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Speaker 1: It's looking as though for some people it may get

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Speaker 1: more expensive to visit the doctor under changes to fees

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Speaker 1: which were recommended by the Australian Medical Association. So the

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Speaker 1: peak body had suggested that gps raise their fees for

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Speaker 1: a third time this year to offset rising operational costs.

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Speaker 1: But we also know that incentives from the federal government

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Speaker 1: to entice doctors to bulk bill children at concession card holders,

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Speaker 1: they've also come into effects. So a couple of different

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Speaker 1: things happening. The ama NT's president, Doctor Robert Parker, joins

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Speaker 1: me on the line now to explain what it all

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Speaker 1: means for Territorians. Good morning to you, doctor Parker. Now,

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Speaker 1: first off, why were or why are fee increases being

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Speaker 1: recommended for some patients.

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Speaker 2: Well, I suppose gps run businesses. They've got to run

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Speaker 2: play staff, they've got to pay a rent, they've got

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Speaker 2: to have enough money to feed their families, you know.

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Speaker 2: And the issue was because of the certain fees and

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Speaker 2: the and the bulk billing, there potential for being able

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Speaker 2: to run a business has fallen behind. So the ama

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Speaker 2: is just making recommendations for fee increases. I mean, it

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Speaker 2: doesn't mean.

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Speaker 3: That if a GP has to follow that.

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Speaker 2: It's just the the AMA making recommendations to make a

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Speaker 2: business workable.

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Speaker 1: I suppose do you know if many in the Northern

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Speaker 1: Territory are going down that path?

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Speaker 2: No, I'm not sure I've got information at the moment

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Speaker 2: about that.

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Speaker 1: How much would it sort of be how much extra

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Speaker 1: for some patients?

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Speaker 2: Well, it depends again. It's the issue about BOLK billing

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Speaker 2: and private patients. Very you know, the government's recently given

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Speaker 2: a lot more money to enable bolk billing, which is

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Speaker 2: really very good. It means hopefully more GPS will be

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Speaker 2: able to both bill now patients who really need ongoing care.

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Speaker 2: I mean, one of the big problems has been because

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Speaker 2: the bulk builling rate has fallen significantly behind the I

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Speaker 2: suppose the CPI and the way that GPS can run

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Speaker 2: the practices. It means a whole bunch of people who

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Speaker 2: are very needy and require primary care haven't been able

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Speaker 2: to access good GP care for chronic illnesses, which means

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Speaker 2: those illnesses then become more complex and people end up

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Speaker 2: an ed and often spend longer times in hospital.

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Speaker 3: Yeah.

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Speaker 1: I guess now, now the.

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Speaker 2: GP reboate has been increased, hopefully a lot more people

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Speaker 2: on healthcare cards will be able to access good gpcare.

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Speaker 1: Yeah, and that's a juggle, isn't it. Like you said,

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Speaker 1: obviously GPS our businesses. They need to be able to

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Speaker 1: operate and profitably so that they're able to continue to operate.

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Speaker 1: But you do want to make sure that those that

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Speaker 1: are doing it tough for able to see a doctor

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Speaker 1: for a reasonable amount of money so that they're not

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Speaker 1: then clogging up their health system. So it is a

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Speaker 1: bit of a juggle.

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Speaker 3: Well, again, it's also the personal thing as well.

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Speaker 2: I mean, these illnesses have a significant personal cost, you know,

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Speaker 2: and then the suffering and disability to go with them.

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Speaker 2: So I mean, apart from the impact on hospitals, it's

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Speaker 2: also hopefully producing healthy people who are enjoying life more.

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Speaker 1: Dr Parker talk us through with the federal government's changes

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Speaker 1: to entice doctors to bulk bill children and concession cardholders.

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Speaker 1: I mean, how big an impact are you expecting that

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Speaker 1: to have in the territory.

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Speaker 2: Well, again, there's a significant increase in the Medicare rebate

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Speaker 2: for those and hopefully the GPS will will be able

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Speaker 2: to accommodate that within their business model. So we're hoping

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Speaker 2: that a lot more people who previously couldn't access BOK

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Speaker 2: building will now be able to access BOK billing and

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Speaker 2: have the health care care health care needs met.

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Speaker 1: So talk us through those incentives for doctors, what exactly

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Speaker 1: will they be if they make those changes.

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Speaker 2: It's more money, so more money. There's more money for

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Speaker 2: the doctor and a greater rebate for the person. And

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Speaker 2: again the farther out you are, one of the big

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Speaker 2: problems has been as I've pointed out many years ago,

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Speaker 2: to the healthcare instead of the lack of and we're

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Speaker 2: on areas. So the current rebates certainly encourage more medical

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Speaker 2: practices in the rural areas to bob bill because they

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Speaker 2: get higher rebates. So hopefully that will also improve the

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Speaker 2: improve the access to care for people living in more

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Speaker 2: remote regions.

