‘Debate is about the scale of fraud’: Why Medicare needs a royal commission

  • Published October 24, 2022

Sydney Morning Herald, 23 October 2022

The country’s powerful Health Services Union has demanded the federal government hold a royal commission into the health system after revelations that billions of dollars are being lost to Medicare in systematic fraud, errors and waste.

HSU national president and NSW secretary Gerard Hayes, a former paramedic, said federal Health Minister Mark Butler’s move to conduct a departmental probe into Medicare didn’t go far enough.

Hundreds of cases of Medicare abuse have flooded in after a joint investigation into Medicare by The Sydney Morning Herald, The Age and ABC’s 7.30 was published last week. According to Medicare expert Dr Margaret Faux, who completed a PhD into claims and compliance last year, up to 30 per cent of Medicare funding – equivalent to $8 billion – is being wasted each year.

That investigation prompted Butler to announce the inquiry, but there are growing calls for an independent review that isn’t influenced by vested interests and lobby groups.

“What we really need is a full royal commission with powers to discover documents and compel witnesses,” Hayes writes in an opinion piece in The Sydney Morning Herald and The Age. The scope should extend beyond GPs and Medicare to consider how and where the health budget is being spent, he said.

Hayes said that a decade ago the HSU was one of the most corrupt unions but public exposure and a royal commission had been the best thing for it to embrace change.

“Ultimately, the exposure was entirely healthy. The rorters were expunged, and the HSU is perpetually alert to how it uses resources,” he said. “Every time we spend a dollar we genuinely ask ourselves if members will benefit. As a result our union membership has almost doubled, our staff has tripled and our finances have transformed from a $23 million deficit to a $55 million surplus.”

Hayes said the broader health system would benefit from the same discipline and rigour. “Instead of brittleness it needs honest self-appraisal.”

Hayes said he was disturbed by the reaction to the story. “One of corruption’s more insidious aspects is the way it gets explained away and diminished,” he said.

“The medico lobbies squealing about Adele Ferguson’s expose on Medicare rorts no doubt believe there is no problem because the practice is widespread and normalised,” he said regarding the reaction of some groups, including the Australian Medical Association, which dismissed the media investigation as an “unjustified slur on the medical profession”.

Hayes said dead people were being billed and patient records falsified. “A cottage industry has emerged to help practitioners milk the system. No one even denies Medicare is being rorted. Indeed, the debate is now about the scale of fraud.”