The Australian Medical Association, a lobby group and peak body for doctors, has offered up a thinly disguised money-grab in the form of expert recommendations in response to the Aged Care Royal Commission.
Hiding behind an engaging title “Putting the health care back into aged care”, a recent report from the Australian Medical Association wastes little time in demonstrating the overt greed of this union. As John Mendadue recently laid bare in discussing the lobbying power of this unrepresentative cabal, the AMA represents only about 25% of doctors and yet presumes to “speak” for all health care practitioners in policy conversations and decision-making, and wields disproportionate influence.
The AMA estimates nearly 30,000 transfers of residents from nursing homes to hospitals in the year were potentially avoidable, cost $312 million (figures calibrated for 2020–21) and accounted for almost 160,000 hospital bed days (page 9 of the report). They go on to suggest over $20 billion worth of savings could be made over 4 years by preventing these hospital admissions (2021-2022 to 2024-25). There can be little argument that these transfers must be avoided. They represent massive dislocations: patients fear them, relatives hate them, they are costly and they cause bed block in the emergency department. But the solution proposed by the AMA is scandalously self-interested.
The Aged Care Royal Commission report highlighted the need for greater assessment of aged care residents’ needs and the critical nature of the education and supervision of those providing care to better prevent illness and injury. They emphasised the necessity for Registered Nurses to be accessible twenty-four hours a day, seven days a week, and for all care providers to be more appropriately educated. The Commissioners noted the research that demonstrates the value of Nurse Practitioners in aged care in reducing the need for hospital transfer. So what has the AMA suggested in its “Putting health care back into aged care”?
The very first recommendation: “Increase Medicare rebates for nursing home attendances by GPs by 50% to compensate for the additional time and complexity involved in comparison to a GP consultation in their rooms”.
The second is no better: “Introduce MBS telehealth items for phone calls between GP, nursing home staff and relatives”.
There are seven such recommendations before there is an endorsement of the need for mandated minimum staff-to-resident ratios; Rec 8 for RNs 24/7 and Rec 9 for mandated minimum qualifications for personal care attendants. The AMA makes no reference to the need for Nurse Practitioners, which is not surprising given the lobby’s consistent rejection of them.
This Report is a barely disguised money grab, nominating a pot from which the gold might spring. There are two truly sad elements here. The first is that the care for the aged has been a disgrace for decades and the Nurses Professional Associations have been trying relentlessly to highlight this, not in self interest but for the sake of the dignity and care of our elders. The second is that the attitude made overt by the AMA Report does not reflect my understandings of or interactions with General Practitioners who I find to be doggedly hardworking, up to and beyond capacity tending to the people they already see, and deeply concerned about older people.
Professor Jill White is a Professor Emerita of the Susan Wakel School of Nursing and Midwifery at the University of Sydney and the Faculty of Health University of Technology, Sydney (UTS) Australia.
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