Doctors Should Reject Budget Bribes – 19 May 1999

GPs will be paid for cutting back on prescribing to patients in a radical plan to lop $187 million off the Australian drug bill, announced by Federal Health Minister Dr Michael Wooldridge in last week’s Budget.

But Dr Bruce Shepherd, who is standing for the presidency of the Australian Medical Association later this month, has denounced the plan as ‘bribery’ and warned patient care could suffer if doctors stand to gain financially by cutting back on prescriptions to patients.

Under the scheme GPs will receive half of any savings they make in three key areas of cardiovascular drugs, medicines for peptic ulcers and reflux. The initial target is to save $187 million over four years. The Government plans to pay back to GPs half of the projected savings off the drug bill.

The plan known as “Quality Incentives for Prescribing Pharmaceuticals” reads as follows:

“The Government will provide incentives for General Practitioners (GPs) prescribing pharmaceuticals to change their prescribing behaviour, both to improve the quality of patient care and to lead to better use of resources through the Quality Incentives for General Practice Programme.

The programme involves measuring the savings accruing from changes in prescribing practices, and allocating half of these savings to GPs. Three high cost/high growth drug groups (antibiotics, peptic ulcer drugs and cardiovascular drugs) which account for around $1.4 billion in expenses per annum have been identified as having the most potential for achieving improved prescribing practices”. Budget Paper No.2 pg 109.

‘It is abhorrent to offer financial incentives to doctors to change their prescribing behaviour,” said Dr Shepherd.

The proposal offers perverse financial incentives to regulate prescribing and directly interferes in the doctor patient relationship, he said.

“This is a classic case of the profession getting too close to Government,” said Dr Shepherd.

“The proposal, which came out of negotiations with the Federal Government will create enormous concern across the profession once its details are made known to practising doctors.”

“Doctors must act in their patients interests, not in the interests of health department bureaucrats who have no responsibilities whatsoever for patients,” said Dr Shepherd.