Reform and disenchantment

It is a few moments after what turned out to be Nicola Roxon’s final speech to the AGPN conference, in November 2011. The auditorium in Melbourne is emptying as the delegates exit for lunch.

Sitting at one of the tables is a GP I’ve known for a long time — not a dyed-in-the-wool AMA hardliner, not someone ideologically opposed to everything that falls from a Labor minister’s lips. But Roxon has just been defending the declining value of patient Medicare rebates by claiming GPs’ incomes are “more than generous”, and he has a glum look on his face.

“She doesn’t seem to get it,” the doctor says. “Never has really.”

It’s true to say that at the end of her four-year tenure as health minister, the extent to which Ms Roxon lost the medical profession — the grassroots — had become stark. Perhaps this disconnect resulted from the axe taken to GP mental heathcare funding by the government, which RACGP president Claire