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PBS LISTING 1ST FEB 2023 1 to be embarrassed . We are in the midst of some huge waves sweeping through the economics of the health system of Australia . And it ’ s our job to stand up and talk about it .”

He said he was suddenly speaking to other owners about the tax demands they were receiving . It was all done on a no-name basis . That shame again .

But it included a practice group with a patient base of 250,000 patients that was facing a tax demand of $ 3 million when you included the demands for backdated payments .

“ It was enough to make them insolvent … Can you imagine the impact of a practice group that looks after a quarter of a million patients who built that practice from the ground up and what that would do to those patients , their families , the communities and the state health system in that area if that collapsed ?”

So the AMA / RACGP campaign evolved rapidly — especially when a few days before Christmas the Queensland Revenue Office published a new ruling , so-called PTAQ000.6.1 — which was a statement of its intent to go after medical centres .

“ Maria and Bruce are both fantastic advocates , playing a little bit of a good cop , bad cop role ,” Dr Chambers said in tribute to the support they and their backroom staff gave him .

Elements of the campaign had been clever , he said — for instance , a practice owner wrangling a meeting with the State Treasurer , untouchable through the formal channels , by booking themselves into a local party event .

And through the various political networks operating in the state , doctors also started making contact with politicians , including the backbenchers with the capacity to make noise in the party room when their constituents were being burnt .

“ You know what I didn ’ t understand ?” Dr Chambers said . “ It was that they didn ’ t have a clue how any of this would affect general practice . They didn ’ t really understand payroll tax at all . And it was actually a case of telling them from the ground up what this meant for their local community .

Initially , there was pushback from ministers , no doubt because the Opposition jumped on board with the doctors .

There was a media conference where Dr Chambers spoke about his experiences .

“ But we got a front-page headline in The Courier Mail the next day because the Treasurer took exception to what he saw and really pushed back and said , ‘ Look , they just need to get it right , and they ’ ve been doing the wrong thing all the time . We ’ ll give them , we ’ ll give ’ em some education ’.” But that didn ’ t happen . “ It began to snowball ,” said Dr

Chambers . Again , as a result of the local AMA and RACGP branches , the payroll tax issue became a regular news item in the Queensland media . Given tax structures and the fine print of GP service agreements are a brand of Mogadon for the masses ; this was an achievement .

Surely it would go through the media mincemeat machine with a ‘ greedy doctors ’ sausage coming out the other end ? Well no .

They are now embedded on YouTube , but Dr Chambers showed the conference audience the news clips from Channel Nine aired in the weeks following the publication of PTAQ000.6.1 .

The presenters look serious revealing the bombshell about to fall on viewers with the end of bulk-billing for the most vulnerable residents .

Then comes a clip of an Inala GP , Dr Matt Young .

Voice over : “ Dr Matt Young spends a lot of time assisting the homeless and others on the fringes . He says GPs are already struggling to see as many patients as they can with the time and funding they ’ re allocated .”

Then come images of Dr Young with his patients .

Dr Young : “ If you are going to create a two-tier health system where people that are well-off are getting well looked after and people that can ’ t afford it , even on some kind of extra fee , then that makes me a little bit embarrassed to be a Queenslander .”

Dr Chambers said the results of this were instantaneous .

The RACGP and the AMA suddenly got a summons to meet the Treasurer in his office — at an hour ’ s notice — where they were given the chance to explain what was happening .

The Treasurer it seems also had no inkling . He didn ’ t understand . He was one of those wondering why GP practices weren ’ t paying payroll tax like everyone else . But he did listen , and he did act .

If you want to know why the next day the State Premier declared a payroll tax amnesty in place for medical centres until 2025 , and one which is backdated to 2018 , it is those lobbying efforts — the GP groups and their staff , the meet and greets , the media coverage , the emails to MPs , the calls to journalists , knowing when to shout and when to stay silent .

And all of it , as regular readers of AusDoc may know , has a passing resemblance to the modus operandi employed by the Pharmacy Guild of Australia , save for the political donations .

If other states and territories aren ’ t going to issue mass payroll

‘ So when the rules are wrong , it is our responsibility to go out and change them .’ tax exemptions for general practice for the reasons given above , this amnesty is the next best thing , according to Mr Copeland .

It is not perfect and not without cost for GP practices , but it provides time to ensure the practice structures work , that the service agreements are robust and the arrangements between the doctor and the practice are clearly documented .

Dr Chambers said : “ We have been criticised for the campaign , that we shouldn ’ t have got out there and told the story . The argument was that we ’ re just going to draw more attention [ from the tax office ].

“ But payroll tax is a tax on patients seeing their GP , and when you can ’ t raise fees as you can for privately billed patients , it ’ s most strongly going to impact the most disadvantaged .

“ And reflecting on the whole thing , this is what I came up with . Laws are not written in stone ; they ’ re just paper . They ’ re crafted by our elected leaders to try to make our society better .

“ So when the rules are wrong , it is our responsibility to go out and change them .”

He ended his presentation with a simple message to the specialty as a whole : “ Please see what you can do .”

Dr Aaron Chambers .

Beclometasone / formoterol

* Mass median aerodynamic diameter particle size < 2 μm . 3

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References : 1 . Pharmaceutical Benefits Scheme ( PBS ). Available at : www . pbs . gov . au . 2 . Approved Fostair Product Information . 3 . Paggiaro P et al . BMC Pulmonary Med 2016 ; 16:180 . Chiesi Australia Pty Ltd , Hawthorn East , VIC . 3123 . Tel : + 61 3 9077 4486 ; Email : medicalaffairs . au @ chiesi . com ; Website : www . chiesi . com . au . Copyright © Chiesi 2023 . All rights reserved . Date of preparation : Jan 2023 . AU-FOS-2200025 . CHIE00042j .