Opinion & Commentary
Patients, doctors could pay for Super Clinics election ‘pork’
Despite all the unknowns surrounding the future of the minority Gillard Government one thing appears certain. It now will be full steam ahead with the roll out of GP Super Clinics national network.
The program was one point of clear policy difference during the election. The Coalition promised to scrap it, while the government dangled the promise of a shiny new neighbour Super Clinic in front of voters. Health Minister Nicola Roxon’s unsubtle advice to voters was to ask ‘what’s in it for me’ when judging the major parties health policies.
This basically confirmed what has long been suspected about Super Clinics. Various justifications have been offered by the government including the myth that Super Clinics will take pressure off public hospitals. But what Super Clinics are, and will remain, is a rare piece of electoral pork.
With many Labor members sitting on thinner than expected margins and facing a Coalition which has bounced back to within a whisker of office under Tony Abbott, a mad scramble for Super Clinics may well begin.
The program could well be fast tracked to allow local Labor members to preside at as many opening ceremonies as possible before the next federal poll. PM Gillard – keen to shed the ‘all talk, no action’ image of her predecessor – may well become as familiar a figure at Super Clinic ‘ribbon cuttings’ as PM Rudd became at talk-fests public hospitals around the nation.
The political realities should not obscure how bad a piece of public policy this is.
There is no justification for the federal government giving ‘free’ capital to select providers of general practice services. This is unfair to existing providers forced to compete on an unlevel playing field and is likely to impact on the sale price of nearby practices. If a Super Clinics goes bust down the track it is also probable that additional subsidies will be provided to save the government of the day any embarrassment.
On the other hand, Super Clinics is a departure from the Labor Party’s traditional support for ‘socialised’ medicine. Super Clinics will operate under the same MBS fee-for-service arrangements as all other practices. To the chagrin of the true believers, modern Labor has not gone down the Whitlam-ite path of salaried’ Community Health Centres’.
Much of the ideological baggage of the 1970s appears to have been shed. Instead, the government has struck on a different way to attempt to sate the public’s insatiable appetite for ‘free’ doctor’s visits. This is progress of sorts.
However, lurking in the background is the Commonwealth’s initial forays into capitation and patient enrolment for diabetes patients. This is very much a trial program and the deliberate exclusion of the AMA from the review process is a sign the government is unwilling to tolerate critics of this approach.
Super Clinics also shed an interesting light on the significance of this policy.
Once governments start subsidising anything, an entitlement mentality is created and the handouts are expected to continue. How will the government limit the size of the proposed national network if entrepreneurial medicos keep demanding their slice of the action? It would not take much political nous to whip up a pro-Super Clinic campaign in the local media, which the sitting member of parliament would inevitably have to endorse and lobby the health minister in Canberra to support.
If the start-up and prop-up costs of Super Clinics become a structural part of the health budget, offsetting savings might be looked for elsewhere. It is therefore conceivable that GP Super Clinics might encourage finance-conscious governments to look more favourably on any strategy that will limit spending on general practice. This could well include NHS-style rules restricting the unlimited ‘fee for service’ access to GPs that Medicare currently provides.
Somebody always ends up paying for election pork. In this case, some of the costs could end up being borne by doctors and patients.
Dr Jeremy Sammut is a research fellow at The Centre for Independent Studies and co-author of ‘No Quick Fix: Three Essays on the Future of the Australian Hospital System’ to be published by CIS this month.
