RDAA president calls for changes to bulk-billing system

RISING workloads and a changing demographic of trainee doctors supports keeping bulk-billing practises for general practitioners, the head of the Rural Doctors Association of Australia said on Monday.

But RDAA president Dr Sheilagh Cronin said changes should be made to the bulk-billing system to give patients price signals for the cost of health care.

Dr Cronin responded to a report released last week, which recommended scrapping the international medical graduates program, which sees overseas doctors imported.

The paper, by Monash University's Dr Bob Birrell, said the latest Census data showed the program, which was created to address a doctor shortage nearly 10 years ago, was no longer need.

Dr Cronin said while she agreed with most Dr Birrell's findings, the paper did not address the rising workloads GPs faced, or a changing demographic of new domestic graduates.

She said the vast majority of new medical graduates aiming to become GPs were now female.

"There might be more GPs now, but a lot of those graduates are women, and many are at the age when they graduate that they start thinking about children," Dr Cronin said.

"By the time they graduate, they are often in their mid to late twenties, and are having children, so many of those new graduates are not necessarily working full-time; they might be doing a couple of days a week."

Dr Cronin also said the aging population, and increases in medical technology and medicines, meant many GPs were also suffering a bigger workload.

"In the last 20 years, we've had so many improvements in medicine, and so many more medicines become available, that people who might have died back then of, say, a heart attack, are living longer," she said.

"They are often living longer, but with more complex medical problems, so you might have someone with liver problems, as well as high blood pressure, and other health issues - and we are the ones who have to make sure their medical balance is right."

Dr Cronin also said the pressure from the increased workload was compounded by the cost of doing business.

"Usually, most GPs who own their practice aren't making any money - it's really only the big corporates who have radiology department and the like, or those which employ several doctors," she said.

"And I don't think anyone wants to turn away patients who can't afford it - so we need bulk billing to help those people access their doctors"

But Dr Cronin said there was potential for other changes to be made to the bulk billing system to help cut down on the $6.7 billion bill (in 2011-12) for the government.

"The whole question of bulk billing is very complex, but if patients don't have some sort of price signals, then doctors are going to have to charge more," she said.

"I think both political sides don't want to turn people away, but there has to be some sort of price signal, and probably more workforce planning nationally as well."