Reform or face ‘a pay cut’

Reform or face ‘a pay cut’

The National Health Care System in Australia is changing on many fronts. In this article we see doctors are told to reform or face ‘a pay cut’.

Change breeds fear and I suspect over the next six months that all health professions asked to implement health reform will suffer scrutiny and media backlash from anxious parties within the current “sick-care” model.

Leo Shanahan, Canberra
The Age, September 20, 2008

The Federal Health Minister says doctors should be prepared to take a pay cut if they continue to do work other health professionals are capable of.

As part of the Government’s attempts to overhaul primary health — which she likened to the reforms of Gough Whitlam — Nicola Roxon said doctors should relinquish roles that can be performed by other workers, such as nurses and psychologists.

“Our health system, including funding for health services, is organised almost entirely around doctors, despite the fact that many services are now safely and ably provided by other health professionals — nurses, psychologists, physiotherapists, dietitians and others,” she said.

“Doctors will need to be prepared to let go of some work that others can safely do.”

In a sign of the importance of health reform to the Government’s agenda, Ms Roxon will tonight make the comments to the annual Ben Chifley memorial lecture, an important forum for ALP policy.

While arguing that doctors should be paid more for the work that “demands their complex knowledge and training”, she says if they are not willing to give up jobs to other health professionals they should face a pay cut.

“To ensure this transition, there needs to be an incentive for doctors to eschew less complex work, and focus on the work that does require their high level skills and expertise. Or if doctors don’t want to let go of it, to accept being paid less for devoting their highly skilled and heavily trained selves to less complex tasks,” Ms Roxon said.

The Government has been in a battle with Australia’s major doctor group the Australian Medical Association over plans to give health professionals such as nurses the right to prescribe drugs and claim Medicare refunds.

Ms Roxon said opposition to reforms in health was historically led by the AMA and the Liberal Party and, comparing her fight to that of Mr Whitlam to introduce the forerunner of Medicare, said the situation was no different.

“Whitlam’s proposal was met with strong opposition. As soon as his interest in a universal health insurance scheme became public, the Australian Medical Association voiced its disapproval.

“And what we have seen, over time, is a clear cycle — Labor introduces a signature health reform; it is opposed by the conservatives, and by the medical profession; as it gathers public support, the fight is won; and the Liberals are forced to accept that the reform has won community support and a firm place in Australian society,” she said.

The AMA has warned that reforms being touted by the Government, which will include giving midwives more access to hospitals and Medicare rebates, could cost lives.

Ms Roxon also points to structural failures in Medicare, arguing that while it supposedly provides universal health care it often does not help prevent diseases that hurt the poor disproportionately.

“If you want to judge how affluent a suburb is, you could check its tax returns — or you could look at its medical records. Rates of diabetes, of heart disease, early deaths, infant mortality, how many teeth a person has left — are all clear markers of socio-economic status.

“Medicare has achieved a lot, but it has not achieved all we need it to.



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