THE controversial GP fee could be bought into effect without parliamentary approval in the same way the government this week sidestepped the parliament to introduce petrol indexation.

Health Minister Peter Dutton on Thursday October 30 repeatedly refused to rule out using a regulation to cut Medicare rebates by $5 to achieve the $3.5 billion in savings from the GP fee outlined in the budget.

The government is facing an uphill battle getting Senate approval for legislation to impose the fee which is opposed by the Australian Medical Association and other key health groups.

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The Opposition, the Greens and the Palmer United Party say they will not support the fee.

The AMA is concerned that as a result the government may be considering by passing parliament to get the fee up in same way it this week implemented its budget measure to index petrol excise by regulation.

“As the government gets more desperate to save money we wouldn’t be surprised if they go down that avenue,” AMA president Dr Brian Owler said.

“That would cut the rebate, take money away from patients and away from GPs and that would be bad for health care,” he said.

The Medicare rebate is based on a Medicare schedule fee that is set by regulation.

The government can simply introduce a regulation to slash the current $37.05 schedule fee for a GP visit by $5 to $32.05 to achieve the savings it wants in the budget.

This would have the effect of cutting the Medicare rebate by $5.

Asked twice whether he was considering such a move Health Minister Peter Dutton said “I don’t intend to comment publicly on any of that.”

“I don’t intend to publicly canvass anything beyond that,” he said.

AMA GP spokesman Dr Brian Morton said if the government went down this path many GPs would be unviable unless they saw more patients or introduced a $5 charge to make up for the rebate cut.

“In the end the government is not going to save any money and the fee will be a negative for prevention and keeping people out of hospital,” Dr Morton said.

The parliament has the power to disallow any regulation Mr Dutton introduces but if he introduced it in the final sitting in June next year the measure would come into effect as planned on July 1 and could not be disallowed until August 18.

Depending on the way any disallowance went ahead it is possible there could be no Medicare rebate at all if the Opposition and crossbenchers in the Senate tried to scotch the fee cut.

And by forcing the Senate to disallow a $5 rebate cut the government gets itself a one vote advantage.

To pass legislation it needs 39 votes in the Senate, it only needs 38 votes if it wants to block any disallowance motion.