Thanks Michael, for that introduction and for welcoming me here today, on this - your first official day as President. Congratulations.
In her absence, I want to thank Amber-Jade for coming along today.
She's a dear old friend, and I think state health minister is really one of the toughest jobs in politics.
When I get the joy of sitting down on one side of the table with eight of them on the other side of the table telling me what we could do better, they often describe the federal health minister job as "all care and no responsibility".
And there is something in that, given the pressures every day on the State Health Minister, so she's doing a terrific job.
It is my great pleasure to be here and talk to you at GP24, upon the lands of the Whadjuk Nyoongar people.
I acknowledge their Elders, past, present, and emerging and extend that acknowledgement to any First Nations people here today.
Can I also acknowledge the effort and the energy of your outgoing President, Dr Nicole Higgins, who told me she has a very good night's sleep last night.
Thank you for your time as President.
We have worked together closely, right from day one, as we sat across from each other and sometimes next to each other on the Strengthening Medicare Taskforce.
It's been an absolute pleasure working with you.
We haven't always agreed. And as you know, one of my great disappointments is I haven't - yet - convinced you of the merits of the Urgent Care Clinic network program, even as we approach a million patients and begin to see - as Amber-Jade said - Cat 4 and 5 presentations decline at nearby hospitals.
But beyond that, you have been a terrific advocate for your profession and your specialty, so you should be very proud of your contribution at such a critical time for general practice in your time as President.
Because on any measure, general practice today is in a vastly better place than it was when you took up your position as President.
We're seeing more doctors, we're seeing more bulk billing, we're opening more Urgent Care Clinics.
As a College and as a profession and specialty, you have begun to change the narrative around general practice and primary care.
To elevate it to its rightful place as one of the most dynamic, challenging, diverse and, certainly, impactful specialties that we have.
Medical graduates are now more optimistic about a career in general practice and rural generalism.
More GPs are recommending the specialty to younger doctors.
A record number of GPs are in training, with more than 5,400 future GPs moving through the federally funded training program right now.
GPs are happier, too. The Health of the Nation Report tells us that.
And it's perhaps because they sense that there has been a very clear improvement in the esteem in which your profession and your specialty is held, in Canberra by your government.
A government that recognises you as fundamental to the health system and absolutely critical to the health of our country.
A government that is prepared to back that recognition with significant new investment.
More than $1.1 billion in additional Medicare payments flowed into general practice in the last financial year.
A 12 per cent increase on the year before.
That surge was driven chiefly by the tripling of the bulk billing incentive - the largest investment in bulk billing in the 40-year history of Medicare.
Already it has been a "game-changer" - to use the words that Nicole used when we announced it last year.
Since it came into effect in November last year, it has created 5.4 million additional bulk billed GP visits.
And the billion-dollar boost to general practice in a single year is an encouraging increase, particularly since the tripled incentive was in place for only eight months of the last financial year.
That's because the incentive was just one part our additional investment.
In the past two years we have also delivered back-to-back increases to the Medicare rebate that are the largest in 30 years.
The biggest, and the second biggest, increases since Paul Keating was Prime Minister.
This isn't just normal indexation.
We have supplemented the Medicare rebate increases and changed the formula by which they're calculated.
Rebates have increased by more in the past two years than they did in the previous nine years.
We haven't yet been able to put back every dollar that was taken out of Medicare during the six-year freeze, but we've started to go a long way towards doing it.
I came to the position - a little more than two years ago - of Health Minister unapologetically saying that, of all of the pressures in health at that time - and there are many - general practice was my number one priority.
I said that this would be a long piece of work that would require continuous effort and investment by government, and I remain very much committed to that.
But I also said from the time I became Minister, that investment - alone - will not be enough to build the stronger Medicare that Australia needs today.
A stronger Medicare that fits the patient profile we have today: one with more chronic conditions and an ageing population.
There needed to be reform of the Medicare system.
That there needed to be reform of the Medicare system.
The Strengthening Medicare Taskforce set the direction for that reform, towards a more multidisciplinary future, fuelled by better digital technologies, new investments and blended payments.
The Taskforce sketched a map to that stronger Medicare, and called for further reviews to flesh out the details.
Those primary care reviews have been delivered to government now, and to the sector as well, with recommendations on everything from how practitioners are paid for their work, what work they are allowed to perform, and where they are encouraged to work in our big, vast country.
Each review has filled in a section of the map that the Taskforce sketched for us.