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Speaker 1: And doctor Parker, do you think that it will then

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Speaker 1: have that on flow right through to you know, to

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Speaker 1: people not presenting to the ED Well again.

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Speaker 2: If people have a lot of chronic illnesses really benefit

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Speaker 2: from regular contact with GPS, and that they will then

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Speaker 2: hopefully prevent people from coming to the team. The pudding

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Speaker 2: will be in you know, health stats six four months

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Speaker 2: out to see if there's actually has an impact on

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Speaker 2: GP on thed presentations.

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Speaker 1: Yeah, very good point. How much extra are the gps

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Speaker 1: going to receive if they do go down that path?

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Speaker 2: Well, I have actually got a figures on me at

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Speaker 2: the you know, Abou's forty fifty dollars more I think

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Speaker 2: when they were getting previously.

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Speaker 1: And it will and it will mostly be but it

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Speaker 1: will mostly be those concession card holders, children, those kind

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Speaker 1: of patients that will benefit.

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Speaker 3: That's right, that's right.

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Speaker 2: So people who can afford medical carelessof to pay, but

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Speaker 2: it's the needy quite often, and quite often the needy

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Speaker 2: have got much higher rates of the illnesses that require

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Speaker 2: regular medical attention, and they're going to get much better

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Speaker 2: benefit from these changes.

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Speaker 1: Dr Parker, how are things going at the moment at

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Speaker 1: Royal Darwin Hospital for example, and also out in Palmerston.

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Speaker 1: I know that it was just a couple of weeks

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Speaker 1: ago that we've had another Code yellow. They do seem

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Speaker 1: to just be something that we hear about quite often

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Speaker 1: these days.

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Speaker 2: Okay, I've actually been off sick myself for the last

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Speaker 2: week league poor bugger. Look, so I've been in touch

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Speaker 2: with it with the workforce. But the problem is, you know,

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Speaker 2: as my letter pointed out, a number of years ago.

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Speaker 2: At that stage, charity hospitals were a crisis point. And

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Speaker 2: when you've got a continuing.

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Speaker 3: Crisis point, it just takes a little bit of.

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Speaker 2: An issue such as increased numbers of beds so people

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Speaker 2: should be in nursing homes, a number of staff off sick,

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Speaker 2: or an it problem to put the hospital in code yellow.

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Speaker 2: So the hospital has already at a tipping point constantly,

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Speaker 2: and it doesn't take much to actually from one reason

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Speaker 2: or another to put it into a code yellow.

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Speaker 3: Again.

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Speaker 1: We are actually hearing at the moment that there's a

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Speaker 1: COVID spike. Well, we've actually been told within our corrections facility.

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Speaker 1: Are you hearing much about whether we've got extra COVID

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Speaker 1: cases at the moment or people being hospitalized?

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Speaker 2: Well, I'm aware of COVID. I mean, I think it's

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Speaker 2: been well recognized that COVID is around the state for

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Speaker 2: quite a while, and there's going to be different variants

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Speaker 2: of it to turn up that evolved, unfortunately, but it's

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Speaker 2: sort of it's now I suppose in the population and

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Speaker 2: with hopefully large numbers of people immunized and people who've

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Speaker 2: already had it, probably more like a flu situation. Rather

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Speaker 2: than the dramatic onset that happened a number of years

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Speaker 2: ago where hundreds.

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Speaker 3: Of people died. So COVID will be with us.

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Speaker 2: For years or decades to come, in one way or another,

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Speaker 2: and there will be spikes as it evolved into one

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Speaker 2: form or another. That's it not surprising that it comes

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Speaker 2: up again?

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Speaker 1: Hey, just before I let you go. Earlier in the week,

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Speaker 1: the ABC was reporting that NT independent Mla Kezi Epiric

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Speaker 1: attended the Global Tobacco and Nicotine Forum in Korea in September.

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Speaker 1: She spoke on a panel about industry regulation. The forum

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Speaker 1: sponsored by tobacco nationals multinationals, I should say, including British

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Speaker 1: America Tobacco, Imperial Brands and a range of vaping companies. Now,

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Speaker 1: Kezia spoke to me on the show on Monday and

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Speaker 1: said that she intended to learn how to prevent smoking

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Speaker 1: in the Northern Territory, especially in indigenous communities, and to

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Speaker 1: enlighten herself as to how she might respond when and

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Speaker 1: if the Northern Territory government introduces vaping laws. What do

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Speaker 1: you make of the member for Goyder's attendance?

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Speaker 2: Well, as I pointed out, another outlets, Katie kids. He

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Speaker 2: is an intelligent woman, she's well informed. A number of

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Speaker 2: years ago, Ima wrote to every parliamentarian in the territory

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Speaker 2: to point out that there was a recent article by

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Speaker 2: some very well respected Indigenous academics that showed that I

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Speaker 2: think fifty percent of all Indigenous people over forty died

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Speaker 2: from smoking related causes, and that was probably a bit

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Speaker 2: higher than in Territorians. So you know, she would have

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Speaker 2: been well informed about the you know, the devastation that

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Speaker 2: smoking causes to the health of Territorians, particularly Indigenous Territorians.

