It's time for Medicare Benefits Schedule reform: National Rural Health Commissioner

Doctor Ruth Stewart made the comments on a visit to Tamworth this week, when she attended a panel event organised by the UNE Smart Region Incubator and The Spinifex Network on rural healthcare.

In an interview after the symposium, she told the Leader that a change to the Medicare Benefits Schedule (MBS) would be "an excellent idea" for the new Labor government to take up.

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The MBS's activity-based design is inefficient, old-fashioned and didn't reward "the kind of health care provision that we want to see," she said.

"I would like to see Medicare move from a principally activity-based payment scheme, to one that includes measures, and payments, for quality and for continuity of care," she said.

The Medicare Benefits Scheme has changed little in any fundamental way in more than 30 years, since the Hawke government resurrected Medicare, which was initially legislated as Medibank under Whitlam.

It is "activity-based" in the sense that it pays health administrators and GP clinics an amount for each medical procedure - which can leave gaps in rural communities.

Medicare is also limited, in that it does not cover all dental or mental health procedures.

Many rural doctors have called for changes to the scheme in the aftermath of the NSW Parliament's damning inquiry into the state's rural health system.

The National Rural Health Commissioner provides policy advice to the minister responsible for rural health.

She said Medicare was a system designed for a different world and a different kind of healthcare, hence the dental and mental blindspots.

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"Medicare was designed in the early 1970s," she said.

"Our concept of what is important in healthcare has changed a lot.

"So I would agree that it is time to review it, but that will be a major challenge. Politically and technically. Because there is no perfect healthcare system anywhere in the world."

Dr Stewart was one of seven panelists at the "What is the future for rural health? Visioning the best future for rural Australians" symposium on Wednesday.

The University of New England Smart Regional Incubator, Dr Lou Conway, said the Spinifex network and the university plan to hold an "innovation challenge" in October off the back of the Wednesday night event.

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Founded in 2019, the Spinifex network is dedicated to advocating for better research into rural health issues.

The October event will be open to all, not just health professionals.

"That's about bringing practitioners, technologists and community together to answer those kind of practical questions," she said.

"How might we either rethink service delivery or solve real challenges in our community?

"Less talk fest, more hey what are some real solutions that we could create, right here, right now."

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Doctor Stewart said the biggest challenge with rural health care remains "workforce", and the NSW government ought to look to Queensland's successful rural generalist model to fix its crumbling GP VMO model.

"I think that New South Wales health has begun the journey to listen to and consult with the rural communities that began with the parliamentary review of GP rural services," she said.

"What I would challenge New South Wales Health to do, is to consider how much weight they give to the rural voices in their midst and to ask themselves, are we being urban narcissists?

"Assuming that what is known in the metropolitan centres, trumps what is known in rural and remote communities for the simple fact that it's metropolitan."

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