AMA calls for changes to the Trade Practices Act
AMA President, Dr Kerryn Phelps, today called for changes to the Trade Practices Act (TPA) to allow doctors to cooperate on patient care, in the AMA's submission to the Dawson Review.
Dr Phelps said: "Good patient care requires doctors to be able to cooperate on work sharing, on rosters, in discussions with hospitals and countless other ways.
"If doctors feel that Allan Fels is waiting to pounce on them every time they discuss the provision of services, the outcome is inevitably a reduction in the availability and quality of medical care."
The recent prosecution of three obstetricians in Rockhampton is a prime example of what can happen. The three obstetricians sought to ensure an around-the-clock roster of services for pregnant women in the Rockhampton area. The consequence of the ACCC's prosecution of these doctors has been that two of them have given up obstetrics and one has left the district, permanently.
Availability of private specialist obstetric services in the Rockhampton area has been reduced by approximately two-thirds, while additional services that were provided by these doctors to groups such as the local indigenous community have ceased.
Dr Phelps said it is difficult to discern any good public interest for either the patients or the community as a whole as a consequence of this sort of action by ACCC.
The AMA is not seeking exclusion of doctors from the TPA, rather a much more commonsense approach to the legislation and its administration, taking into account the special requirements communities have from their health services.
People want availability of high quality health services on a 24 hour 7 day basis. They want specialist services to be available in rural and regional areas. They want local hospitals functioning effectively.
Under the current administration of the TPA, if doctors get together in a country town and organise for one of their number to take out, say, medical indemnity insurance for obstetrics and provide obstetric care for all their patients, this is a breach of the TPA and they may be prosecuted.
If doctors in a local area meet to invite a specialist from a capital city or one of the major towns to visit their region on a regular basis this is also a breach of the TPA.
If doctors in a country town cooperate on a weekend and evening roster and discuss the fees that they will charge their patients at night and on weekends this is a breach of the TPA.
If doctors jointly co-ordinate on-call arrangements with a hospital this again may well breach the TPA.
Dr Phelps said that doctors are now scared when they meet to discuss professional issues and the provision of services that something will be said that Allan Fels will subsequently decide was in breach of the TPA and that they will all be prosecuted.
In the course of the prosecution, the ACCC will seek maximum publicity and, as in the case of the Rockhampton obstetricians, may write to every one of their patients suggesting that the doctor may be in breach of the law even before the inquiry process has been completed.
Dr Phelps stressed the potential for enormous damage to a doctor's professional and personal reputation regardless of whether he or she is subsequently found to have breached the TPA or not.
The TPA must be amended so that it is no longer a sledgehammer to hit doctors with but rather a guide to professional conduct in the public interest.
CONTACT: Sarah Crichton (02) 6270 5472 / (0419) 440 076