The risk we’ll lose GPs, our primary-care base

The risk we’ll lose GPs, our primary-care base

January 29, 2023

Credit:Illustration: Badiucao

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The risk we’ll lose GPs, our primary-care base

The Resolve Political Monitor found 82 per cent of Australians either supported or strongly supported raising the Medicare rebate to encourage more GPs to offer bulk-billing (Sunday Age, 29/1). Whatever your ideology, sense of entitlement or financial position, there is little doubt people value access to affordable healthcare and see the need for urgent support, including to reverse the trend of graduates eschewing general practice as a career choice.

The survey did not address mixed-billing practices – where some services, or some patients on some occasions, are bulk-billed in an attempt to assist the disadvantaged or improve access for particular services. Lengthy, complicated consultations are a real loser for doctors, especially if they are bulk-billed (but a winner for patients if they can find this niche service).

Doctors share their mostly Medicare revenue with the practices. If the cake is too small, cutting it into more slices will not help. If Health Minister Mark Butler does not want to increase the rebates (which should have been done long ago), then he will need to provide more support to practices directly so they can redistribute money to their staff and general expenses according to their cost structures.

Or just lose general practice and come up with a better idea. We are haemorrhaging recruits into other areas, notably the specialties. How many of these do we need if there is no primary-care base to facilitate efficient referrals?
Dr Clyde Ronan, Yarrawonga

Our theatre nurses are exhausted and unsupported

Re “Cancer surgery delays as staff shortage bites” (Sunday Age, 29/1). It cannot be a surprise that there is a critical shortage of operating theatre nurses. Consider a profession where a person is usually rostered for a 10-hour shift which typically ends at 10pm.

This vital work requires intellectual, physical and emotional skills and energy. The theatre nurse can then be required to extend that shift and be on call until 8am the following day. More often than not the result is more hours of work, disturbed sleep, if any, and exhaustion at the end of a very long shift.

Yes, the nurses are paid overtime for the extra hours they have worked but the recovery time required, along with disruptions to regular life, can only be addressed by changes to the rostering practices in some hospitals. No wonder many theatre nurses are feeling exhausted, unappreciated and unsupported.
Edna Russell, Ocean Grove

Danger if non-doctors can diagnose, treat, prescribe

General practice has been dying a slow, inexorable death for many years. The paltry Medicare rebates have driven many small, traditional practices to the wall and forced them into large, corporate practices that survive on economies of scale and maximising throughput. This is the inevitable result of the undermining of the value of a thoughtful, unrushed consultation by keeping the Medicare rebate completely out of touch with the reality of running a practice.

As if this demise was not enough, moves are now afoot not to increase the rebate, but to fragment primary care and allow allied health practitioners to diagnose, prescribe and treat under the Medicare banner. This beggars belief.

Apart from the obvious conflict of interest of pharmacists prescribing drugs for which they receive a financial benefit, there is real danger in letting people who do not have medical degrees loose on the community and GPs will be left to pick up the pieces. The cost to Medicare will blow out enormously.

If pharmacists, physiotherapists and nurses want to take over the role of a GP, I suggest they go back to university and study medicine. The trickle of new medical graduates who want to be GPs will dry up rapidly and they will seek the well-remunerated and higher-valued specialties. This is hardly a great way to alleviate the GP shortage.
Dr Philip Barraclough, Mount Eliza


Right to express views

The controversy surrounding Srdjan Djokovic posing with Russia supporters opens up a can of worms. Australia is a country with freedom of speech, and freedom of association is enshrined in our Constitution. Just because the large majority of Australians and the government support Ukraine does not remove the right of a pro-Russia group of people to hold and express their views in a peaceful way.

Posing for a photo with supporters of Russia is legal and peaceful. Just because you happen to be the father of the world’s best tennis player does not remove this right. That the Russian flag and the Z sign got through tennis security is a different issue.

We should support the right to peacefully express our views, including the views of the minority, not punish those who do not hold the majority view. Even in a time of war. (By the way, I am pro-Ukraine and abhor the war.)
Jennifer Frank, Northcote

Need to take a stand

Players from Russia and Belarus should not have been allowed to compete at the Australian Open. Obviously they had no part in Russia’s decision to invade Ukraine. While their personal views are not known, most, if not all, of those players are likely to be opposed to that decision.

