Dr Kerryn Phelps, AMA President - Radio 3AK

HILLIER: Dr Kerryn Phelps, the President of the AMA, joins us now. Good morning, and welcome to the program.

PHELPS: Good morning.

BEDFORD: Doctor, how is your relationship with the Health Minister, Dr Wooldridge?

PHELPS: Well, I have to say it hasn't really been good from the beginning. We went in…that is, the Vice President and I went into initial discussions with the Health Minister very much in good faith and all along have operated completely in good faith but really have been met by something of a brick wall. So, I think that this latest development is very regrettable, I have to say, and certainly not the way we would like it to have been.

BEDFORD: He raised concerns on this program that the AMA was really just a union looking after doctors. I'll just say some of the comments that he had to say - this was when we spoke to him after the Budget was released.

"The AMA are just a bunch of whingers, they grizzle the whole time, they never put up anything constructive, and they're completely irrelevant. I prefer to deal with the College of General Practitioners or the Divisions of General Practice who have been constructive."

BEDFORD: A response to those comments, Doctor?

PHELPS: They're very familiar comments from the Minister - it's almost like a mantra, and, of course, I believe, completely unfounded. The AMA consistently sends to the Government and the Minister's office extremely constructive papers, documents, suggestions about what can be done to improve the health system. We sent a very comprehensive budget submission. We sent in to the Government and provided information about the problems that are happening in the public hospital system and how they might be addressed. We gave a submission in a great deal of detail to the Senate Inquiry into Public Hospital funding and, you know, so those comments, most people, who have any knowledge of the way this system works would realise them for what they are. I think of concern, also, are the comments about the Minister preferring to deal with the College and the Divisions of General Practice and the concern the medical profession has about that is that the AMA is the only independent voice for doctors in the country, and as such, we are able to speak freely about…

BEDFORD: Why isn't the Division of General Practitioners' independent? What do you mean by that?

PHELPS: They're entirely Government funded. So, how can a body that's entirely Government funded, when, if they argue with the Minister, they could well have their funding threatened, as has been the case with a number of organisations, and they are not particularly free to say exactly what they are thinking about general practice issues. But the other thing that you've got to realise is that the health system is about more than general practice - it's about specialists of all colours.

BEDFORD: Well, I guess, from our point of view and from listeners who are consumers, patients who see doctors, we'd like to know that an organisation like the AMA is there to look after our interests and not just the interests of doctors. Is that also the AMA's role?

PHELPS: Absolutely. The AMA has a dual function. Part of that is to advocate for doctors, and I think it's extremely important that we have a happy and more motivated medical workforce. And the thing about doctors is that we're working in the system every single day. Patients are, hopefully, only in the system for a very brief time when they happen to be sick or when one of their relatives are sick. But doctors and nurses are seeing what's happening at the coalface every single day, and so we're in a very good position to be able to advocate for public health and for patients as well. And that is the other part of what we do. And, look, I think that one of the concerns, I believe, over particularly the last week or two, is that the Minister's stated intention is to try and win fights by bashing doctors. Now, the AMA represents the view of doctors and patients and so by bashing doctors the Minister, I believe, is going to be alienating the patients of Australia. And, in all of this, I don't believe that the public of Australia are going to buy that strategy.

HILLIER: In corporatisation of doctors, are we seeing a disturbing trend heading towards an Americanisation of our health system?

PHELPS: We certainly are. We're seeing some very large conglomerates starting to develop which has all of the elements of a mini health maintenance organisation as we see in the United States, although not so mini any more. And corporatisation is the beginning of that - it's not just general practice, it's across other speciality groups as well. And some of these corporatisations are buying up radiology, pathology practices, other specialists, also buying up hospitals - in one instance, now, a pharmaceutical company and hospitals - and we're going to see, I think, some very interesting and quite concerning developments and I think what we need to be monitoring all the time, and, certainly, what the AMA's monitoring, is what these developments mean to patient care and quality of care. And, you know, that won't necessarily be a bad thing in every instance, it won't necessarily be a good thing in every instance, but it certainly needs a monitor.

