Doctors may start charging for bandages, band aids and other dressings under a controversial plan that will threaten bulk-billed GP consults.
Doctors may start charging for bandages, band aids and other dressings under a controversial plan that will threaten bulk-billed GP consults.

Band aid and bandage fee threatens free GP visits

Exclusive: Doctors would be able to charge patients a new fee for bandages, band aids and other dressings under a controversial proposal labelled a Medicare co-payment by stealth.

The government committee in charge of reforming Medicare has proposed general practitioners should be able to bulk bill patients for a consultation but then charge them an additional fee for "wound care consumables".

Currently these dressings are provided free of charge by most doctors.

Solicitor and Medicare administration expert Margaret Faux has warned the new fees amount to a "Medicare co-payment" cleverly disguised as fees for dressings.

The constitution prevents the government controlling these types of medical service charges and, if allowed, doctors could start billing patients for disposable gloves, specimen jars and even disinfectants, she warns.

"If the majority of patients attending the practice have blood taken and a gauze pad with tape is applied to the puncture wound, that's potentially a $5 co-payment for most patients right there," she said.

The new fee has been outright rejected by Consumers Health Forum (CHF) which said the charges would deter people from going to the doctor.

They instead want doctors reimbursed for administering dressings in other ways.

"We strongly oppose the introduction of any side fees for GP treatment which would dilute the principle of no-cost medical treatment provided by bulk billing," CHF chief Leanne Wells said.

"To introduce charges for dressings when we know out-of-pocket costs already keep people away from the doctor would likely be the thin end of the wedge, imposing additional costs barrier to patients and quite possibly lead to poorer outcomes for patients including lingering wound infections because people can't afford to replace dressings," she said.

The Australian Medical Association (AMA) is supporting the changes because some dressings can cost more than the Medicare rebate a doctor receives for a consultation.

New age wound dressings can cost $50 but Medicare only pays a GP $38.75 when they bulk bill a patient for a consultation.

"At present, the way that wound care is provided in General Practice puts the burden on the patient to purchase their own bandages; or on practices to try fund it for free, even though dressings sometimes cost more than the patient's rebate," said AMA Vice President Dr Chris Moy.

Patients end up out of pocket at the pharmacy or GP's end up funding an arrangement which is not viable, he said.

"Rather than allow this to continue, GP's would simply like the ability to recoup the cost of dressings, without losing the ability to bulk-bill our patients. And to further support patients, we'd like a scheme set up to subsidise dressings for vulnerable patients groups - something sorely needed to improve wound outcomes in this country," he said.

A spokesman for Health Minister Greg Hunt said the Medicare Benefits Reviews Taskforce on Wound Management was independent of Government and comprised of clinicians and consumers.

Australian Medical Association Vice President Dr Chris Moy.
Australian Medical Association Vice President Dr Chris Moy.

"The Government is reviewing the recommendations of the taskforce's report and will respond in due course," the spokesman said.

"The Morrison Government has a rock solid commitment to Medicare. It is key to Australia's successful healthcare system," he said.

The taskforce recommended the change in a report to the government last month.

It noted the changes would hit patients hip pockets.

"The Working Group acknowledge that allowing practitioners to charge patients for the cost of wound care consumables at the same time as a bulk-billed attendance will reduce cost for providers, however may not reduce costs for some patients," it said.

It has called for the government to set up a national wound consumables scheme that would reduce the out of pocket costs for patients.

Ms Faux said there was a major problem with the way Medicare failed to properly fund the costs of dressings but allowing doctors to charge for them "is not the solution".

"When we pay for a care we don't pay for every individual bolt in the wheel, we should pay doctors an overarching payment for treating the condition rather than for every individual component," she said.

Originally published as Band aid and bandage fee threatens Aussies' free GP visits