That is not the point. Australia and the rest of the world needs to send every signal they can to Russia and its allies that what they are doing is unacceptable. Banning players from those countries from sporting events is one signal. Whilst harsh for the players, that is an unfortunate consequence of the terrible course of action Russia has embarked upon.
David Gregory, Toorak

Ignoring elite athletes

Twelve months ago, Dylan Alcott retired as an international tennis player. There was a lot of media coverage. I did not realise it was also the end of international wheelchair tennis – but so it would seem from the little or non-existent media coverage of the wheelchair events at this year’s Australian Open.

Nothing in The Age, not even in the results column headed “A Walk in the Park”. Or is that the reason? These talented athletes cannot walk, so they do not deserve to be recognised? Really? I expect better from The Age.

My niece goes to the Australian Open just to see the wheelchair tennis. She has never played tennis but she recognises and appreciates the skill of the players. Why doesn’t my daily paper?
Julie Moffat, St Leonards

Producers’ divisive ruling

Excluding white journalists from reviewing seven methods of killing kylie jenner (The Age, 29/1) – while the rest of society is going through massive change trying to stop racism and open up opportunities for all – is bewildering and divisive. One thing the play’s producers have convinced this white person to do, is not attend it and seriously think about protesting out front for the first time on my life.
Sandy Richards, Merricks Beach

Why not just buy a ticket?

Surely there is nothing preventing a critic, or their employer, from purchasing a ticket to seven methods of killing kylie jenner , seeing it and writing a review.

Any power producers have to dictate who reviews a play derives from the expectation that tickets will be provided for this purpose. At the very least, the selection of which productions are, and are not, reviewed is heavily influenced by the provision of tickets, even if the integrity of critics is unimpeachable. Perhaps reviews should include a disclosure of who covered the cost of the critic’s seat.
Mark Summerfield, Northcote

Reinforcing disadvantage

Re families of public school students having to pay for basics and extras (The Age, 26/1), despite the fact that state education is supposedly free. At higher socioeconomic status (SES) schools, fees can amount to more than $2000 for certain subjects, extracurricular activities, equipment and uniforms. Expensive overseas excursions are not uncommon.

Typically at such schools, more than 90per cent of families pay fees. They also support school funding by donations of materials and expertise, and school fetes can raise $50,000 or more.
In lower SES schools, additional funding is desperately needed but fees are much lower, usually $300 or less, and often only a minority of families manage to pay these.

Disadvantage is reinforced and gaps widen, to the extent that the OECD categorises Australian education as among the least equitable in the world. It is essential but improbable that Australia achieves real equity and transparency in the funding of education for every child and school.
Stephen Dinham, emeritus professor, Melbourne Graduate School of Education, University of Melbourne

Treat us with respect

The start of the school year and, yet again, there is a teacher shortage. Pay us what we are worth (consider how much those in the construction industry earn) and we might consider it.
Ross Ogilvie, retired teacher, Woodend

Refreshing and delicious

I made the chilled yoghurt and cucumber soup (GoodFood, 24/1). It was delicious and just the thing for lunch on a hot day in the Mallee.

I wish that I had known about this soup when I was young (in the 50s), when there were no airconditioners, only slightly cool water tasting of canvas coming from a water bag, and for lunch we were served up disgusting, tinned, camp-pie meat with a naked lettuce salad, including the mandatory slice of orange.

I wish Persian recipes had been better known then, as our climate is similar to the Middle East and similar fruit and vegetables grow in our gardens. The dishes are a better match for us than the inherited British cuisine. Thank you, Hamed Allahyari, for coming to Australia and making things better for us.
Bronwyn Hunt, Kerang

Just bring on the Voice

What sort of country are we? We took their land, we took their languages and we took their culture. Surely we at least owe them a Voice which can be heard in federal parliament, the heart of our democracy. C’mon Australia. Just do it.
Ross Corben, Knoxfield

Or why not legislate it?

If Anthony Albanese is determined to give the First Nations people a say in policies and programs that affect them, then why not legislate it now and see how it works instead of encouraging a debate about a referendum which is dividing our people and families, not to mention the cost of it.
Carolyn Wood, Rosanna

We are all Aussies first

I am becoming more confused daily. Everybody over the age of 18 has a voice and it is called a vote. Also, a number of MPs identify as Indigenous or having Indigenous heritage, and they surely represent their voters and speak for them. How many more referendums, legislation, statements, declarations, mandates, standards are needed to unify or divide us? We are first and foremost Australians.
Geraldine O’Sullivan, Hawthorn

Referendum will pass

People of goodwill, from across the political spectrum, have tuned into the Uluru Statement from the Heart and are ready to move our nation forward by voting Yes. Media coverage of the naysayers has been disproportionate to the level of support the No vote has.

