It was announced on Friday that Health Minister Nicola Roxon has decided to recognise sports medicine as a specialty, based on the recommendation to her from the Australian Medical Council (AMC).
The AMC assessment and decision took seven years to be made, so it might seem routine that the Minister would rubber stamp it. What makes it extraordinary is that in the fine print of the announcement is that sports medicine won’t actually become a specialty under Medicare, which effectively is saying that the Minister acknowledges the AMC recommendation, but won’t be implementing it.
If this type of Orwellian doublethink is deliberate then it also suggests that the Health Minister is no longer running Medicare — perhaps it is Treasury.
Sports medicine in Australia won’t change substantially, which is a pity. Two weeks ago it received a setback when Roxon withdrew all Medicare rebates for injections, which was one of the only procedures in sports medicine that Medicare actually rebated.
However, the field will survive even without Medicare support. It has been a healthy specialty for many years in Australia, but has generally been the preserve of elite athletes and the wealthy, as in the vast majority of instances patients must self-fund treatment.
If Roxon actually implemented sports medicine as a specialty under Medicare, there is a chance it might move from the stadiums and inner suburbs to the outer suburbs and country towns — places where people aren’t doing enough exercise and need better infrastructure to encourage them to get off the couch. Under questioning, Roxon will probably say that her government couldn’t afford to make sports medicine a specialty.
High rates of inactivity and obesity in the less wealthy parts of Australia could present the counter-argument that we can’t afford not to. The financial argument is hollow when you consider that sports medicine has been a fully recognised specialty in New Zealand for over a decade.
Our financial minnow of a neighbour also funds physiotherapy and any other treatment needed for all sports injuries for every New Zealander. It just means that this is considered an area of importance in New Zealand but not in Australia.
If you want to play sport in Australia, it is user pays if you get injured. It is surprising that a Labor government could be happy with a status quo that wealthy Australians can afford to get injured playing sport but working families cannot. The private system provides very good sports medicine services but the Rudd government doesn’t have plans for the public system to do so.
The Australian Sports Commission (ASC) and Football World Cup 2018/2022 bid teams are two other bodies who should also be very disappointed by the snub of sports medicine. The mail is very strong that Roxon’s department will be disbanding the ASC and taking over all of its responsibilities.
There is a feeling that Roxon is anti-sport and the sports medicine decision will do nothing to change that impression. The World Cup bid team know that sports medicine is a fully recognised specialty in many of the countries bidding against us, such as England and Qatar.
All rival bids will gleefully accept the free kick that Roxon has given them, as it is one of those subtle points of difference that can be used to assess whether a government has a strong enough commitment to sport.
This is all very well and good, but is there a need for sports medicine funding from Medicare? The article unconvincingly suggests that there is a link between availability of sports medical practitioners and increased community participation in sports.
Is there any evidence to suggest that people make decisions as to whether they should play amateur sport, based on whether they can afford a specialised practitioner if they get injured? If I recall correctly, you often pay a fee to an insurance body when you sign up with many amateur sports clubs. That would be the most consideration that people give to insurance and injury when they decide to participate in team sports.
It is irrelevant here to argue that sports medicine is a “recognised speciality”; that’s only one reason for considering if it should be funded publicly. Surely the most important thing that public health officials have to consider, is whether or not it will actually reduce obesity rates, and not just fund health services that benefit only “elite athletes and the wealthy”? This appears to be another example of an industry desperate for government support to fund it, when there is no evidence the community will actually benefit.