Federal budget 2014: Victorian doctors slam GP co-payment

Victorian doctors have slammed the new $7 co-payment for GP visits and medical tests and say they will fight hard to prevent Victorian hospitals from introducing similar fees for emergency department care.

On Tuesday night, the Commonwealth opened the door for the state and territory governments to start charging people for emergency department services after announcing that as of July next year, Australians will be charged a $7 co-payment for GP visits, including imaging such as X-rays and pathology such as blood tests.

A spokesman for the Australasian College for Emergency Medicine, Dr Simon Judkins, said the new fees could prompt more patients to go to emergency departments instead of their GPs because hospital treatment is free.

He said the potential for this to occur, combined with a Commonwealth Government announcement that it will cut hospital funding to the states, could prompt the Victorian Government to introduce fees for emergency department care to raise more funding for the health system.

But Dr Judkins said doctors would strongly oppose such a move because it could deter people from seeking help with devastating consequences.

He said doctors were particularly worried about poor people and those with mental illnesses who could walk out of hospitals when they realise they might have to pay.

‘‘We already have patients in emergency departments whose conditions deteriorate because they have to wait for a long period of time so if you throw in an additional disincentive of having to pay money before you see the doctor… then there’s potential for patients who are acutely unwell to walk out and deteriorate,’’ he said.

Dr Judkins said any new fee for emergency care would hit the poorest people the hardest, undermining the principle of universal care.

”People who work in public hospitals pride themselves on delivering equitable care to whoever turns up at our front door. We would hate to go down the path of the American system where people are charged for emergency care,” he said.

Dr Judkins said designing an emergency department fee would be difficult, too, because many patients who could be considered ‘‘GP type’’ patients present with problems that can escalate into serious illnesses such as meningitis or stroke.

‘‘The logistics of determining what is a GP-type visit or what is an emergency visit can only be done retrospectively and the bureaucracy and infrastructure that you would have to put into place to monitor that would far outweigh the cost or revenue made from such a co-payment,’’ he said.

‘‘We think any disincentive for anybody to come to an emergency department when they think they have a genuine health emergency needs to be strongly opposed.’’

Victorian Health Minister David Davis was unavailable for comment on Tuesday night, but Victorian Treasurer Michael O’Brien told 3AW radio that the Napthine government would closely monitor the $7 fee increase to see a doctor.

“We don’t want to see people deciding they are not going to see their GP because of this co-payment and they wind up clogging up our emergency departments in our hospitals with things which are really more appropriately seen by a GP,’’ Mr O’Brien said.

He said the Victorian Government was also concerned about the longer term reduction in federal funding for state hospitals.

“The state budget has put extra money into our hospitals, and extra money into our schools, and we will be very concerned if the federal government is, sort of, stepping back over the next decade,’’ he said.

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Record injection for WA infrastructure

Perth Airport to attract more than $600 million from Tuesday’s federal budget. Photo: Erin JonassonThe Abbott government says the 2014-15 federal budget will invest record funds for infrastructure for Western Australia.

Tuesday’s budget includes $611 million to improve access to Perth Airport and $590 million for the Swan Valley Bypass.

The government will also spend $307 million to upgrade the Great Northern Highway, $174 million to widen the North West Coastal Highway and $140.6 million for new interchanges on the Tonkin Highway.

Infrastructure and Regional Development Minister Warren Truss said the government was committed to the $1.6 billion Perth Freight Link and would work with the WA government “to involve the private sector” in co-contributing to the project with the two governments.

The federal government has unveiled an $11.6 billion transport infrastructure package for Australia that will take total federal spending to $50 billion by 2019-20.

It says the investment will in turn spur state and private sector investment in roads and rail across the continent and could spur up to $125 billion total investment by 2019-20.

Fairfax Media revealed last week the Abbott government’s plans for an asset recycling fund in the budget, which will be handed $5 billion to encourage states and territories to privatise assets by offering a 15 per cent bonus payment from Canberra.

