twrama 1990_final oc.. - AMA WA

OPINION
systems will improve what’s there now. This is cold comfort
considering the critical timeline begins in less than three months
for the new e-PIP entitlements, of which there are five. The
progressive tiers have gone and soon it’s all in or all out – i.e. you
comply with all five components including the PCEHR or none of
them.
This potentially means a loss of all the e-PIP money to practices
should you not take up the PCEHR, up to the $50,000/practice
ceiling payment. And all while the MDOs are still advising of
the risks, the potential for massive fines, the medico-legal liability
arising from acting on incomplete information or the penalties
if you access a patient’s PCEHR without them physically in the
room, however practical or well intentioned.
It is this government’s appalling ‘take a stick to GPs’ approach
which leaves so many of us angry, bewildered and in an ethical
and practical bind. As if it is not enough that there will be no
dedicated funding for GPs to do this work (let alone how on earth
we will absorb the additional workload it will generate), do not be
ambushed by Minister Plibersek’s now famously empty August
announcement on MBS Fees for PCEHR, which was positively
media-promoted and falsely praised as if it were some sort of a win
for the profession. Bollocks! It was nothing, merely that if you have
a Level B consultation of already 17 minutes and you spend five
minutes on the patient’s PCEHR, it will be allowed to become a
Level C, so there may be a few extra dollars in it for you, nothing
more.
The fact is this Labor Government is struggling for political
wins as far as it sees the forthcoming election. Despite their
multiplicity of failures including the failed Health Reforms, Pink
Batts and education among other issues, Australians are still fairly
evenly divided on their policy achievements, even the Immigration
debacle.
But they are so fearful of the fallout of the Carbon and Mineral
Rents Resources Taxes, they have utterly “tied themselves to
the mast” on the National Electronic Health Record. Originally
meant to be launched on 1 July 1 this year amid great fanfare, it
infamously and very belatedly limped in with no real kudos and
little media coverage ensuring that as few Australians as possible
knew about it – instead leaving it largely promoted face to face
through Medicare offices and mail outs. But I know in the run
up to the election, the PCEHR will be very heavily promoted as
a glowing success in an attempt to curry political favour with the
electorate. And we GPs are the bunnies who are taking the fall
over this no-carrots and all-stick approach.
By the time you are reading this, the pitiful rise in the 1
November MBS Fees List would have been released and all GPs
and practices would have received a letter
from the Department about the
new eligibility requirements
for the PIP e-Health
Incentive, which represent
a staggering rise in
requirements for many I heard no fewer than
practices. The first four
six times: ‘We will
of these requirements
must be compulsorily make it better over the
met by 1 February 2013
years to come’…This is
• Integrate health
care identifiers into cold comfort
electronic practice
records
• Ensure secure messaging
capability
• Achieve data records and clinical coding
• Electronic transfer of prescriptions (e-Rx and Medisecure will
be interoperable by January)
• Personally controlled electronic health record system
(by 1 May 2013)
I am sure some practices will walk from the e-PIP; many I know
remain undecided. Perhaps it will spur a huge shift away from
bulk-billing as practices recoup the losses through fee-for-service
and decouple themselves from block payments. I do know, it is a
hell of a shabby way to treat GPs and as AMA (WA) President
Richard Choong said, the government has not yet thrown enough
money at this to walk away from it!
It is a fight that I also took to the recent Federal GP Council in
Canberra – to see if getting mad also meant getting some ‘Winds
of Change’. Keep watching this space. ■
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October MEDICUS 19