OUR HEALTH SYSTEM REQUIRES A FULL MEDICAL

And in more detail...

Healthy living is about having a secure roof over your head and a job that satisfies your needs. It’s about living in an environment with clean air and water. It’s about many things, including your physical health. And indeed, having good health is vital to enjoying a quality of life. If you don’t have good health, the rest is just noise.

Medicare, that precious institution that has served the physical health needs of more than a generation of Australians, is no longer the shining example of government social policy it once was. It’s sick. GPs are leaving the system. The number of med school graduates taking up general practice has dropped dramatically. There are not enough doctors servicing the needs of rural and regional Australia. Nurses are exhausted and fed up. Healthcare fund memberships are falling due to spiralling monthly payments and a perceived lack of value. Public hospital emergency rooms are full of people seeking non-emergency treatment. Ambulances are “ramping”, being used as hospital overflow facilities. Indigenous health outcomes, particularly for children, continue to be appalling. The declining mental health of our teenagers and the failure to address this adequately is resulting in ballooning rates of suicide and eating disorders. And these are just a few of the symptoms of a healthcare system in crisis.

Medicare needs a significant overhaul. Its finite resources are suffering from monumental waste and mismanagement. It also requires more funding to maintain good national health outcomes because the inescapable reality is that our healthcare needs increase as we age. And now that a more significant percentage of Australians are getting older, the only way Medicare will cope with this changing demographic is to be allocated more resources and become more efficient.

But more money in the system, though crucial, is not enough to get Australia’s healthcare back on its feet. We need fresh ideas to deal with the challenges. A bedrock problem is the falling number of GPs in the system.

Medicare pays a GP $62.05 for a standard 20-minute consultation. This is a recent increase, up from $39.75, but in an ongoing inflation environment, the increase is quickly eaten away by the soaring costs of mortgages, rents, medical supplies, building and medical insurance, clerical staff, and so on. Indeed, if Medicare kept pace with inflation since its inception, the Medicare payment to doctors would be in excess of $80.

Medicare needs a significant overhaul. Its finite resources are suffering from monumental waste and mismanagement. It also requires more funding to maintain good national health outcomes because the inescapable reality is that our healthcare needs increase as we age. And now that a more significant percentage of Australians are getting older, the only way Medicare will cope with this changing demographic is to be allocated more resources and become more efficient

The lack of investment by Medicare in general practice for well over a decade has given rise to numerous problems. GPs have been forced to put up their rates to keep their practice viable, often placing a visit to the doctor out of reach of low-income people within the community. So, they seek treatment in a hospital emergency waiting room instead, which takes resources away from genuine emergencies and further stresses hospitals struggling to cope because their funding in real terms hasn’t increased either.

The crowded emergency rooms force amboes into “ramping”, parking their ambulances outside the hospital where they’re used as de-facto overflow facilities, taking these units offline and making them unable to respond to triple-zero calls.

The conspicuous lack of support for general practice also discourages medical graduates from taking up this branch of medicine. Indeed, the number choosing to be GPs has fallen from 40% to just 15%[1].

Nowhere is the decline in the numbers of GPs felt more keenly than in regional and rural Australia, where retiring local doctors often leave behind a void that is impossible to fill.

A Royal Commission into Australia's healthcare system

Medicare is so important to the fabric of Australia, and the problems and issues it now faces are so widespread and complex that The Good Party believes a wide-ranging Commonwealth Royal Commission into its workings, and the broader healthcare system, is urgently needed.

Medicare is so important to the fabric of Australia, and the problems and issues it now faces are so widespread and complex that The Good Party believes a wide-ranging Commonwealth Royal Commission into its workings, and the broader healthcare system, is urgently needed

A Royal Commission is not a process to be taken lightly. However, the Good Party believes it is vital to help the government understand the healthcare system's interconnectedness so that funding and planning for Australia’s healthcare needs can be effectively managed now and in the future.

The Commission’s terms of reference should be broad and include the actual cost of funding public health, the schedule of Medicare payments for services, the rorting and mismanagement of Medicare, the critical role of nursing, setting limits on fees charged by specialists and hospitals, arresting the decline in health fund membership, healthcare in the bush, health issues facing First Nations Australians, mental health, the cost implications of caring for an increasingly older population, and so forth.

The Good Party would make the Royal Commission its first order of business.

Women's health

Women are built biologically differently from men with a range of organs men don’t possess. And it’s because of these biological differences that women have health issues and requirements that men never experience. 