And as we use it to find a path to a stronger Medicare, I'm going to rely very heavily on the College to help navigate the way.
You are an absolutely critical stakeholder in this work of reform.
I look forward to working closely with your new President, and the new Board, just as I worked closely with Nicole.
I've no doubt that Dr Michael Wright - a GP who has worked extensively on health funding reform and has a PhD in health economics - you can't imagine how much Blair Comley is looking forward to that - will be able to provide me and Blair with the sort of frank and fearless advice that I have come to expect from College presidents.
I can't promise that we're always going to see eye to eye on absolutely everything.
Though perhaps I might tempt you to visit an Urgent Care Clinic, Michael.
What I can promise, though, is that my door will always be open to you and your membership.
Open to your advice and open to your views.
Particularly as we start to walk the path towards a more multidisciplinary, GP-led team-based primary care.
As we consider the structure of those reforms, the timeframes for implementation, the additional investments that may be needed, I will seek your input and feedback, Michael, as the voice of your College, your specialty and your members.
A membership that, as you said, is now more than 50 thousand strong.
In your President, the College has someone who quite literally wrote the book - or the PhD, at least - on continuity of care.
On how better care for chronic conditions comes when patients identify their regular GP, and their regular GP receives financial incentives to provide good wraparound care.
Michael completed his PhD on this topic around six years ago.
At the time, Australia was caught in a chronic cycle of chronic condition pilots.
Just pilot after pilot after pilot - or what the Grattan Institute called, a little while ago, "more pilots than Qantas".
Thankfully, we have made it through that turbulence and Australia now has, I think finally, the foundations of an enduring system in place, with MyMedicare.
Eighty per cent of practices - more than 6,300 around the country - are now registered with MyMedicare.
Together, they have registered more than 2 million patients, with another 50 thousand joining every couple of weeks.
This is organic growth.
Without slick marketing or advertising.
No financial reward yet for patients or practitioners.
Just more than 2 million patients seeking a stronger relationship with their regular GP.
We are growing this program slowly, steadily and carefully.
We don't want it to be another pilot that drops off the edge of the table.
The first blended funding program under MyMedicare launched in July.
Already the General Practice Aged Care Incentive program - or GPACI, as its affectionately known, has seen thousands of practices register.
Those practices receive payments on top of Medicare rebates, to provide wraparound care to older Australians in residential aged care.
In a matter of months, the program has registered more than 75 thousand patients, or the equivalent of about 40 per cent of all of those patients in residential aged care.
This is a promising sign, and we will monitor the program closely as it continues to roll out.
Because as a country, we are getting older and living longer, with more of our years spent in chronic conditions, as you know better than me.
Today, 1 in 2 Australians have a chronic condition and 1 in 5 have multiple conditions.
This means that more Australians, for example, are prescribed the same medicine year after year, decade after decade, and perhaps even for the rest of their lives.
And as I said, somewhat contestedly last year, a 30-day prescription just doesn't make sense, for that patient and that medicine.
A 30-day script does make sense when people were prescribed short courses of medicine for a one-off bout of illness - something that was much more common when Medicare was introduced 40 years ago.
A 60-day script for common medicines prescribed on an ongoing basis, saves patients money and time, and fits the patient profile we have today, as well as freeing up some more of your time.
60-day scripts - I see as a real complement to strengthening Medicare - was difficult reform, but it was good policy.
It was always good policy, even when PBAC first recommended it back in 2018.
And I really want to acknowledge the efforts of the College, and particularly Nicole, in advocating for that good policy.
It was a contested space, I think Nicole would agree.
It is because you spoke up so strongly in support, and your GPs spoke to so many of patients about the benefits, that we have seen such a strong uptake of 60-day prescriptions.
The first tranche of medicines became eligible in September last year.
By October of this year, 30 per cent of scripts for those medicines were issued for 60 days, and that number is continuing to grow.
It is one of three major cheaper medicines policies that we have delivered since coming to government, that together have already saved Australians more than a billion dollars in out-of-pocket costs.
We are also seeing, I'm delighted to be able to say, rush of new doctors joining the health system - not just through GP training programs the College runs - but also from overseas.
I have to say, but every UK health minister I have spoken to - and in two and half years I've spoken quite a number - all lovely - they all say "stop taking our doctors!".
I said, "well, maybe start paying them more than 28 quid an hour, and put on some better weather, and they might not want to come to Australia".
But, seriously, more than 17 thousand internationally qualified medical practitioners have registered to practise in Australia in the past two years.