The money for that fund will be funded by the sale of Medibank Private and by rolling in money from existing Building Australia funds and an Education Investment Fund.

Another $3.7 billion will be used to fast track already announced Coalition projects such as $1.5 billion for stage two of the East West link road in Melbourne and $866million for the Perth Freight link.

Treasurer Joe Hockey has described the infrastructure program as the biggest in Australia’s history.

WA will share also in continued funding for roads maintenance, including $2.5 billion over six years for roads to recovery and $565 million over six years for black spots projects.

Mr Truss said the infrastructure package would deliver better roads which “means less congestion, faster travel times and lower fuel costs”.

“The Abbott Government’s investment in Western Australia will also improve freight transport linkages to key domestic and export markets,” he said.  Follow WAtoday on Twitter

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Joe Hockey ‘daring’ states to ask for a rise in the GST, says Labor

Prime Minister Tony Abbott in Canberra. Labor has accused the government of daring the states to ask for a rise in the GST. Photo: Andrew Meares Treasurer Joe Hockey does breakfast television interviews on the front lawns of Parliament House after budget day. Photo: Alex Ellinghausen

Federal Budget 2014: Full coverage

The Abbott government is ”daring” the states to push for an increase in the GST, Labor says, after Treasurer Joe Hockey revealed in the budget that the states would be stripped of billions of dollars of funding for health and education.

Shadow treasurer Chris Bowen said on Wednesday the funding cuts would force the Premiers to begin the potentially politically toxic argument to raise the goods and services tax to make up the shortfall, but Mr Hockey refused to be drawn on the issue in morning interviews, saying the GST was a ”matter for the states”.

Mr Hockey faces a fight on the issue, with the treasurers from conservative-led states Queensland, NSW and Victoria indicating on Wednesday that they would oppose the cuts.

Mr Bowen told ABC Radio that “as sure as night follows day, Premiers will say ‘to make up from this cut, we will need to increase the GST”.

“Mr Abbott and Mr Hockey have set it for this express purpose,” he said, adding that Labor’s position was clear in opposing a rise in the GST or broadening its base.

Opposition Leader Bill Shorten said the GST was firmly in the government’s sights and that the Coalition had deliberately shifted greater burdens onto the state in health and education spending to force their hand.

But Mr Hockey told ABC radio on Wednesday that he made “no apologies” for his decision to push funding for schools and hospitals back on to the states and the Commonwealth would ;;sit down with the states to work through the details”.

He signalled that he would be difficult to move on the cuts, saying the ‘‘same taxpayer’’ funded hospitals and schools.

When asked if it could lead to an increase in the GST rate, Mr Hockey said the government wouldn’t move on the 10 per cent rate without taking it to an election.

But if the states wanted more money from the GST, ‘‘it’s up to them to argue the case to change the GST.”

Mr Hockey said the commonwealth had always funded those services at base levels, but the Rudd and Gillard governments went on a ‘‘spending spree’’ with no plan to pay for the increases in funding for schools and health.

Prime Minister Tony Abbott echoed his Treasurer’s sentiments on Wednesday saying the GST was “a matter for the states.”

“The states do well out of this budget, we are expecting them to run public hospitals and run the schools,” he said.

In a later interview with ABC Radio, Mr Abbott further explained his position.

“Changes to the GST is not something the government is planning, the states are perfectly entitled to argue for change, each level of government should be sovereign in its own sphere,” he said.

Queensland Treasurer Tim Nicholls said it would be tougher to deliver services because of cuts to future spending on health and education

‘‘We will use the time between now and the implementation of those decisions over the next couple of years to take the fight up with Canberra,’’ Mr Nicholls told ABC radio on Wednesday. ‘‘The revised funding models are going to make it tougher to deliver the services.’’

