AMA President Professor Brian Owler has called for an end to sustained Federal Government attacks on the medical profession amid mounting evidence that GPs are playing a crucial role in keeping health costs down.

Responding to the latest salvo fired by Health Minister Sussan Ley in which she alluded to widespread misuse of Medicare among general practitioners, Professor Owler said the profession was getting “very weary” of the Minister’s attacks, which he said were aimed at creating the impression GPs were rorting the system as a way to justify cuts to health spending.

“The Government tries to come out with this narrative about GPs doing the wrong thing,” the AMA President told ABC radio. “We’ve seen this from this Government before, and I think it’s about time that this Government actually started to appreciate, particularly their general practitioners, and stop painting the profession as people doing the wrong thing so that they can just find more savings in the Budget.”

Professor Owler made his comments after Ms Ley seized on a report from the Professional Services Review (PSR) agency to claim that that an increase in incorrect Medicare claims by doctors may be just the “tip of the iceberg”.

The agency reported a 40 per cent jump in the number of cases of suspected inappropriate practice referred to it for investigation in 2014-15, from 44 to 62, with much of the increase involving claims made for chronic disease management items.

“The MBS items and their associated rules are necessarily somewhat prescriptive,” the agency said in its Annual Report. “This provides scope for less scrupulous practitioners to populate the clinical record of an attendance with copious ‘generic’ computer template material. PSR committees often find that these are of little apparent relevance to the particular patient.”

“PSR committees frequently find that some practitioners in large practices provide [chronic disease management] services opportunistically despite the lack of clinical relevance.”

The Agency reported that action was taken in 70 per cent of cases referred to it, including ordering 24 doctors to repay $2.6 million of Medicare benefits, fully or partially disqualifying 13 practitioners from Medicare for anything up to 12 months, and issuing six reprimands. A further $1.57 million was refunded in negotiated settlements.

Ms Ley said she was deeply concerned that grey areas and ambiguities in Medicare rules that made it hard to track and prove abuses by less scrupulous practitioners could mean many more instances of misuse and rorting may be going unreported.

“These findings show the importance of having clear, strong rules around the use of individual Medicare items to ensure they are clinically relevant and reflect contemporary practice, but also aren’t misused for financial gain,” the Minister said.

The attack came just weeks after Ms Ley echoed claims that around 30 per cent of services and procedures provided by doctors through the Medicare Benefits Schedule were unnecessary or potentially harmful.

But Professor Owler said the number of practitioners found to have engaged in some form of wrongdoing by the PSR was a tiny fraction of the 100,000 registered doctors working in the country, and it was wrong Ms Ley to attempt to “politicise” the Review.

“The Government has been too eager to use the inappropriate behaviour of a small number of doctors – which the AMA does not condone – to tarnish the reputation of all GPs,” he said.

A major study (see page 8) has found that GPs, far from being a drag on the health system, are playing a crucial role in keeping patients healthy and out of expensive hospital care, and should be a focus for Government investment.

Professor Owler said the results showed that the Government should be praising, rather than bagging, GPs, and, at the very least, should be removing the freeze on Medicare rebates.

“Instead, the Government is regularly engaging in criticism of hardworking GPs, calling them ‘rorters’ in its efforts to sell its cost-cutting MBS review model and in its unbalanced portrayal of the latest Professional Services Review (PSR),” he said.

Adrian Rollins

Patients will have full access to use and share their electronic health record as they see fit, including sharing with retailers and IT developers, under a radical proposal outlined by Health Minister Sussan Ley.

Ms Ley said it was time Government “got out the way” and allowed consumers to have open-source access to all their health data, enabling them to use and share it as they liked.

“What if we, as Government, got out the way and gave consumers full access to their own personalised health data and full control over how they choose to use it?” she said. “It’s a revolutionary concept in health – but it shouldn’t be – given it’s already happening with industries like finance across the globe,” the Minister told the National Press Club.

But a parliamentary committee on human rights has already raised concerns about possible privacy breaches around the storage and use of health records uploaded to the central database of the MyHealth Record system.

The committee, chaired by former Howard Government Minister Philip Ruddock, said the proposed system raised significant privacy concerns – particularly the proposal that a person’s electronic health record be automatically uploaded to the database unless they actively opted out of the arrangement.

Mr Ruddock questioned whether such an approach justified the potential breach to privacy.

He told Parliament that there need to be a substantial concern, not simply pursuit of a desirable outcome, to justify limiting human rights.

Ms Ley said consumers already had control of personal data in industries like finance and banking, and patients should be similarly able to use their personal health information to create a portfolio of products and services specifically tailored to their health needs.

“What if you, as a consumer, were able to take your personal Medicare and Pharmaceutical Benefit Scheme data to a health care service; to an app developer; to a dietician; to a retailer and say how can you deliver the best health services for my individual needs?

“Why can’t we allow someone’s doctor to use an app developed on the free market to monitor their patient’s blood pressure at home following an operation, or keep a real time count on their insulin levels?

“The answer is – we can, and allowing consumers open-source access to their health data is the way to do it,” the Minister said.

Ms Ley said this was an area she was “keen to explore” as a way to give patients greater control over their health.

Adrian Rollins