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Speaker 2: So and she took that with her a career. So

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Speaker 2: I suppose she's got every right to go as a parliamentarian.

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Speaker 2: I mean, it is a concern where you're actually get

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Speaker 2: funded by the tobacco industry to go rather than using

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Speaker 2: your parliamentary entitlement. But you know she's got a right

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Speaker 2: to do that as an intelligent in form woman. I

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Speaker 2: don't think she's going to get very far with the

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Speaker 2: vaping because there's more and more evidence now that vaping

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Speaker 2: is a very difficult in its own regard and respect

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Speaker 2: to health and the at leite to it's an early

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Speaker 2: entry into smoking, which is why I think there's a

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Speaker 2: legislation now.

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Speaker 3: That it has by prescription.

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Speaker 2: Well, there is a lot of underground vaping, so I

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Speaker 2: don't think you're going to get very far with the

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Speaker 2: vaping in the territory. But yeah, I suppose I don't

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Speaker 2: disute her right to go, and I'm glad she went

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Speaker 2: to get more information. But the fact she was actually

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Speaker 2: founded by big tobacco is a concern.

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Speaker 1: Well, that was going to be my next question. I mean,

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Speaker 1: do you think she can remain independent on this issue?

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Speaker 1: And I asked her this as well, do you think

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Speaker 1: she can remain independent on this issue after having these

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Speaker 1: big companies pay for her to attend?

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Speaker 2: No, I think it's very difficult. I think it puts

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Speaker 2: you in a very difficult position where you've got a

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Speaker 2: significant conflict of interest in any potential vote on or

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Speaker 2: discussion on vaping.

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Speaker 1: I'm just on vaping, doctor Parker, do you reckon? I mean,

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Speaker 1: are we doing enough to try and stamp this out,

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Speaker 1: particularly amongst our young people. I know that the federal

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Speaker 1: Health Minister, Mark Butler I noted that he was speaking

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Speaker 1: about this nationally yesterday and making sure that we're doing

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Speaker 1: everything that we can to try to really steer our

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Speaker 1: young people away from it, but it seems to be

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Speaker 1: a real issue in the territory with our youngsters.

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Speaker 2: Well, I think it's an issue everywhere, and I mean

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Speaker 2: there's been a lot of social media and other issues

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Speaker 2: encouraging vaping with young people. It's sort of a very

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Speaker 2: popular trendy thing to do, I think, and it's certainly

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Speaker 2: the people who manufacture the vapings that do it with

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Speaker 2: particular flavors in other ways inducements to try and bring

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Speaker 2: people into vaping. It's a real problem, and I think

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Speaker 2: there's more and more evidence now about the direct direct

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Speaker 2: health effects of vaping, some damage to lungs and further

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Speaker 2: health effects from that. But also then their potential you know,

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Speaker 2: particularly you know they're smoking, had significantly decreased among young

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Speaker 2: people in recent years, and vaping's obviously been a way

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Speaker 2: to try and get more and more young people into

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Speaker 2: this area and smoking. So that's a significant concern. I

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Speaker 2: agree with part agree with mister Butler.

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Speaker 1: Yeah, it's a look, it's a really difficult one, isn't it,

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Speaker 1: Because I know that we've already got lots of regulations

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Speaker 1: in place where it seems like we do. I don't

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Speaker 1: know if the answer with young people. Is that is

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Speaker 1: more education? I really don't know what the answer is,

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Speaker 1: but it does seem to be something that they don't

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Speaker 1: think is going to harm them.

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Speaker 2: Well, that's right, and certainly the social media influences seem

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Speaker 2: to be putting out you know that it's a trendy

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Speaker 2: thing to do, which is and you can only educate

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Speaker 2: to a certain degree. I totally agree about education, but

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Speaker 2: where you fit them into a curriculum. I look, I

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Speaker 2: totally agree with you more education to try and prevent

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Speaker 2: people vade them because again, the article that always sticks

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Speaker 2: with me as an article about when vaping was first

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Speaker 2: developed is this area of China where it was like

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Speaker 2: Elle's kitchen with this sort of all these different laboratories

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Speaker 2: with a toxic chemicals producing vaping in a totally unregulated manner,

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Speaker 2: and I presume in a lot of cases I still continue,

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Speaker 2: so you don't know quite what you're taking into your

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Speaker 2: lungs when you vape and what the ongoing effects are. Look,

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Speaker 2: I totally agree that vaping, but again you've got a

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Speaker 2: very strong sort of social influencing area that promotes it.

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Speaker 2: So it's quite difficult to balance the two.

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Speaker 1: Well, Dr Robert Parker, we always appreciate your time. I

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Speaker 1: hope your legs are okay and we'll catch up with

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Speaker 1: you again soon.

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Speaker 3: Okay, good to talk Katie.

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Speaker 1: Thank you