Bill's Speeches

ADDRESS TO THE ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS - CANBERRA - WEDNESDAY, 19 SEPTEMBER 2018

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I'd like to acknowledge the traditional owners of this land upon which we meet, and I pay my respects to elders both past and present.

I also would like to acknowledge everything your profession does working to Close the Gap in health between the First Australians and other Australians.
 
I acknowledge President-elect of the RACGP, Dr Harry Nespolon.

The Minister for Health, who has had to go having concluded his speech, my colleague Catherine King, the Shadow Minister for Health and Medicare, the Leader of the Greens and of course our many parliamentary colleagues.

One of the best things about being Opposition Leader – and it’s not a very long list – but one of the best things about being Opposition Leader is that it gives you the chance to move around the nation to visit people who work in our health care system. 

Since the last election, I’ve personally been able to hold more than a dozen roundtables with GPs, all around Australia - regional and metropolitan. 

I've heard and we’ve spoken about ice and addiction more generally.

We’ve spoken about better support for people living with dementia.

And about the challenges of chronic disease, of obesity and of course the importance of preventive health

My colleagues and I have made a priority of speaking with GPs because we understand that you are at the frontline in terms of the battle to keep Australians healthy.

But you and your 39,000 colleagues are also essential to preserving the universality of Australia’s health system. You are the people who fulfil the promise of Medicare, who are so important to ensuring that we keep health care accessible and affordable for all Australians.

Something that sets GPs apart is the relationship and understanding you build with your patients.

Because, really, the Australian people trust you with the most important thing in their world, the health of their family.

And I hope that amidst all the daily stresses and strains of your job, the time pressures and the emotional commitment to which you've got to commit to make your vocation meaningful, I hope all of you find a moment periodically, a moment or two, to realise quite how much you mean to Australians. 

The report that we are launching today speaks to the overwhelmingly positive view that people have of their GP and of the care they provide.

But it also outlines some of the big challenges facing your profession and our nation's health, more generally.

In particular we see issues around funding and, again, I note that the patient rebate, the Medicare rebate, is the number one concern of practitioners.

Because the freeze in the Medicare rebate puts GPs in a very difficult position. You either have to absorb the growing costs of running your practices, or you'd have to pass it on to your customers. 

But there is an unwritten assumption, every year that governments freeze the rebate, the expectation is that you will do more with less. And when that comes with the requirements of providing quality care for patients with complex conditions, people with multiple chronic diseases, older patients with more complicated health conditions, then the challenge becomes even greater. 
 
And of course the increasing number of Australians seeing a GP for assistance with their mental health shows that – as a nation – we are getting a lot better at talking to professionals about this than we have been in the past. But of course as people are willing to open up more, what that means is that we need to do a lot more to invest in specialist resources for mental health.

There are ongoing concerns, wherever I go, that are echoed again in this report, about a continuing failure to prioritise preventive health.

We see that across the board but in particular with obesity.

You know, I'm like a lot of parents, I’m worried that our children are being force-fed junk food advertising while they’re watching television. And this democratic right that adults have to feed other people’s children with sugar. 

The challenge of obesity is one which parents have to confront but of course it's one which doctors have to treat. 

Then of course, along with the rebate and the challenges of being required to do more with less, and the challenges of obesity there is aged care. 
 
There are a lot of problems in the sector, 4 Corners is scratching the surface in that regard.
 
But because of my time listening to GPs, I was aware much earlier than 4 Corners that there is a crisis in aged care.
 
Of course, when I said that in the Parliament of Australia, the Government attacked me and said I was fearmongering. We can never, in the political discourse, be afraid to tell the truth for fear of upsetting people. On the contrary, that is what our job should be.
 
What I hear from GPs, especially GPs who are working or doing practices related to aged care facilities, is that the financial recognition and compensation that the work requires is not being matched within the system.
 
At the moment the rebate for a visit to residential aged care facility is $59.35. A lot of the time that’s less than you would receive for the consultation in your own practice if you spend the time in the same way.
 
So when you factor in the time involved in providing good care to older Australians with multiple and complex health needs, including many people in these facilities who are living with dementia.
 
When you factor in the extra pressure of working on your own, without the support of your network or your practice. When you look at the difficulty in establishing a continuity of care, a working relationship with the providers. And then you factor in even just the travel.
 
The story in aged care is the story for too many GPs around the nation, you’re being asked to do much more with a lot less.
 
And we don't need a Royal Commission in two years to tell us that this is a problem, you can just talk to your GP.
 
This is where parliament needs to step up - and we should not use the Aged Care Royal Commission as an excuse to delay solutions where we know they are required now.
 
We need to put the resources behind our GPs on the frontline now.
 
It’s our job to make sure that you have the support and the incentive and facilities to do your job.
 
This will be Labor’s priority, for the health of the nation.
 
Thank you and good morning.


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