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Speaker 1: So we know that primary health was a big winner

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Speaker 1: in the federal budget with a raft of measures announced

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Speaker 1: to make it easier and cheaper to see a doctor. Well,

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Speaker 1: that's certainly the aim and the hope. The bulk billing

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Speaker 1: incentive has been tripled for GPS with three billion dollars

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Speaker 1: injected into Medicare. The Palmerston GP Superclinic, Robin Karl, she

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Speaker 1: is going to join us in just a moment's time

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Speaker 1: to tell us how this break well, you know how

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Speaker 1: this change, i should say, is going to make a difference,

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Speaker 1: and joining me on the line right now. It is

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Speaker 1: the Palmeston GP Superclinics CEO, Robin Carl.

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Speaker 2: Good morning, Robin, Good morning Katie.

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Speaker 1: Robin. What was your reaction to the federal budget announcement.

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Speaker 2: Well, I think the first reaction was it's about time

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Speaker 2: there's been some increases to Medicare that were more realistic

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Speaker 2: and more reflective of the actual cost of delivering services.

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Speaker 2: So that initial announcement where the bulk billing benefits for

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Speaker 2: those people that Medicare really is intended to assist, so

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Speaker 2: kids and people on concession cards and low income earners,

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Speaker 2: that's fantastic. I think there's a few other things in

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Speaker 2: there that sound okay on the surface, but until we

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Speaker 2: see a little bit more detail, it's going to be

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Speaker 2: a little harder to know just what impact it's going

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Speaker 2: to have.

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Speaker 1: Yeah, right, So obviously the you know, the headline was

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Speaker 1: the fact that it's going to hopefully help a lot

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Speaker 1: of territories and a lot of assies when it comes

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Speaker 1: to bold billing due to the to the changes. But

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Speaker 1: what do you think that it actually will. Do you

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Speaker 1: think it's going to sort of pass down that far,

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Speaker 1: or how do you reckon it's going to work.

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Speaker 2: I think what we're going to see is those practice

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Speaker 2: that historically have been bulk billing young children, pensioners, healthcare cardholders,

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Speaker 2: and sea who have over the past couple of years

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Speaker 2: in particulars are increasingly difficult to be able to afford

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Speaker 2: to do. So that tripling of the bulk billing incentive

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Speaker 2: actually brings the amount of money that Medicare will support

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Speaker 2: much closer to the actual cost of delivering that service.

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Speaker 2: So I think particularly families with lots of young children.

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Speaker 2: So if you've got three kids and they're all sick,

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Speaker 2: and you take them to the doctor and you have

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Speaker 2: to pay out of pocket, it's going to get very expensive,

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Speaker 2: but it looks like now that benefit's going to be

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Speaker 2: much close to that sixty to seventy dollars range that

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Speaker 2: practices have been charging for those consultations. So if they're

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Speaker 2: able to move back to building those particular patients, that

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Speaker 2: will be very good for the community. Obviously, the biggest

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Speaker 2: issue is access. We still have a chronic shortage of

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Speaker 2: general practitioners across the country that most particularly in regional

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Speaker 2: or my areas. So even getting that incentive, if you

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Speaker 2: can't actually access the doctor, it's not going to be

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Speaker 2: particularly helpful.

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Speaker 1: Robin, where are we at from your perspective when it

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Speaker 1: comes to that GP shortage here in the Northern Territory.

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Speaker 2: I think we're still a long way from resolving the shortage.

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Speaker 2: I think that there have been some major changes in

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Speaker 2: the federal government's approach to classifying region and remote communities

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Speaker 2: over the past five to six years that have seen

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Speaker 2: much easier for those doctors historically that we've depended on.

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Speaker 2: So overseas medical graduates, for example, that come to Australia,

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Speaker 2: they've come on board knowing that they would have to

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Speaker 2: serve some time in regional areas, but they change what's

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Speaker 2: called the MMR, which is the remote classification to areas

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Speaker 2: on the East coast of Australia not that long ago.

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Speaker 2: So the MMR for somewhere like Liverpool, which is not

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Speaker 2: too far from Sydney, is exactly the same as if

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Speaker 2: you're in Palmerston. So if I'm someone with a young family,

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Speaker 2: just move to a country that I don't know, and

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Speaker 2: I have the choice between living a couple of hours

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Speaker 2: out of Sydney or a four and a half hour

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Speaker 2: flight from Sydney, I'm probably going to do the out

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Speaker 2: of Sydney option.

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Speaker 1: Seems crazy.

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Speaker 2: That makes it re call.

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Speaker 1: Yeah, it really does.

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Speaker 2: I couldn't wrap my head around that one, except maybe

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Speaker 2: there's a few more votes in it. Yeah, that political

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Speaker 2: party decided with that decision. That's a very good point. Yeah,

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Speaker 2: we really have to look out why our graduate doctors

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Speaker 2: aren't moving into general practice and why they're not interested

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Speaker 2: in moving into the remote and regional areas. We're very

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Speaker 2: un fortunate we have a great training program here in

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Speaker 2: the territory, but it's a long term investment and we're

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Speaker 2: only just in the last two three years starting to

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Speaker 2: see a return on that investment. For example, we've got

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Speaker 2: a couple of doctors who are working with US now,

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Speaker 2: one who fellowed last year, who was a medical student

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Speaker 2: with US, who did her GP training with US, and

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Speaker 2: the stayed on met US. So the system works, it

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Speaker 2: just takes time.