Currently, if you’re between the ages of 50-75, you’re eligible for a free mammogram every two years. However, many medical experts are advising that screening for breast cancer should begin younger, at age 40.

Also, the free mammogram screening program is managed by the Cancer Council through its 500 established clinics and a fleet of mobile breast screening vehicles. But millions of women require mammograms annually and the charity’s limited resources often force lengthy wait times.

Also, the mammogram is not an infallible test; it doesn’t pick up all breast cancers and should be augmented with a breast ultrasound for a more certain result. And with breast cancer being the second largest cause of cancer death in Australian women (after lung cancer), we believe urgent changes to the breast screening program are required.

We think it's outrageous that mammograms and breast ultrasounds don't attract the full Medicare rebate. This has to change. And the screening also must be expanded to the pool of test providers in the broader private sector. This would put an end to those wait times and, if you live in a regional town or centre, the often lengthy excursions to Cancer Council-supported clinics.

Lowering the screening age to 40 and including breast ultrasounds in the program will catch far more cancers early, prevent deaths, and provide women with better certainty.

It's clear to us at the Good Party that if Medicare had been engineered by women from the outset, rather than men, these tests would have been more broadly based and attracted the full rebate from the get-go. (See also our policies for Women)

Increasing GP numbers has to be a key objective

Bolstering the number of general practitioners is a key objective of the Good Party. Increasing the Medicare payment per consultation would be a fundamental step in the right direction. Inducements to newly minted doctors to take up general practice should also be considered. As studying for a degree in Medicine is expensive, costing a quarter of a million dollars, waiving a percentage of HECS could make general practice a more attractive option for med school graduates (See our First Degree is Free policy — you might have no HECS to repay).

Making more and better use of nurse practitioners

A measure that could relieve some of the pressure on hospital ERs and, by extension, also on the state ambulance services would be to make more and better use of nurse practitioners. These nurses with higher qualifications can diagnose and treat a wide range of health conditions, and they’re under-utilised in our current healthcare mix. Indeed, Nurse Practitioners are trained to diagnose and treat many ailments sitting in GP waiting rooms. So why can’t they be licenced, for example, to set up health-treatment facilities for non-emergency consultations?

Nurse Practitioners can:

• Diagnose and treat a wide range of health conditions
• Design and implement therapeutic regimens
• Initiate referrals to other health professionals
• Order and interpret pathology and radiology tests
• Prescribe medications (or deprescribe them)
• Provide patient rebates for some services through Medicare

Having more nurse practitioners on staff in hospitals

Hospitals would benefit immeasurably from having more nurse practitioners on staff. Unlike registered nurses, nurse practitioners are able to sign patients out of the system, making more beds available sooner and saving on related expenses. We recognise, though, that hiring nurse practitioners is an additional cost in a system already stretched financially. However the benefits outweigh the costs, and so the Good Party will lobby for additional funding for this important hiring.  

Reintroducing the "House Call" with nurse practitioners

The triple pressures of cost, time and availability have ended the once-common — and welcomed — doctor’s house call. Licencing nurse practitioners to make house calls would reduce the load on the dwindling numbers of GPs and hospital ERs. Young mothers with sick children would especially appreciate a House Call, as would older senior citizens who are housebound because their mobility isn’t what it used to be.

These nurses with higher qualifications can diagnose and treat a wide range of health conditions, and they’re under-utilised in our current healthcare mix. Indeed, Nurse Practitioners are trained to diagnose and treat many ailments sitting in GP waiting rooms. So why can’t they be licenced, for example, to set up health-treatment facilities for non-emergency consultations?

Getting healthcare to the homeless

A further vital use for nurse practitioners and the House Call concept would be to apply it to the more than 8000 people who sleep rough in our communities every night. It’s reasonable to assume that many homeless people suffer from health problems that are either ignored or undiagnosed. A wealthy country like ours should consider every Australian’s health needs. Vital charitable institutions like the Salvos, Wayside Chapel and the Australian Red Cross that are in regular contact with our homeless could be funded to manage a “House Call for the Homeless” scheme. The Good Party will ensure that Medicare allocates resources to make this initiative a reality.

