Date published: 
18 October 2018
Media type: 
Transcript
Audience: 
General public

LEON BYNER:

Now, older Australians - we reported this to you in the last day or so, older Australians denied Medicare rebates for GP-ordered knee MRIs from November, and people will have to wait months to see a specialist or pay up to $500 for a scan. I caught up with the Health Minister only a few minutes ago and I asked him: why have you done this?

GREG HUNT:

Well actually firstly, that’s incorrect. Secondly, there is an expert panel of medical specialists from around the country that’s reviewing the whole of the Medicare schedule and they make recommendations. One of them was that they were deeply concerned that there was a practice emerging which was sending patients over 50 to MRIs when that wasn't necessarily the appropriate diagnosis or treatment for them and so the medical experts made a number of recommendations.

They made that knee MRIs are more available for under-16s. They were concerned that better treatment was being deferred for the over-50s and they said that it was important to go to a specialist as a first step. And so that's- was announced quite some time ago and at the same time they've increased the access to 3D mammography for breast scans for women and MRIs for prostate cancer diagnosis for men. So they make a series of recommendations and all were accepted by the Government.

LEON BYNER:

So again, let's be clear, what happens then on 1 November, that's different to what is happening now?

GREG HUNT:

So what happens on 1 November is that instead of going directly to- from a GP to an MRI for the over-50s, it would have to be referred via specialist.

LEON BYNER:

So, no more GPs sending you for an MRI?

GREG HUNT:

That's the advice, the recommendation, the analysis of the medical experts, the task force that comprises some of Australia’s great doctors and physicians.

LEON BYNER:

Alright but this is for the knee only isn’t it? It’s not an MRI per se?

GREG HUNT:

No, correct, and there are over 200 Medicare items which have some sort of age-related component to them across the country.

So it's a standard approach and it came about simply because there had been a very odd change in practice in the last couple of years, a dramatic increase in the number of direct referrals for knee MRIs as opposed to other forms and the medical experts themselves said this was potentially having a detrimental impact on chronic knee pain and that it was deferring treatments which could have and should have been occurring immediately, which weren’t appropriate and didn't require an MRI.

And so the clinical experts, the medical experts themselves, saw a practice that was beginning to emerge and found that it wasn't appropriate. Entirely reasonable for somebody to get a scan if a specialist thinks there is a strong reason for it, but as we say, some new things have been added, some have been changed and that's why we go to the medical experts.

LEON BYNER:

Will you save any money out of this?

GREG HUNT:

All up, our Medicare expenditure is going up very significantly. So there would be some reductions on an item like this but others where there's significant expenditure on 3D mammography, on prostate cancer testing, additionally knee MRIs for the under-16s; so it comes in as a package and our focus is simply what’s the right medical outcome for people.

LEON BYNER:

Alright so if you're 49, you can still be referred by your GP for an MRI for your knee, but when you're 50, no, you've got to go to a specialist?

GREG HUNT:

Correct. That is absolutely the case and I think it's important to be clear on these things. But as I say, we have over 200 items on the Medicare schedule.

So the list of 5700-plus different Medicare items and over 200 of them are age-related in some way, and this came about entirely because of the recommendations of the Medicare taskforce which it has GPs, surgeons, pathologists, radiologists, public health experts, medical administration experts and they recommend some things come on, some things be changed.

And I've given you three examples of extended access that were recommended, but precisely because there was some strong evidence that older people with things such as chronic knee pain and osteoarthritis were being referred by- for MRIs when according to the clinical experts it's not the appropriate tests and can lead to delays in treatment. That's why they recommended this change.

LEON BYNER:

That’s Health Minister Greg Hunt.

Ministers: