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HEALTH 2009-2010 FEDERAL BUDGET SPECIAL
Roxon prescribes for nurses ■ Louise Durack
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idwives, nurse practitioners, hospitals and cancer services are some of the big winners in this year’s Budget (link), whereas pathology and imaging services and high-cost specialist services such as IVF procedures have been targeted for cuts. Health minister Nicola Roxon’s plans to reform maternity services start with a $120 million scheme to allow midwives to practice independently, with access to Medicare and PBS services and with indeminity insurance
support. Nurse practitioners get a similar budget boost, with $60 million to expand their numbers and provide MBS and PBS items. This year’s budget also sees $1.5 billion funding to upgrade hospital infrastructure around Australia and $2 billion for cancer care infrastructure, including digital mammography services. Specialists’ fees will be capped in areas such as IVF and cataract surgery, and major savings are expected from cuts in MBS fees for many pathology tests, though these will be offset by more incentives for pathology and imaging providers to bulk bill.
In primary care, GPs lose the promised access to MRI scans of the knee and brain, and many incentive payments will now be now paid retrospectively. In addition, non-accredited practices will now have to adhere to proper vaccine storage processes to claim immunisation incentives. The government is also tightening up the Better Access Incentive for mental health, saying psychologists and other allied health professionals will no longer be eligible unless they take part in further training. comment@6minutes.com.au
How the Budget hits your wallet ■ Jared Reed So, how will the Budget affect the average GP? Super benefits take a hit, but there are advantages to nurse practitioner prescribing rights, says one analyst. From 1 July, the tax deduction for GPs who place their practice buildings into negatively geared super funds will halve, with the maximum contribution and matching benefit possible dropping from $50-25,000 for under 50s, and $100-50,000 for over 50s. Taking the icing off the popular tax strategy will discourage owner-operator GPs
GP tax strategies will be hit. from using this saving to build bigger buildings, or merging with other practitioners, says Mr David Dahm, CEO of practice management firm Health and Life. He says GPs recently affected stockmarket-wise had looked to the strategy with the hope of
saving money. “There’s still a tax advantage in putting your practice property into a super fund, and it’s still tax advantageous but it’s obviously limited the advantage … it’s not to say stop expanding your building, there’s still a good commercial reason for having your building, regardless of whether it’s in super or not,” he told 6minutes. He adds that nurse practitioner prescribing rights and MBSaccess should be welcomed from a financial perspective by practices, not viewed as a threat. What do you think? comment@6minutes.com.au
Other Budget changes: • The controversial ‘vial recycling’ scheme for highcost chemotherapy drugs put on hold. • Increased PBS price controls on drugs such as statins. • New funding model for Divisions will benefit those in areas of population growth. • New geographic system for rural and remote areas of need, based on 2006 data. • New GP rural incentives programs will extend cover to 2400 more GPs. • Lower Medicare fees for ageing diagnostic and imaging equipment, to encourage upgrades. • Number of GP Regional Training Providers to be consolidated. • GPET to take over the Prevocational General Practice Placements Program. • Data matching between PBS and Medicare to stop fraud. • Duration of rural training placements to be increased from six to 12 months. • Changes to return of service obligations for bonded medical students. • New Medicare items to be reviewed after three years for value for money.
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