Ley on Sunday announced that consultations had begun on all of the nearly 5,800 items on the MBS. The MBS lists a wide range of consultations, procedures and tests and the rebate the government pays for each.
The review, which was announced in April, was necessary because up to 30% of items on the schedule currently were unnecessary, out of date or unsafe, Ley said.
The suggestion that GPs were putting patients at risk infuriated the Australian Medical Association (AMA), reopening a schism that first emerged between the government and the powerful lobby group after the introduction of the now discarded GP co-payment.
“We took singular exception to the minister’s press release yesterday, where the headline was unnecessary – ‘dangerous, unsafe, redundant procedures’ which does nothing but undermine confidence in the relationship between a doctor and their patient,” the vice president of the AMA, Stephen Parnis, told Channel Seven on Monday.
Ley denied suggestions the government was acting unilaterally.
“This is a review led by doctors and clinicians, has people involved in health knocking down the door to get a seat at the table so that they can provide us with the advice to improve our health system,” Ley told ABC TV on Monday.
Ley said the MBS system “needed a good spring clean,” pointing to the fact that many items had been on the register since the system began in the early 1980s.
The AMA has acknowledged that a review is needed, but has expressed concerns the review will axe necessary services as a budget-savings measure.
“We do need a review. We need a schedule that does reflect modern practice,” Parnis said. “But the government seems to have gone off the rails with what they’re doing now, and we’ve been compelled to say that what they’re trying to do at the moment, which is cut away from the Medicare Benefits Schedule without updating or adding new item numbers or new approaches, is of profound concern to us.”
Ley said fretting about a loss of services was pre-emptive.
“There are no services being cut, because again this is a consultation. Advice will come to me at the end of the year and then decisions will flow from that based on what doctors are telling me,” she said. “So I absolutely reject any suggestion that there are any cuts to services or funding as a result of what we are talking about today.”
The treasurer, Scott Morrison, told Macquarie Radio the review was about modernising Medicare, and that it “wasn’t clear one way or the other” as to whether it would recoup savings.
But Ley admitted not all of the potential savings found from the MBS review will go back into the health portfolio.
“We will reinvest them back into procedures that are new and innovative, and we will also reinvest back into the government’s bottom line [which is] important because we need to keep Medicare sustainable,” she told Sky News.
The Greens leader, Richard Di Natale, who is also a trained GP, welcomed the review but warned against taking money out of the health portfolio.
“It’s a good thing to have a clinician-led review,” Di Natale told reporters on Monday. “What we should be doing is reinvesting every cent we can save by stopping those unnecessary procedures and investing in those areas of health where we get good value for money.”
The relationship between the AMA and the federal government deteriorated significantly shortly after the 2013 budget, when the government announced its plans to introduce a GP co-payment.
The organisation led the fight against the co-payment, and subsequent iterations of fee changes, which led to the government rethinking much of its initial policy direction.