the scheme, said “The review makes clear that the agency’s foundations need significant work in order to deliver and sustain the full NDIS. The agency has developed an action plan and will provide further advice as to whether the current implementation timetable is consistent with a successful full scheme rollout.”

Once fully implemented the scheme will cost the Commonwealth an estimated $8b per year, partially funded by increases to the Medicare levy, and aims to serve the needs of over 400,000 Australians with permanent disabilities. The scheme is currently being trialled in Tasmania, South Australia, Victoria’s Barwon region and the Hunter Valley in New South Wales. But Ken Baker, CEO of National Disability Services, peak body for non-government services in the field, said “The NDIS is eight months into a six-year marathon. We’ve exerted a lot of effort and ingenuity to get this far so quickly – it’s too early to decide that the road ahead is too steep.” The review listed many serious problems with the scheme’s agency, the majority of which were attributed to the former Labour government’s decision to bring the roll-out date forward to July last year, 12 months earlier than originally planned. The review said that the rescheduling affected staffing throughout the organisation, and that “There is also a lack of clear guidance for staff on the way the scheme operates, including eligibility and reasonable and necessary support. Insufficient effort was devoted to preparation for the next phases of the rollout. As a result there are some challenges emerging, the biggest challenge of all is over the horizon. There are also major pieces of work to be done on service provider development, workforce availability, housing, mental health, market regulation and design.”

Private health priority treatment ‘against spirit of Medicare’, AMA official warns, as scheme expands – By Elise Worthington
The Australian Medical Asoc has said that a private health scheme which promises members access to prioritised bulk-billed healthcare goes against the spirit of Medicare laws that are intended to guarantee quality in access to healthcare. Last November Medibank Private began trialling the coverage at 6 medical practices in Brisbane’s north, and plans to expand the coverage to 30 other practices across QLD, and additional practices in other states. Medibank’s national medical director Dr Ian Boyd said the feedback has been positive from the 4,500 patients who have accessed the program so far, and said “The service allows them to have access to a GP within 24 hours for a standard daytime visit, and also allows them to have access to a GP in the metro areas in the after-hours period for home visits. This is bulk billed at the patient end and offers a great service to our members. Federal Health Minister Peter Dutton is very supportive of what we are doing. We are looking at rolling this out nationwide if we continue to get the success and the positive feedback we have had so far.” Minister Dutton said of the scheme “I am interested to see the outcomes of the trial in Queensland and I’m open to involvement of insurers. They cover 11 million Australians, and if they can help to keep those people healthy and getting more regular access to primary care that is good for the health system as a whole.” But Dr Brian Morton, chairman of the AMA’s Council of General Practice, argued unequal access to health services cannot be allowed, and said “We can’t go down a track like the US system where there’s managed care, where there’s great disadvantage to an enormous number in the population. Clinical decisions have to be maintained as clinical decisions – we can’t have private health insurers dictating who gets seen, when they get seen, where they’ll be treated.”

“The main reason the AMA is very cautious about this trial is that it’s not in the spirit of the law regarding Medicare.

“It’s not available to all patients – it really goes against the spirit of Medicare, being equity in access for every Australian.

The scheme involves Medibank paying part of its clinics’ costs to ensure that its patients receive free after hours care and gain appointments within 24 hours.

Dr Morton described the scheme as “through the back door”, and said “It’s through a corporate structure that a practice must have and it’s on an immersive or capitation payment, so it doesn’t necessarily reflect fairness and access by every general practice and every patient in Australia.”

Medibank Private trial includes:

A 24-hour guarantee – members will get an appointment to see a doctor within 24 hours of calling.

No out-of-pocket expense – participating GPs have agreed not to charge an out-of-pocket expense.

Access to an after-hours GP – after-hours home visits by a GP with no out-of-pocket costs.

A range of one-off health assessments available to people at different life stages with no out-of-pocket costs.

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