The revelation that most of the Rudd Government's GP super clinics will not be operating for at least another two years has brought opponents of this expensive program out into the open.
The centrepiece of the government's health and hospital reform agenda is facing renewed criticism just as Tony Abbott has flagged Coalition support for a national referendum on a commonwealth takeover of hospital funding.
It is worth remembering that then newly minted opposition leader Kevin Rudd made the same promise in the days of Kevin 07 and has backed away from it since. Abbott's support for a referendum, however, could prove a policy game changer.
The opposition is targeting the systemic problems that plague public hospitals run by giant state government bureaucracies.
Direct federal funding of hospitals run by local boards is far superior to throwing taxpayers' dollars at so-called solutions to the hospital crisis, such as super clinics, that are more ideologically driven than evidence-based.
Under the $275 million super clinics program, the Rudd government is funding the start-up costs involved in bringing together general practitioners and allied health professionals, such as physiotherapists and podiatrists, who want to amalgamate their practices into one-stop shops. An initial 38 clinics have been announced in the past 18 months.
General practitioners fear super clinics, generously subsidised by taxpayers, will compete unfairly and put established private practices out of business.
This follows the direct action taken by suburban GPs associated with the Doctors Action Group who in early November closed their surgeries in protest against the threat super clinics posed to the traditional family GP. GPs are legitimately worried about the long-term effect of large-scale and centralised super clinics on private general practice.
The concern is that young doctors will not buy into an established practice, into which retiring doctors have invested large amounts of capital and years of service, when the alternative is to join a government-controlled super clinic for free with the capital costs paid for by taxpayers.
If private surgeries are crowded out and it becomes too costly and difficult to establish one from scratch, it is conceivable that a future federal government may force doctors to work in super clinics on a salaried basis. Super clinics are therefore a slippery slope that potentially could lead to the nationalisation of Australian general practice.
For the ideologues in the federal health bureaucracy opposed to private medicine, the end of fee-for-service GP care is a time-honoured objective.
In fact, super clinics are a throwback to the Whitlam government's polyclinic model of the 1970s.
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