Doctors could shut their practices and patients could flood hospitals as a result of changes to Australia's public healthcare system, critics say. Under the Australian government's proposed Medicare changes, GP patients will pay an extra A$20.10 ($16; £11) to see a doctor for a short consultation. The changes, introduced quietly last year, face opposition in parliament. A body representing GPs says the move could force the closure of practices by transferring the cost onto doctors. The Royal Australian College of General Practitioners (RACGP), the main professional organisation for GPs, says the changes - if approved - could make it too expensive for doctors to "bulk bill", or receive payment direct from Medicare rather than charging their patients. Where patients cannot afford the rise, practices may have to be closed, the RACGP warned. Medicare has been paying A$37.05 towards short GP visits, lasting under 10 minutes, made by millions of patients every year. Under new proposals, it will pay A$16.95, with patients making up the rest.RACGP President Dr Frank R Jones said patients and GPs were united against the changes. "Under this reform, there is no doubt that both GPs and patients will be worse off," Dr Jones said in a statement. "The government has seemingly forgotten the core mandate for the Medicare system is a patient rebate system, not a system for doctor payments."How does Australian Medicare work? Healthcare is provided by both private and government institutions The government funds its Medicare system via a 2% levy on everyone except low-income earners, with the balance being provided by the government from general revenue As well as Medicare, the government funds a separate Pharmaceutical Benefits Scheme that subsidises a range of prescription medications The RACGP has launched a campaign, under the slogan, "You've been targeted", that includes a petition for GPs and patients. It also offers drafts of letters that GPs and patients can send to their local member of parliament and to Prime Minister Tony Abbott, as well as a poster to display in practice waiting rooms. Patient care 'at risk' There are fears that rural doctors could be particularly hard hit under the changes. In Tasmania, for example, small GP outfits would simply become unviable in areas where patients could not afford to pay out of their own pockets and doctors could not afford to cover the extra cost, Huon Valley GP Dr Bastian Seidel told an Australian medical newspaper, Medical Observer. Four Federal crossbench senators have indicated they will vote to repeal the government's changes. Labor opposition leader Bill Shorten, who described the change as a "sneaky backdoor mechanism", has also said his party would vote it down. 'We will move to disallow [Prime Minister] Tony Abbott's changing of the rebate system," Mr Shorten said at a press conference on Wednesday. If the minority environment party, the Greens, joins the four crossbenchers and the opposition in opposing the Medicare change, it could be killed in the Senate when the parliament resumes next month. Senators Jacqui Lambie, Ricky Muir and Nick Xenophon, and Palmer United Party Senator Glenn Lazarus have all expressed opposition, according to Fairfax Media. Independent senator Ms Lambie said the government's decision would mean fewer people would visit their GPs and serious illnesses might not be detected in time for effective treatment. A spokesman for Health Minister Sussan Ley told local media on Tuesday that the changes to consultations under 10 minutes were designed to better reflect the time doctors spend with their patients, and to encourage longer GP consultations with patients for better health outcomes. "Under the current rules, a GP can access Medicare rebates for up to 20 minutes, even if their patient is in and out the door in six minutes," the spokesman said.

• published: 14 Jan 2015
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