AMA Conference: Nicola Roxon

For further information, contact Melissa Maimann at Essential Birth Consulting. Nicola Roxon's opening address at the AMA conference

Maternity Services

It is also the patient – especially the mother and child – we had in mind with our maternity services package as well.

The Government conducted a review of maternity services headed by the Chief Nurse and Midwifery Officer, Rosemary Bryant and the budget changes respond to that review.

As a result we will allow eligible midwives to write PBS scripts, and make their services eligible for Medicare rebates. This is a key plank of our $120.5 million maternity services reform package. In addition, we will support indemnity insurance for midwives working in collaboration with doctors. Something I imagine you will support, given the similar role played by the government when medical indemnity insurance was having some challenges.

Again, I stress this will be a collaborative relationship. We want the support of midwives, GPs and obstetricians in implementing this reform. We are about improving collaboration and teams – not setting up competing structures.

... Again, this change is about sustainability and choice and putting the needs of the patient first ...

Reason for tough Budget decisions

So, as you can see, our workforce, rural and maternity packages are all about improving access to quality care for patients – no matter where they live ...

But it’s also about sustainable access. We want to lock in investments for the future. We don’t want positive reforms or useful programs threatened because costs are spiraling elsewhere in the system without delivering benefits.

That’s also why we have also made tough decisions in the budget to improve affordability and fairness. It is in no-one’s interests, least of all the patient, if Medicare expenses get out of control. So we have made decisions that some of you won’t like – nevertheless I’d like to take the time to explain them and I’m confident you will see the logic of doing so.

Medicare Safety Net

For example, our changes to the Medicare Safety net ensure every single item that is currently eligible, remains eligible ...

The changes are to introduce a cap to the amount that can be claimed in a number of areas that have fallen prey to some excessive fees.

An independent review of the Safety Net found that for every dollar spent in 2007, as much as 78 cents went direct to the specialist’s wallet, rather than reducing patients’ out pocket costs. Now while that might be good news for a few of your team – you can easily understand why it makes everyone else jumpy.

Cancer specialists, for example, feared we would make changes affecting their patients when the safety net has been very effective in reducing their costs. Because of this and because there was no evidence of a spike in fees – we introduced no caps in cancer at all.

But excessive medical fees and profits were evident in a few areas - obstetrics, Assisted Reproductive Technology, injection of therapeutic substances into the eye, hair transplants, and varicose vein treatment.

In these areas, we are imposing a cap on the benefits which are payable under the Medicare Safety Net, from January 2010.

If reasonable fees are charged, patients will continue to be supported by Medicare and the safety net, but if the charges continue to be excessive then taxpayers will not be picking up the cost. We hope the high end chargers will chose to moderate their fees, but if they don’t we’ll be asking patients to vote with their feet – and go to specialists who charge sensibly. This will benefit not just them, but all taxpayers.

It will mean change – but it will ensure publicly funded services remain viable.

Medicare should always put the patient, not the specialist, first.

We believe these changes strike the right balance between reasonable costs incurred by specialists, and affordability for taxpayers..."

Melissa Maimann, Essential Birth Consulting 0400 418 448