Even Liberal voters know Peter Dutton is using faulty logic in justification for not putting forward a bipartisan position. Green voters similarly seem to be annoyed that Lidia Thorpe hijacked the Invasion Day protest as a platform for promoting a No vote. I believe a majority of Australians in a majority of states will vote Yes, and this will be the impetus for much needed other reforms and reconciliation.
Mary Howe, Bentleigh

Cruel shaming of all …

Although I am a healthy weight now, on and off over the years I suffered from eating disorders (anorexia, bulimia and binge eating) as a result of body shaming by others (friends, family members, classmates, strangers). Therefore I am pleased that Taryn Brumfitt has been chosen as Australian of the Year. Hopefully her message will permeate all levels and platforms of society so that others do not have to suffer from the scourge of body shaming like I did.
Samantha Keir, Brighton

… our different body types

I am a bit tired of overweight people crying “poor me”. Other body sizes suffer the stigma of not being perfect too. Try being 180 centimetres tall and constantly thin. Trying to gain muscle, fat, anything, to stop the “thin stigma” is impossible for me and many like me. Go to the gym or the beach and you are the skinny person. Clothes hung on a scarecrow and comments like “you’re looking scrawny” and “you could do with a few pounds”.

Body image is not just a large person’s problem. You don’t get ads on television promoting how to “beef up” or gain weight. Skinny people need to stand up and be counted too. All people who do not fit the “mould” of the promoted body image should be recognised.
Phil Robbins, Anglesea

Reduce use of plastic

Banning single-use plastic straws, plates, cutlery, polystyrene food and drink containers, drink stirrers and cotton buds (The Age, 28/1) will bring Victoria up to the mark with the EU and most of Britain. Their experience over several years, while patchy, is counted as progress.

It is worth remembering that we are also dealing with a health problem. Micro-plastics at sea are a vehicle for bacteria and are building up in our food chain. This is toxic for marine life, and possibly hazardous for us as well, although the evidence is difficult to assess.

Before science delivers alternative solutions for the manufacture, recycling and reuse of plastics, we share the onus for change. Awareness-raising campaigns would help, as well as tighter regulations.
Jennie Stuart, Balwyn

Paying the price

The definition of robo-debt: the consequence of the politicisation of the public service.
Jack Morris, Kennington



Kubler and Hijikata are now double trouble for the tennis world.
Ian Payne, Epping

Srdjan Djokovic’s arrogance: the apple doesn’t fall far from the tree.
Ian Maddison, Parkdale

I hope a reporter will ask Novak Djokovic’s father where he stands on the war in Ukraine.
Jim Beggs, North Balwyn

Congratulations, Australia, for enforcing COVID-19 laws in 2022 on the world’s greatest player. And congratulations, Novak, for bouncing back.
John Hughes, Mentone


Aboriginal activists who advocate a No vote will throw racists who plan to vote No into confusion. They won’t know which way to vote.
Henry Herzog, St Kilda East

“Gas shortage to test climate goals” (28/1). Take the option suggested and supply local needs before exporting overseas.
Lindsay Donahoo, Wattle Glen

Education: fashions come, fashions go. There are always lots of arguments.
Anne Kennedy, Surrey Hills

Is Lidia Thorpe the left’s equivalent of Pauline Hanson? At least the Libs disendorsed Pauline.
Felicity Bloch, Hawthorn


Re “Canape scarfing a dying art” (Spectrum, 28/1). Would someone please preserve Anson Cameron for his wonderful writing.
Jane Ross, San Remo

Re the missing radioactive capsule: It fell off the back of a truck just doesn’t seem to cut it as an excuse.
Margaret Gawler, Malvern

After years of, at times, frustration and distress, we solved DA’s quick crossword (27/1). To be framed and straight to the pool room.
Phil Wylie, Aspendale

I’m delighted the US state of Oregon is concerned about our native kangaroo species (24/1). It’s a pity they’re not as concerned about their native human species.
Jennifer Sanders, Glen Iris

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