A broader role for Pharmacists

During the COVID pandemic, pharmacists proved to policymakers that they are more than capable of filling a vital role in Australia’s healthcare system. Now that the pandemic has passed and the emergency is behind us, we should take these learnings and use pharmacists more. They are trusted and under-utilised healthcare professionals, often with close and broad relationships within their local communities. While not clinicians in the traditional sense, pharmacists can diagnose a wide range of ailments and prescribe medicines for them when necessary. And pharmacies are everywhere GPs aren’t, especially in rural and regional areas. Queensland and New South Wales are trialling a broader role for pharmacists. Assuming the trials are successful, the scheme should roll out nationally.

Keeping Telehealth on the air

During the COVID lockdowns, Telehealth proved to be an essential resource, linking healthcare professionals with patients to provide advice and treatments without the risk of the virus’s transmission. With the worst of the pandemic now behind us, Telehealth is one of the numerous government initiatives being wound back. The Good Party would see Telehealth maintained. Having proved its worth under adverse conditions, Telehealth should continue to perform its essential role, utilised by people in country and regional areas where GPs are scarce, by older Australians who aren’t as ambulant as they used to be, and also by people with disabilities for whom a trip to the doctor can be difficult.

Towns and centres in rural and regional Australia are desperate for a local GP. Many shop for a doctor overseas, offering all kinds of inducements to come and set up a practice or take over a practice from a retiring physician

Attracting GPS to the bush

Towns and centres in rural and regional Australia are desperate for a local GP. Many shop for a doctor overseas, offering all kinds of inducements to come and set up a practice or take over a practice from a retiring physician. The federal government could sweeten the deal by, for example, doubling the Medicare payment per consultation in non-urban areas. It could also offer to suspend HECS fee repayments for doctors fresh out of med school who head for the bush. And waive them entirely if the doctor remains in a country practice after five years of service (see our First Degree is Free policy. You might have zero HECS to repay)

Healthcare for First Nations People

Indigenous Australians have shorter lifespans than non-Indigenous Australians. On average, Aboriginal males live 71.6 years, 8.6 years less than their non-Aboriginal peers, and women live 75.6 years, 7.8 years less[2]. Poor access to healthcare is a large part of the reason why.

The child mortality rate of Indigenous Australians also continues to be stubbornly high, with Aboriginal children dying at twice the rate of other Australians[3].

These facts are a national shame, and the Good Party will engage with influential Aboriginal Aunties and Uncles to develop strategies to address them.

Aboriginal children also face some specific healthcare issues. For example, they are 8.5 times more likely than non-indigenous Australians to suffer from ear infections, fluid build-up and perforated ear drums. These problems can be easily treated, but if not can lead to permanent hearing loss. And in the meantime, these children can and do suffer from various learning difficulties that lead to all kinds of disadvantages later in life.

Aboriginal and Torres Strait Islander kids are also highly susceptible to the common bacterial infection called “strep throat”, which, if left untreated, can become rheumatic heart disease (RHD). All too often, this can require open heart surgery to repair or replace damaged heart valves.

The Good Party would address these health issues plaguing Aboriginal kids by seeing that specially trained health professionals are federally funded to visit Indigenous schools and settlements and provide treatment regularly.

Aboriginal children also face some specific healthcare issues. For example, they are 8.5 times more likely than non-indigenous Australians to suffer from ear infections, fluid build-up and perforated ear drums. These problems can be easily treated, but if not can lead to permanent hearing loss. And in the meantime, these children can and do suffer from various learning difficulties that lead to all kinds of disadvantages later in life

Addressing the mental health of our teenagers, First Nations People, and veterans

According to the Australian Institute of Health and Welfare, suicide is the leading cause of death among Australians aged 15-24.

Suicide rates among indigenous Australians are double that of non-indigenous Australians. Our defence force veterans are killing themselves in alarming numbers. Hospitalisation rates for girls self-harming are also rising.

These are terrible facts. The reasons underpinning the statistics are multi-faceted and complex, and the disconnection many people felt during the COVID-19 pandemic exacerbated the problem. There is clearly a need for a substantive nationwide mental health program. While the states administer the health services, the Good Party will see that state-based mental health programs for young Australians are matched dollar for dollar.

More pay and better conditions for nurses

Anyone who has spent time in a hospital knows how vital nurses are. They are tireless, dedicated and significantly underpaid. During the pandemic, they were our heroes. But unfortunately, underpaid and overworked, they are also leaving the profession in droves. The Good Party supports nurses’ demands for better wages and conditions.

[1] Medical Journal of Australia (MJA), April 13 2020

[2] https://www.creativespirits.info/aboriginalculture/health/aboriginal-life-expectancy

[3] Australian Government “Closing the Gap Report 2020”