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Legislative Assembly for the ACT: 1995 Week 10 Hansard (6 December) . . Page.. 2710 ..

MRS CARNELL (continuing):

decision on whether they stayed or went. When the conditions of the negotiations changed, the doctors one by one, not as a group, determined that they believed that it would not be economically feasible for them to stay in the system. I then said to my negotiators, "If that is the case, maybe it is the rent problem. Bring down the rent by 30 per cent. See whether that works". That negotiation was done one by one with the various people, understanding that 100 per cent bulk-billing is less economically viable than bulk-billing just people with health care cards or pensioners. We attempted that approach and individually - not as a bloc, but individually - over time each one of those CMPs determined that it still was not economically viable.

Some of the CMPs have already left the system. Some decided very quickly that they had other options and that the redundancy payment was a very nice little nest egg and they would jump very quickly; so they determined to go very quickly. Others have indicated that they will go but are staying until Christmas or sometime after that. The whole thing has happened with a domino effect, I suppose. Until a couple of weeks ago we did not realise that all of them were going to pull the plug, that none of them were going to stay. It was only then that we determined that we had better get some advertisements in newspapers to get some other 100 per cent bulk-billing doctors, in line with the Assembly motion. Advertisements have been run in various places for 100 per cent bulk-billing doctors for our health centres, with a 30 per cent discount on rent, in line with the Assembly motion. We are still attempting to achieve that end.

Mr Connolly: You have already paid out all your redundancy payments and the doctors are gone.

MRS CARNELL: This Assembly did not say that those doctors had to stay. This Assembly said that only 100 per cent bulk-billing doctors could be in our health centres. Interestingly, Mr Connolly had employed at least three non-100 per cent bulk-billing doctors in our health centres up to date. They bulk-bill only pensioners and health care card holders; I do not even know whether they do people on low incomes but they certainly do the first two. So it is not unusual for those people to exist in our health centres. I thought, "Fine; in line with the Assembly motion, we will hold to 100 per cent bulk-billing". That is the basis upon which we are advertising, seeking people to come into the system. The Assembly's motion by its very nature changed the negotiation base. We immediately went from a situation where we had CMPs who were interested in coming to our health centres as bulk-billing doctors to having no CMPs that - - -

Mr Connolly: So it is all Paul Osborne's fault.

MRS CARNELL: No; this Assembly, not Paul, determined that. Anyone can put forward a motion, but this Assembly as a whole determined to change the basis of the negotiation. We paid attention to that. We still are operating within those boundaries. If we could change back to bulk-billing doctors, as Mr Connolly did and as Mr Berry did, we would have no trouble in getting doctors into our health centres. For whatever reason, and I suggest that it is because the Medicare rebate for GPs at this stage is too low, GPs believe that, even with a 30 per cent discount in rent, even with some very good deals for the current CMPs on the equipment that is currently in their surgeries, it is still not worth their staying. It is interesting to note that this decision to cease salaried general practice creates a net saving of $600,000 per annum.

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