Forget the human costs of the planned mass medical screenings of Aboriginal children, screenings that may well involve invasive testing. Let’s look at the relevant item numbers under the Medical Benefits Scheme, noting, of course, that the average GP charges about 50% higher than the MBS rate:

Child Health Check for indigenous children: Item 708 — $167.45

Add Item 10990 for child <16yrs — an additional $5.30

As well, there are pathology items that could include:

Full blood count: Item 73803 — $8.20

Midstream ur-ne exam & culture: Item 69333 — $20.70

V-ginal swab: Item 69312 — $34.00

An-l swab: Item 69312 — $34.00

Urethral swab: Item 69312 — $34.00

Throat swabs: Item 69303 — $18.85

S-philis serology: Item 69387 — $28.85

Ch-amydial & G-norrhoea serology: Item No 69364 — $36.10

HIV test: Item No. 69384 – $15.75

Total $403.20

So, running with the estimate of 24,000 kids falling into this category, we’re looking at very little change of $9.7 million — not counting what the average GP might surcharge on MBS items. And that doesn’t count the cost of getting all these GPs armed with provider numbers up to the Northern Territory and some of the most remote communities in the country — let alone housing them. Or the cost of sending the samples off to the pathology labs.

It must be sending the Treasury bean-counters crazy. But maybe there’s an easier and cheaper way of doing it, given Brough’s military background. Let’s look at the overseas cost of hiring GPs to international emergencies.

The current going rate for GPs funded by the Australian Government to head overseas is not inconsiderable. For the Solomons it’s $4000; for East Timor — a war zone — it’s $7000. A week.

So, at a not unreasonable 45 minutes per “Child Health Check for indigenous Children”, we’re looking at about 450×40 hour weeks for our GPs. A complete bargain at $1.8-3.15 million compared with the MBS cost of GPs of $4.1 million. Throw in the travel and pathology costs and it’s still a reasonable discount on the cost of checking out blackfellas. The 60 doctors Brough has promised will be able to knock the lot over in less than a couple of months.

But, mind you, there are innate problems in such calculations.

A good number of the GPs recruited to the “national emergency” will have signed up to a code of ethics. Those ethics go well beyond “do no harm” — but extend to providing care when one has knowledge of an illness, and the possibility of healing that sickness. That is, you don’t test or screen for things you have no capacity to heal — or at least provide comfort.

The cheapest of pathology tests — the full blood count (Item 73803 @ $8.20) — is likely to reveal at least the tip of the iceberg of ongoing Aboriginal childhood illness and disease. Perhaps a bit of endemic anaemia? Or the odd onset of Type 1 diabetes? What’s the poor GP going to do? For that matter, what’s the Australian Government going to do? Walk away after six months, as they have promised?

There are other issues on the agenda. Strong rumour has it that the Northern Territory Aboriginal-controlled medical services were given a lecture last Friday by federal officials. Any dragging of feet — let along quibbles about compulsory medical checks of children — would be met head-on by the Commonwealth. Any medical service that gets in the way will be met with the threat of breaching their funding agreements — and a consequent removal of the very resources that provide primary health care services to the children Howard is purportedly determined to rescue.

The NT Government has remained virtually silent on the issue. If they had any mind at all to reducing the burgeoning costs of acute health hospital care, they would be snapping at the heels of low-rent apologists like Abbott — who in other contexts wears medical ethics on all too prominent sleeves. They would be demanding the health checks become a regular part of the Territory landscape, and that primary health care be supplied well beyond the six months Howard has suggested.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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