Two years of back-to-back records - the most new doctors coming into our system in more than a decade.
Of course, no country can build a health system solely on overseas-educated doctors.
It is certainly no substitute for a highly qualified and supported home grown GP training program.
But at a time when too many Australians are finding it hard to get into see a GP, in the short term, this influx of new doctors is making it easier - and particularly, as you know, in rural and regional Australia.
Doctors like Dr Reddy in the Tasmanian town of Beaconsfield - a town of just 13 hundred people in the West Tamar there.
Dr Prasanth Gangapuram - or Dr Reddy, as he is known to the locals - was awarded Practice of the Year in Tasmania by the College this year.
And it was a well-deserved award.
Dr Reddy is originally from India.
He had been working in the Australian health system since 2018, until he took over the Beaconsfield Family Medical Practice at the start of last year.
At the time, the town had just two general practices - and it was about to lose one of them, with the retirement of the GP who'd been running it, after 30 years.
Dr Reddy has made some changes to the original clinic, elevating it from a solo GP practice to a comprehensive healthcare hub with four full-time GPs and expanded services including pathology and allied health.
He also recruited staff from the town's other practice when it also closed.
Importantly, every patient that walks through Dr Reddy's doors is fully bulk billed.
As Nicole said at the launch of Health of the Nation Report last month, for Dr Reddy, - and I quote
"the tripling of the bulk billing incentive meant that he's able to serve the needs of his community, keep his doors open and save that town."
The bulk billing rate in Dr Reddy's area in the past year is now over 80 per cent.
It has recovered close to 3 percentage points since we tripled the incentive and is now close to where it was before the COVID disruption.
Across the country and in every state and territory, we have stopped, what the College described at the time as, the "free-fall in bulk billing".
A description they said reflected "a tipping point" for general practice.
But we know, as Amber-Jade said, there is more to do.
We know that patients are still doing it tough, and cost of living is hitting household budgets really, really hard - including in relation to what they think they can do around health care.
The pain that people are feeling in this area was evident in the Bureau's Patient Experience Survey released this week.
It's why our government has a laser like focus on keeping health care affordable with measures like cheaper medicines and bulk billing.
Because while the tripling of the bulk billing incentive has helped more GPs bulk bill, more often, it has also done the equally important task of helping to maintain bulk billing in areas where it is already common.
Like in Fairfield in southwest Sydney, one of the most culturally diverse communities in our country.
There, Dr Dong Hua provides accessible care and supports vulnerable patients experiencing real financial hardship.
I had the great privilege of meeting Dr Hua when he came to Canberra for the Stronger Medicare Awards earlier this month.
He was one of several GPs that the Expert Panel named as "Medicare Champion".
To address chronic disease in his community, Dr Hua has established a multidisciplinary care team of nurses, GPs, podiatrists, psychologists, and physiotherapists.
He also coordinates diabetes care case conferencing and metabolic clinics where patients get free access to endocrinologists and diabetic educators, as well as weight-loss programs with dieticians and exercise physiologists.
Every patient at his practice - the Kenyon Street Medical Centre - is completely bulk billed.
Indeed, in Dr Hua's area, Fairfield in Western Sydney, bulk billing is the norm.
Just under 97 per cent of GP NRAs in that area bulk billed in the past year.
In fact, Dr Hua has a lovely way of describing the impact that GPs can have.
He said - and I'm going shamelessly steal this - he said:
"I'm a GP because of the diversity of medicine we are presented with in primary healthcare ... its intergenerational role allows me to be my patient's specialist in life."
'Specialist in life'.
It's hard, I think, to imagine a better description of general practice than 'specialist in life'.
As GPs, you have a greater impact on your patients, your community and your country than the other procedural specialties.
Because you see your patients month after month, year after year.
You don't just treat a short-term sickness, you treat a person holistically, right throughout their life.
You see a child grow into a teenager and then into a young adult.
You see them become a parent themselves, and see their kids grow up too.
And as you do, you change their lives for the better.
You're their 'specialist in life'.
So on behalf of the government and the 22 million patients of Australia you see every single year, thank you for that absolutely critical role that you play, as our 'specialists in life'.
It's been a privilege to work with you so closely over these past couple of years.
I've being taken into some side room where Michael is going to present me with your latest log of claims for the next election.
Notwithstanding I haven't seen that yet, I think I'm really looking forward to continuing to work with you in the next little while, and - the election willing - for some time after that.
Thank you very much and all the best for the conference.
