E&OE…
Topics: GP management plans
RAY HADLEY:
The Federal Health Minister Greg Hunt’s on the line. Minister, good morning.
GREG HUNT:
Good morning, Ray.
RAY HADLEY:
Am I right about all of this? Because it came as- when the lady starting talking to me about it I thought here’s another lady that’s over the edge. But everything she told me is true.
GREG HUNT:
Some things right, some things wrong with respect. What’s correct is we’ve got 20 doctors under investigation at the moment and I want to thank your listeners and if there are any other cases where they feel the system’s being abused I’d like to know and I’d either like them to contact me directly or to come through you or your producer.
However, what we see is these are for very serious conditions for the vast majority of cases; cancer, heart disease, serious diabetes. You might have many other chronic conditions things such as stroke or asthma. So they’re designed at $144 to be a one-off payment, where a doctor sets out a long-term plan.
Particularly for people with these deep underlying conditions where the Government and the public can save thousands or tens of thousands of dollars by early comprehensive action and most importantly (inaudible) the patient.
But as we did where we saw there was straight out abuse of the after-hours system and we’ve changed that. If there are any cases I’d like to know them but at the moment this is very different to the afterhours on all the evidence I have. Twenty doctors under investigation but over 30,000 that are using it appropriately.
RAY HADLEY:
Well give my listeners an atypical without referencing any particular doctor…
GREG HUNT:
Sure.
RAY HADLEY:
Make it simple because there’s no list of eligible conditions and you mentioned asthma. Well with all due respect to people that suffer asthma, and members of my family have in the past and continue to, it’s a bit different to being told you're dead in six months with cancer. So, what have these doctors done that has made you investigate them. What have they done?
GREG HUNT:
So what it would be is where they are doing one of two main things. One is the number of these chronic disease management plans that a particular doctor is doing might be especially high. And relative to what the general doctor population is doing, the GP population, they have a much higher percentage or they might be claiming for the same patient on multiple occasions where of course it's only meant to happen once.
RAY HADLEY:
So it’s a one-off payment of 144 is it, that what you're telling me?
GREG HUNT:
Correct.
RAY HADLEY:
Okay, so I go along to the doctor and I say, look Geoff, I've got a problem with asthma. And he says well we need to get you in the enhanced primary care plan or the chronic disease management plan. He gets $144 and he's then supposed to give me a plan, is that right, to do with the asthma?
GREG HUNT:
Correct and that would involve exercise or in the case of diabetes it might involve diet, it might involve seeing an exercise physiologist. If somebody has a severe musculoskeletal problem, so you’ve got problems, you know, deep chronic back pain that can literally stop you working or be agonising, to get you involved with physios, to get you involved with people who are able to deal with if there are any psychological problems which come with chronic pain as so many of your listeners will find.
And you take these early actions and you can most importantly improve the health of the patient and in addition save thousands of dollars and tens of thousands of dollars in some cases by helping patients on the path to recovery rather than being a burden to themselves and a burden on the themselves.
RAY HADLEY:
That’s in the utopia that we have- we live in, Minister, but we don’t live in that utopia. There are rorters all over the place, as you well know, as your colleagues know in Centrelink. DSP, the like. As soon as you put something on the table you'll find doctors, a small percentage and a small percentage of people who want to rort the system.
Then you just mentioned what – so a bloke goes along to his doctor, his GP, says look I've got this chronic problem asthma. Then he comes back a month later and says: you wouldn't believe it, I've got this chronic muscular pain as well.
And then a week later he comes back and said: I've got an ingrown toenail, which is really chronic. And so the doctor’s dipping in for $144. And the thing the lady told me, she's in the health system, she said Ray, the doctors don't even write a plan up. They just take the 144 and just say: here take an aspirin, you'll be sweet.
GREG HUNT:
Well if they’re doing that they’re breaking the law and I want those examples.
RAY HADLEY:
Well of course they are but you’ve 20 of them already. I mean I'm suggesting to you there's a lot more than 20. I’m suggesting you’ve got the tip of the iceberg here.
GREG HUNT:
Well I would invite openly and enthusiastically any cases, any evidence of that. This is what we did with the after-hours where we looked at that and decided there were people who were abusing it. We've now had referrals to the, from what we call the Medicare Integrity Division, two the cop on the beat, who is now reviewing a dozen doctors for potential different forms of prosecution or penalties and one corporate is under very serious investigation as we speak.
So I have no hesitation in throwing the book at any abusers. As I say, at the moment there are 20 cases we have based on the evidence. And it’s not just that we wait for evidence, we go out and we review the data and we can see what every doctor is charging and whether or not there are patterns. So, if there are individual cases, we want to know, and so thank you to you and thank you to your listeners.
This is what you and I did on Pink Batts almost a decade ago. Yourself and Nicola Berkovic of The Australian led that within the media and I picked it up from Opposition. So, if there are cases, we’ll deal with them and deal with them mercilessly.
RAY HADLEY:
Minister, is there any suggestion that it’s not just (inaudible) doctors, but there- I know that we live in a trusting society. But you know, there’s an old expression that you may or may not- the odd backhander. Do you think that maybe there’s a sharing of the $144 with these repeat patients, where- look, I’ll get $100, you’ll get $44; just keep coming back and everything will be hunky dory?
GREG HUNT:
Well, that’s a straight out criminal fraud. We haven’t seen any cases or evidence, but if anybody, anybody is aware, not only should they report it to us, to the Federal Health Department, to me and my office, but also to the police because it’s a straight- that would be a straight out criminal fraud.
RAY HADLEY:
Okay. If people out there know of other people that they have contact with, who are benefiting from the enhanced primary care plan or chronic disease management plan, where should they go apart from phoning our program? Is there a website? Is there somewhere they can email details? Who should they talk to?
GREG HUNT:
They can come directly to me. I’ll just give you my details now. So greg.hunt.mp@aph.gov.au.
RAY HADLEY:
Okay. I’ll put that on the website to make it easier for people to get down. And the other thing is, is there any suggestion, given that there’s no list of eligible conditions- oh look, if someone’s got terminal cancer, or is in chronic pain, or has a really big problem with diabetes, we’re not trying to scare people from seeking help from their GP. But is there some way of narrowing so that it’s not open to the sort of abuse it is at the moment?
GREG HUNT:
So, that is actually being reviewed by, we have what’s called a Medicare taskforce, an independent panel, with one of the best most capable medicos in Australia, Professor Bruce Robinson, who’s leading it.
He’s fearless. He blew the whistle on a lot of the after-hours abuse. But he is considering exactly that question of what’s the appropriate balance at this stage. And Bruce is one of these guys you would love. He’ll call something out as being dodgy if it’s a problem and he hasn’t identified a significant abuse on that front, but he’ll call it out and I want to know.
RAY HADLEY:
Alright, thanks for your time.
GREG HUNT:
Thanks very much Ray.
RAY HADLEY:
Federal Health Minister, Greg Hunt, online from our Canberra studio.