BEDFORD: Doctor, what can the AMA do? I mean, monitoring all sounds very well. But a lot of your doctors are now being employed by companies like Mayne Nickless, who are, as you say, buying up pathologies and hospitals themselves. What can the AMA do, other than just monitor?

PHELPS: Well, we've been making sure that Members of Government - Coalition and ALP and Democrats - are aware of these developments and we've been expressing our concerns. We've also come up with a corporatisation kit for doctors, so that if they are considering going into a corporate entity, as is their free choice to do so, that they are fully informed about the implications for them and what they need to talk about and to think about. And one of the very strong principles that we've been advising doctors about is that, in short, their contracts allow them clinical independence - that is, that they can make decisions that they believe are in the best interests of their patients and not in the best interests of profit and shareholders' money.

HILLIER: Are there any sweeteners given to doctors, you know, for personal favours and prescribing certain medicines?

PHELPS: There certainly hasn't been any evidence of that at this stage. But one of the things we'll be looking at is to make sure that there is clinical independence for doctors and that is in the patients' best interests. One of the real concerns was the recent Supreme Court decision in the United States where they found that the benefit of the shareholders was paramount over and above the benefit of the patient.

BEDFORD: Doctor, I'm just a little bit concerned. You say that part of the AMA's role is to talk to Government and look at these issues. How successful can you be if you don't have a working relationship with the Federal Health Minister?

PHELPS: Well, you can talk to the Health Minister all you like and, if you're not getting a good reception, then it's fairly useless. But we have discussions with not just the Health Minister. He's not the only person in Government that has influence, and has his hands on the levers. And the AMA talks directly to the Department of Prime Minister and Cabinet, and we have very constructive discussions with the backbench health committee, who are also involved in making decisions. We speak to the Department of Treasury. We speak to a vast range of other departments…

HILLIER: Doctor, at the end of the day, you and he have to be able to sit down at the table and smoke the peace pipe, don't you, and actually make this work, because don't you know the bigger picture is that it involves far more than yourself and Dr Wooldridge?

PHELPS: That is the AMA's strategy - to sit down and talk about health policy. The AMA's strategy is not to beat other people about the ears with words or rhetoric. We want to be able to do what we can to bring to the attention of the Minister, to the attention of the Government, and to the Australian people the problems in the health system and how it can go about fixing them. We are into conflict resolution, not conflict escalation.

BEDFORD: Doctor, are you continuing to take legal action against Dr Wooldridge?

PHELPS: We made it very clear from the outset - and this was a decision, not just of me, but of our entire AMA Executive, and we reinforced that decision last week - and that is that the GPs of Australia were insulted by the Minister's comments and we made it very clear, from the outset, that unless an apology was forthcoming for those comments, whether they were made in the heat of the moment or whatever, that we would proceed with legal action.

BEDFORD: Are you concerned that taxpayers will have to foot the bill if there is a pay out in your favour?

PHELPS: I'm not talking about a pay out. We're talking about an apology, and we've continued that …… all along.

BEDFORD: Yeah, it doesn't look like you're going to get the apology. So, will you take it further?

PHELPS: Well, the onus is clearly on the Minister. He's had at least three opportunities to apologise now. All he has to do is to apologise for what were obviously intemperate remarks, and I don't think that that's too much to ask under the circumstances, and the feedback that's coming through to us at the AMA is deep concern for how little respect the Minister is showing to the medical profession.

BEDFORD: Doctor, just finally, he did question your qualifications as a GP, which are obviously, you are highly qualified, and we really appreciate your time this morning as someone who takes on such a large role with the AMA. How much medicine do you actually get to practice these days?

PHELPS: I work three days a week in my practice, sometimes on Saturdays.

BEDFORD: Gosh, you must be busy.

PHELPS: So, three to four days a week.

BEDFORD: A very busy person.

HILLIER: Dr Kerryn Phelps, thank you very much for your time this morning, we appreciate it.

Ends