Transcript Of Interview – ABC2 Breakfast With Joe O’brien And Virginia Trioli
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1 April 2010
SUBJECTS: Diabetes management plan, health reform
VIRGINIA TRIOLI: Now the president of the Australian Medical Association has slammed the Government's $400 million diabetic care plan.
JOE O’BRIEN: Doctor Andrew Pesce has called it policy on the run and says the AMA was never consulted. For more, the Health Minister Nicola Roxon joins us now from Melbourne. Minister, good morning.
NICOLA ROXON: Good morning.
JOE O’BRIEN: Now you have received positive reactions from some interest groups as well but there has been - there have been some interest groups that are quite angry that they were not consulted. If improving the health system is your prime motivation, why didn't you involve key stakeholders in developing this policy?
NICOLA ROXON: Well, I absolutely reject that assertion. This was recommended by our Health Reform Commission, that report was released in July last year. It was recommended by our Primary Health Care Taskforce. The chair of the AMA's division of General Practice was on that committee and recommended voluntary enrolment for chronic disease.
This is a policy position that the AMA has opposed as an institution forever but all the other doctors' groups, nurses' groups, diabetic patient groups have welcomed this investment and certainly there are implementation details which in our press release we make quite clear we intend to work with the AMA on others - and others to implement.
But the absolute shift in being able to provide a flexible package of care for a diabetic patient who is not currently having all their needs met is something that we are unashamedly proud of and have been consulting with the community. Of course governments always keep final details to announce at appropriate times but I think this is a big step forward.
Nearly half a billion dollars of extra money into diabetic care where you can actually flexibly as a GP buy the extra services that might be needed for a patient, no cost to the patient and very importantly for the first time actually having some of the payment linked to stabilising a person's condition, not just providing the service.
JOE O’BRIEN: Can you guarantee that doctors will be adequately compensated?
NICOLA ROXON: Look, this is a quite generous package for doctors and most importantly for their patients. I think when people do work through the detail they will be very supportive. Our calculations show that most general practices will be about $10,000 better off.
But the way it's packaged is very important. It's not just about making sure the GPs and health professionals are paid well, it's about making sure we get a better health outcome for patients with diabetes who are far too often ending up in hospital because they're not getting the treatment that they need in the community....
NICOLA ROXON: ...and that's what's really motivating us here.
JOE O’BRIEN: There - there is a concern though that the scheme might not result in better treatment for patients. The Royal College of General Practitioners are concerned the funding model means there's a financial incentive for GPs to minimise care for a patient.
NICOLA ROXON: Well, I think that that's not properly understanding the mix of payments. There's payments that are provided to a practice when a person chooses, this is all voluntary, when a person chooses to enroll and be part of this program and it does allow practice to flexibly provide and buy appropriate services that they might not have in their own practice.
But a big part of the payment is also on the stabilisation of care so there's no incentive I don't think for a doctor to pocket the money and not provide the care to the patient because then the patient's results won't be as stable as they could be but it's all a balance because of course some people are not able to stabilise their condition no matter how good their care is and you don't want to penalise a doctor for that either.
But this allows much more creativity and teamwork between doctors, nurses, diabetic educators, podiatrist, optometrists, making sure that a person's whole body and all of their health needs are taken care of.
JOE O’BRIEN: On the Health Reform Plan more generally, John Brumby seems to be sticking to his guns. Is there any way you'd agree to hospitals funded by a state-based pool of money contributed to equally by the states and the Commonwealth?
NICOLA ROXON: Well, look, that's not our preferred position. We've made clear that we think our plan is a good one but obviously Premier Brumby...
JOE O’BRIEN: And there's no way you'll agree to that?
NICOLA ROXON: Well, look, we're talking with and meeting with the premiers - Premier Brumby often has very strong views, you know, we respect that. That's why we're taking so seriously our discussion with all of the premiers, but we believe that the model that we have is the right one. There's still a couple of weeks to go until COAG where a whole range of issues will continue to be discussed. But we believe we can deliver better health and better hospital services through our plan and that's what we'll be pursuing.
JOE O’BRIEN: On a dark Melbourne morning, Nicola Roxon, thanks for talking to us.
NICOLA ROXON: It's a pleasure.
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