John Duggan. Advice from expert clinicians or the AMA

For those interested in the cost of health care the recently released interim report by the Medical Benefits Schedule (MBS) Review “obsolete MBS items track one” demonstrates the dawning recognition that there are procedures and tests that do not justify their existence or federal funding.

The story begins with the decision of Ms Sussan Ley, Minister for Health to form the Medical Benefits Schedule Review taskforce, with a mandate to review the schedule in its entirety. The Task Force is ‘an expert clinician led Medicare Benefit Schedule (MBS) review … established to lead an accelerated program of MBS reviews to align MBS funding services with contemporary clinical evidence and improve health outcomes for patients’.

The taskforce, chaired by Professor Bruce Robinson, Dean of the Sydney University Medical School, is an expert clinician-led group whose main duty is to align MBS funded services with contemporary clinical evidence and improve outcomes.

One role of the taskforce of 13 members is to appoint chairs and members of working groups to progress the work using evidence based reviews and data and assessment of literature. Priority areas will include safety, clinically unnecessary service provision and accepted clinical guidelines. It also has the power to recommend adding new services to the MBS.

Of the host of clinical committees created several have already reported on obsolete items – an interesting group. The strictures about kidney x-rays (MBS item number 58705) illustrate the problem and variety of obsolete and useless procedures recommended for abolition. The gastroenterology group reviewed the practice of treating gastric bleeding by infusing refrigerant fluid into the stomach, discarded soon after its initiation about 60 years ago and which was only used eight times in the last 11 years.

It is evident to any medical scientist that the review is overdue and can only benefit both patients and the budget.

Whether the AMA feels happy about the review will be reflected in its attitude to the recommendations of the Task Force.

John Duggan is Conjoint Professor, School of Medicine and Public Health, University of Newcastle.

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