farmdoc's blog post number 494

It’s a Mad, Mad, Mad, Mad World is a 1963 comedy film with an all-star cast and memorable music. And a true title, of course. Today’s post is the first of three about this mad world we live in. It’s based on the editorial in the 17 August issue of the Medical Journal of Australia: The federal government, driven by both ideology and pragmatism, is intent on dismantling general practice in this country. It began with the 2008 annual Ben Chifley Memorial ‘Light on the Hill’ address to the Labor Party faithful by health minister Nicola Roxon (pictured). She proposed that health services be delivered by new players, and notably nurses, in ubiquitous teams. Less than a year later, nurse practitioners are to be granted access to the Medicare Benefits Schedule; and to be allowed to order tests, write prescriptions and refer patients. In the Australian Capital Territory there’s to be a ‘trial’ of nurse-only clinics. There are calls for the term ‘general practice’ to be replaced by ‘primary care’. As if that’s not all bad enough, here’s the pièce de résistance: a push for all practitioners working in primary care, irrespective of their qualifications and expertise, to be called ‘doctor’. As C J Dennis wrote and Ginger Mick said: ‘You could er knocked me down wiv 'arf a brick!’ I may be a Sentimental Bloke. But I know I’m a sheep man in cattle country; and that it’s a MMMMW.