Commission of Audit chairman Tony Shepherd incorrect on doctor visits

Updated

The National Commission of Audit chairman says people are visiting the doctor more than 11 times a year and he doesn't believe Australians are "that crook".

Tony Shepherd's audit report recommended the Government introduce a $15 co-payment for people to visit their GP, which he says "will give people cause for thought over whether they really need to go".

In its first budget handed down on May 13, the Government announced a $7 co-payment for general practitioner, pathology and diagnostic imaging services. The introduction of the fee is expected to save the Government $3.5 billion over the forward estimates. That money will go into a new Medical Research Future Fund.

ABC Fact Check examines Mr Shepherd's May 1 claim that "Australians, on average, go to the doctor now 11 times per year".

The claim: Tony Shepherd says on average Australians go to the doctor 11 times a year.

Tony Shepherd says on average Australians go to the doctor 11 times a year. The verdict: Australians visit the GP around five times a year, and visit the doctor, which has a broader definition, between six and seven times a year. Mr Shepherd is incorrect.

What the statistics say

There is no shortage of data when it comes to measuring the number of visits to general practitioners or the broader definition of "doctors".

The latest figures from Medicare show there were 128,704,593 visits to GPs last year. That includes visits for enhanced primary care, such as a procedure to have a skin cancer burnt off.

If this figure is divided by a 2013 population of 23 million, then Australians, on average, visit a GP about 5.6 times per year.

Other Medicare statistics, which measure 'professional attendance' by Medical Benefits Schedule, include visits to specialists, consultation physicians and psychiatrists.

Using this broader definition, the average Australian makes 6.9 visits to doctors per year.

And a recent report by the National Health Performance Authority, an independent agency that monitors and reports on healthcare services, arrives at a very similar conclusion.

It looked at local Medicare catchments and found that in 2011–12, the average number of GP attendances per person varied across Medicare Local catchments, ranging from an average of 2.4 to 7.4 attendances per person.

The OECD's Heath at a Glance 2013 looks at how often people visit the doctor across 35 developed countries.

The report, which uses 2011 figures, says Australians visit the doctor just over six times each year.

The average number of doctor visits per year ranged from over 13 in Korea and Japan to less than four in Sweden, Mexico, South Africa and Brazil.

Australia was almost identical to the OECD average, at between six and seven visits per year.



Discouraging doctor visits

In contrast to the Commission of Audit's recommendations, patients in many European countries are given incentives (or are required) to consult a general practitioner about any new episode of illness.

This happens in Denmark, Italy, Netherlands, Norway, Portugal, Spain, and UK, according to the OECD's report.

The National Commission of Audit recommends: "The introduction of co-payments for all Medicare funded services, underpinned by a new safety net arrangement that would operate once a patient has exceeded 15 visits or services in a year. General patients would pay $15.00 per service up to the safety net threshold and $7.50 per service once the safety net threshold has been exceeded. Concession card holders would pay $5.00 per service up to the safety net threshold and $2.50 per service once the safety net threshold has been exceeded."

The report says all consumers should "make a small contribution towards the cost of their health care through a co-payment for all items listed on the Medicare Benefits Schedule", which has nearly 6,000 items (excluding pharmaceuticals), ranging from medical, nursing and allied health services to pathology and imaging services. The report says all consumers should "make a small contribution towards the cost of their health care through a co-payment for all items listed on the Medicare Benefits Schedule", which has nearly 6,000 items (excluding pharmaceuticals), ranging from medical, nursing and allied health services to pathology and imaging services.

Dr Liz Marles, president of the Royal College of General Practitioners, says Mr Shepherd's figures "are based on assumptions and are not grounded by any evidence".



Days after his initial press conference, Mr Shepherd qualified his statement by saying: "I use that as a bit of a throwaway line, but put it this way, there are 253 million visits a year. That's 11 times 23. So, you know, there's a lot of visits going on each year in our - to doctors and providers under the Medicare system".

Fact Check asked the Department of Finance, which is handling enquiries for the Commission of Audit, where Mr Shepherd's 253 million figure came from.

A spokeswomen said: "The Commission of Audit's Report notes that 'In 2013-14 an estimated 353 million medical and associated services will be funded through Medicare, approximately 15 services per year for each person in Australia'."

Medicare-funded services

There are approximately 15 Medicare-funded services used by the average Australian each year. These include blood tests, x-rays, ultrasounds and vaccinations. But the number of Medicare-funded services each year does not directly correlate with the number of doctor visits.

Services are often undertaken by nurses or other health professionals. Furthermore, one visit to the GP could result in a patient using several Medicare-funded services. For instance a GP may bill for a short consultation, and a repair of a wound in the one visit.

A Medicare document developed for GPs states: "If during the course of an attendance you determine the need for a surgical procedure, Medicare benefits are generally payable for both the consultation and the medical procedure."

The response by the Department of Finance spokeswomen does not substantiate Mr Shepherds claim that Australians visit the doctor 11 times each year.



The verdict

Mr Shepherd is incorrect to state Australians visit the doctor 11 times a year.

The evidence shows they visit the GP around five times a year, and visit the doctor, which has a broader definition, between six and seven times a year.

Sources

Topics: doctors-and-medical-professionals, health, federal-government, australia

First posted