NSW Treasurer Andrew Constance, who will announce NSW’s budget on June 17, said the federal budget was really just ‘‘cost-shifting’’, estimating his state would have to find an additional $1.2 billion over four years to make up the shortfall.

‘‘We have committed expenditure to these areas. What we’ve seen from the commonwealth in this year’s budget is a cost-shift in terms of their growth monies,’’ he told ABC radio. ‘‘We want to see the agreements honoured. These are vital areas of service delivery at a state level.’’

NSW Premier Mike Baird said on Wednesday: “What we saw last night was a kick in the guts to the people of NSW.”

“I have a question to the Prime Minister and to the federal Treasurer . . . what services would he like us to cut here in NSW on the back of the funding cuts that we have seen overnight?”

Mr Baird described Mr Hockey’s actions as a “flick pass”.

“Our message to Canberra is, ‘no, we are in this together. You cannot outsource your problems to the states.”

Victorian Treasurer Michael O’Brien said on Wednesday: “We don’t want to see people deciding they are not going to see their GP because of this co-payment and they wind up clogging up our emergency departments in our hospitals with things which are really more appropriately seen by a GP.”

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Budget update for SMEs

MYOB CEO Tim Reed Photo: Jessica Shapiro

To help Australia’s small and medium business operators get the most out of the 2014 budget changes, MYOB strongly encourages them to take advantage of current tax deductions, to innovate and to make the most of online technologies to help boost their productivity, business performance and their confidence in the economy.

Following the handing down of the budget, it can be tempting for business owners to bunker down, play it safe and postpone their plans for growth. There are still opportunities to be had for SMEs.

I’m pleased the government has set a target of reducing regulatory compliance costs on businesses, individuals and the community by $1 billion every year. Business owners and managers will continue to call for tax reform, deregulation and reduction of red tape – our latest SME research shows GST and BAS simplification continue to top the list of initiatives they hope to see. We call on the government to keep tax reform on the agenda and to consider broadening the GST to not only address the needs of health and education spending but to also ease the burden of completing a BAS on Australia’s two million businesses.

With the retirement age set to increase to 70 by 2035, small business stands to gain the most from taking up a new $10,000 incentive payment encouraging employers to hire over 50s. We encourage small and medium businesses to keep this in mind as they hire and install a new step in their hiring process to ensure they capture this benefit whenever they meet the necessary criteria.

I hope the rise in the fuel excise rate does lead to increased investment in roads including highways and rail in our cities and regions, to help ease the pressure of rising fuel prices. Fuel prices was once again the top pressure point for SMEs this year, and has been since 2011. This change is likely to be the least popular part of the budget with SMEs, particularly so with certain sectors that will feel more pain – our latest research shows agribusiness and Western Australian-based businesses felt the most pressure from rising fuel prices. 61 per cent of SMEs would welcome investment in transport infrastructure in our major states and cities. Adopting online and teleworking technologies can also help ease the pressure by enabling business operators to operate from home or any location outside of the office.

Plans to facilitate innovation and self‑reliance via a new Entrepreneurs’ Infrastructure Programme will be well-received by SMEs. Our research shows more than half of SMEs would support increased government funding for innovation, R&D and training on how to use the internet to grow their business. The benefits of online technologies include the ability to compete on a more level playing field with local and global rivals, increased productivity and less time spent on business administration. This means more time for growing the business, which has the potential to make a difference to our economy.

Further support for small business include creating a specialised unit to help small businesses gain better access to government contracts, which is supported by half of the SMEs we surveyed. We strongly encourage assisting SMEs to gain access to government contracts and also encourage SMEs to take up these opportunities.

Small business will feel reassured that the budget has been put on a sound footing for the medium term. While no-one likes tax increases, and a number of consumers will likely feel the pinch, and this may constrain spending, past behaviour indicates there is a chance that Australian’s will believe the worst  is behind them and that economic growth will continue unabated – fulfilling the rising business confidence that recent surveys have shown.

Tim Reed is MYOB’s CEO

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