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Speaker 1: Yeah, Robin, you and I have spoken before about local

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Speaker 1: doctors moving away from bulk billing and slugging patients fees

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Speaker 1: because they could no longer sort of absorb those costs.

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Speaker 1: Do you think that the changes that were announced in

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Speaker 1: terms solve Medicare and with the bolt billing, that it

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Speaker 1: will see some of those revert back to bulk billing.

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Speaker 2: I think it will see them revert back to bolk

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Speaker 2: billing for those patients that bulk billing was designed to support,

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Speaker 2: so the kids, the pensioners, and healthcare cardholders, and certainly

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Speaker 2: our practice has always bolt willed those patients because that's

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Speaker 2: what bolt billing is designed to support, those people who

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Speaker 2: are on lower incomes or who perhaps are struggling a

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Speaker 2: little more with their health outcomes. So that makes that

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Speaker 2: far more affordable for practicing to do that. They've also

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Speaker 2: announced that there's going to be two increases to the

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Speaker 2: Medicare rebate throughout the next six months, which is also great.

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Speaker 2: We've got a lot of catching up to do in

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Speaker 2: terms of making the medicare rebate more in line with

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Speaker 2: the cost of delivering services, but any increase that we

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Speaker 2: can get will actually make it far more palatable for

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Speaker 2: practices who've had to move away from bolt billing everybody

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Speaker 2: or those critical groups simply be because it's just not

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Speaker 2: viable for them. It'll make it a little easier for

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Speaker 2: them to move back into, particularly focusing on those high

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Speaker 2: risk kind needs groups.

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Speaker 1: Yep. Now, Robin, I know a number of urgent care

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Speaker 1: clinics we're also announced federally. What can you tell us

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Speaker 1: about those and do you know who's going to be

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Speaker 1: able to access them or who's going to be operating

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Speaker 1: them at this point.

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Speaker 2: Well, I can't tell you a huge amount because it's

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Speaker 2: not a huge amount of information around and that's coming

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Speaker 2: from someone who has actively been involved in disgusting whether

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Speaker 2: or not we can actually open one of the USA

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Speaker 2: care clinics within our service. The intent of it is

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Speaker 2: that the government keeps using the word free. I think

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Speaker 2: it's really important. There is no such thing as a

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Speaker 2: free anything. When it comes to ELD. There's always a

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Speaker 2: cost attached, So we're really talking about services that are

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Speaker 2: able to accept as full payment the Medicare rebate. And

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Speaker 2: my best understanding of it is the intention needs that

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Speaker 2: it's for people who are it's a truly urgent requirement.

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Speaker 2: So it's not I felt stick last night. I need

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Speaker 2: a medical certificate today. I think I need a check

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Speaker 2: on my blood pressure, you know, because I'm overdue for

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Speaker 2: those sorts of things. It's really about my kid fell

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Speaker 2: off his bike. I need him to be seen really quickly.

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Speaker 2: Will we need an X ray? What will we need

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Speaker 2: to do. I've got a severe laceration. I need to

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Speaker 2: get that scene tore. Those sorts of things. I'm suffering

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Speaker 2: chest pain, I need to get an ECG. I need

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Speaker 2: to know what's wrong with me. That's my understanding of

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Speaker 2: what that's for, and the whole intent of it is

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Speaker 2: to reduce the pressure on the public hospital emergency departments.

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Speaker 2: Which if you've got an area where the additional services

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Speaker 2: are easily accessible, so for example, X ray services and

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Speaker 2: pathology services and they could all work together, then that's great.

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Speaker 2: But given the focus is on particular extended hours when

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Speaker 2: a lot of those services actually don't work, I'm not

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Speaker 2: entirely sure how government thinks it's going to reduce the

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Speaker 2: pressure on the hospital mansion to departments at the end

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Speaker 2: of the day, especially here in the territory. If you

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Speaker 2: want an X ray after ours, if you want pathology

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Speaker 2: tests done after ours, your only choice is to go

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Speaker 2: to the hospital. Yeah, so perhaps there'll be a little

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Speaker 2: bit of triaging. It may make the attendance of the

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Speaker 2: person at the hospital farm or streamlined, if all the

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Speaker 2: initial work has already be done, and when they arrive

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Speaker 2: at the hospital it's just because they need an X ray,

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Speaker 2: it's just because they need some blood's taken and a

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Speaker 2: pathology test done straight away. It's a little hard to

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Speaker 2: see how it's going to help. In the Northern Territory,

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Speaker 2: there's already some services that do provide urgent access to

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Speaker 2: care no matter what the time day is. So it's

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Speaker 2: great on the surface. It's when you dig into the detail,

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Speaker 2: it's a little hard to understand how it's going to

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Speaker 2: have the desired impact.

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Speaker 1: Sounds like there's quite a bit of detail still to

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Speaker 1: work through on those those urgent care clinics. So, oh, Carl,

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Speaker 1: it's all great to catch up with you. We really

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Speaker 1: appreciate your time this morning. Thanks so much for having

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Speaker 1: a chat with us and talking a little bit more

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Speaker 1: about those bulk billing incentives.

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Speaker 2: Yeah comment Katie, always your pleasure.

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Speaker 1: Thank you, We'll talk to you soon