Call the doctor

the queensland government’s payroll tax grab on doctors will worsen the current shortage of medical practitioners in regional and underserviced areas. BY Amanda Stoker

As federal Health Minister Mark Butler and his Strengthening Medicare Taskforce acknowledge the need for more general practitioners, Queensland Labor is simultaneously implementing policies that make a career as a GP in Queensland undesirable.

Butler said: “It’s not too long ago … that about half of medical graduates chose to be a general practitioner… now less than 14 per cent of medical graduates are choosing general practice as their career.”

Yet, the Queensland state government is making a career as a GP less attractive than ever.

Last December, the Queensland Revenue Office ruled that doctors contracted to work in medical centres would be treated as employees for payroll tax purposes.

By imposing a new tax on the work of GPs, who are largely sole practitioners or small businesses sharing space and support services, Premier Annastacia Palaszczuk is making already marginal medical practices, particularly in rural, regional and remote parts of the state, cross the threshold into becoming non-viable businesses.

The likely result is the withdrawal of GP services from already under-serviced parts of the state.

Queensland Labor’s GP payroll tax grab will work directly at cross-purposes with federal Labor’s Medicare shake-up.

Butler observed, “about half of all emergency department presentations right now are classified as semi-urgent or non-urgent – about 4 million every year … many could and probably should be dealt with outside of hospital settings”.

But Queensland Labor’s budget position is so poor that they are now prepared to rob Peter to pay Paul. Taxing GPs to the point that they exit the regions will result in more pressure on already-overwhelmed emergency departments.

It is also another breach of state Labor’s election promise of “no new or increased taxes”.

There has been an understandable backlash from the profession and patients – but the premier has not backed down. While she has indicated there will be a longer period of time for doctors to adapt to the new tax, it will not be shelved. It is no surprise that the time extension is to just after the next election, for which the date is fixed. Shadow treasurer David Janetzki says the delay is a mere “political fix”.

The taskforce recommended work to fast-track the supply of GPs, rural generalists, nurses, midwives and other medical professionals. Yet, another administrative and financial burden on general practices that already face inflation, price-sensitive customers struggling with the cost of living, frozen Medicare rebates and high demand, will only deter medical graduates from pursuing a career in general practice.

Those doctors that nevertheless choose general practice will be forced to charge higher fees to patients to cover the state government’s tax.

It is a well-established fact that fewer available GPs in the community increases pressure on hospitals, as people seek non-urgent care from emergency departments. That’s inefficient.

More worryingly, the crisis in Queensland health is so severe that this back-up treatment option isn’t even always available.

Hospital ramping rates in Queensland have reached extraordinary levels. During the last LNP government, ramping – that is, the percentage of ambulances that have to queue at emergency departments waiting for space and expertise to become available and hand patient care over the hospital – was at 15 per cent. Under Labor, it consistently averages 44 per cent statewide, with 46 per cent in regional areas.

About 60,000 people wait in line right now for elective surgery, and 272,000 wait in line to see a specialist. The last LNP health minister, Lawrence Springborg, got the surgery waiting list down to zero.

These statistics point to the mismanagement and rolling crisis permeating Queensland Health’s bureaucracy and political leadership.

It’s the same health bureaucracy that is responsible for the biggest scandal to face the forensic testing of DNA evidence in Australia’s history.

Medicare’s objective is to provide all Australians with access to quality health services, no matter where they live. But federal Labor’s attempt to make sure the system delivers that outcome is now being undermined by Queensland Labor’s financial desperation.

Amanda Stoker is a former LNP senator for Queensland and a distinguished fellow of the Menzies Research Centre.