As a rural doctor, one cannot be less than gob smacked that once again solutions to the rural workforce crisis have been put in the too-hard basket. The Federal Government has largely ignored the rural workforce crisis, along with the two other vital major crises in health – dental and mental health care provision. All three crises – which are crying out for solutions – have been similarly  rated as not being politically sexy enough to fund sound solutions in an election year.

This is a sad reflection on a government elected to serve all Australians and which has been provided with a sound, simple solution for the rural workforce crisis – the AMA-RDA Rural Rescue Package.

As to whether the changes to practice nurse subsidies will see an improvement or worsening of rural care is anyone’s guess. I am pleased to see that the AMA has lobbied successfully for a loading to be applied to the payments to rural practices and that the Government will have a transition arrangement to protect practices. However, the eventual loss of fee-for-service practice items and the decision to cap the funding at five grants looks like it will leave some GPs and practices worse off.

Similarly the Divisions, which are to be rather dumbly renamed as “Medicare Locals”, will be funded to organise and provide incentives for after-hours GP care. But as an offset, the existing PIP incentives for GPs to provide after-hours care will disappear. How many of any extra dollars will go to the renamed bureaucracy and how many to coalface medical workers? Your guess is as good as mine.

As GPs we see an awful lot of the Australian population and they all too often ask for our guidance as to what judgement they should make of the Rudd Government’s health initiatives. Without provision by government of sensible detail, what can we tell them? Do we embrace the changes or deride them, or as in this Budget, throw our hands in the air and tell them that it is all indiscernible smoke and mirrors?

Pharmaceutical honesty will prevail, under a government deal where manufacturers will have to disclose to government what they sell pharmaceuticals to pharmacists for, and savings will be pocketed by the patient, not the pharmacist.