Australian Medical Association

The AMA wrote to the Pharmaceutical Society of Australia on 15 November 2011 opposing the continued dispensing proposal under the Fifth Community Pharmacy Agreement. Continued dispensing will represent a significant change in the professional role of pharmacists and their role within the health care team. The draft guidelines circulated by the Pharmaceutical Society of Australia heighten the AMA's concerns that continued dispensing will undermine the collaboration between pharmacists and medical practitioners.

The idea of a chaperone may seem old fashioned. But patients differ in their preception of what is required during a medical examination,  particularly if the patient comes from a different background. The presence of a chaperone is one way to minimise complaints being made against doctors.

Whenever you are conducting an examination, whether it is in a suburban surgery or in a busy hospital, consider whether you should have a chaperone present.

The AMA has made a submission to the Medical Board of Australia on its Proposed Registration Standard – Granting registration as a medical practitioner on completion of intern training. The Board's proposed standard includes the option for health services to provide interns with exposure to emergency medicine (EM) in a general practice context. Of utmost concern to the AMA is the absence of clear criteria about what would constitute appropriate exposure to EM under this type of arrangement. As a result, the AMA has offered to be part of the team that will prepare guidelines to better define the Board’s requirements. In the mean time, the AMA maintains that all interns should have access to a term in an Emergency Department.

The AMA's submission to the Senate Finance and Public Administration Committee on the National Health Reform Amendment (Independent Hospital Pricing Authority) Bill 2011 highlights the importance of the Pricing Authority, the Australian Commission on Safety and Quality in Health Care, and the National Health Performance Authority collaborating on their roles and responsibilities, for example, on data collection requirements.

It also points out that the Pricing Authority should consider the standards set by the Performance Authority when calculating the national 'efficient' price, that is, it must take into account the performance that must be achieved. In addition, the National Health Reform Agreement allows states to pay hospitals less than the determined efficient price, therefore, we recommend that the actual payments made to hospitals are reported to Parliament so that it is clear when poor performance is linked to insufficient funding.

Overall the Bill before Parliament responds to the AMA's lobbying last year to ensure the Pricing Authority considers the range of variables affecting the actual costs of providing health care services when calculating the national efficient price. However we recommend that the Authority is explicitly required to ensure hospitals can fulfil their teaching and research obligations.

Second Submission

The AMA submission to the Department of Health and Ageing position paper on the role and governance of Lead Clinician Groups released on 20 May 2011 emphasises that the Commonwealth Government's attempts to provide doctors with a meaningful role in how local hospitals are run has failed.

First Submission  - 17 February 2011

The AMA submission to the Department of Health and Ageing discussion paper on the role and governance of Lead Clinician Groups released on 25 January 2011 strongly opposes the limited role for doctors proposed. The AMA submission provides a model for Lead Clinician Groups that ensures doctors are involved in decisions made at the local hospital level about resource allocation, service planning and provision, and patient care.

The AMA has made an additional submission to the Department of Health and Ageing to raise concerns identified by AMA member junior doctors. This submission:

• emphasises the need to ensure that time-based targets do not impact on the ability of public hospitals to provide quality clinical education and training;
• calls for ongoing resources to support the ability of emergency departments, the hospital and community providers to fulfil education and training obligations; and
• recommends that the monitoring and evaluation of the impact of targets also includes the impact on education, training and junior doctor experiences.

This submission supplements the submission lodged by the AMA on 25 May 2011.

The AMA submission on the proposed PCEHR expresses concerns that the proposed form of the PCEHR will provide only limited safety benefits and these are significantly outweighed by its inherent clinical and medico-legal risks for medical practitioners and the administrative burden it will impose on medical practices.

The AMA has made a submission to the Department of Health and Ageing, on the implementation of elective surgery and emergency department targets, which strongly advocates for an evidence-based approach to implementation. The AMA supports measures to improve the timeliness and quality of patient care in public hospitals but cautions against imposing arbitrary time-based targets that may carry more risks than potential benefits if they are not slowly, carefully and cautiously implemented.

The AMA submission highlights that the Australian Guidelines for the Prevention and Control of Infection in Healthcare 2010 already govern the management of health care practitioners who have blood-borne viruses and makes the point that there is no need to de-register a medical practitioner because they have a blood-borne virus.  The AMA has asked the Board to clarify its role in regulating the scope of practice of medical practitioners who are infected with a blood-borne virus in isolation from the way this issue is managed by medical practitioners and the health care organisations in which they practice.  The AMA has suggested the Board undertake a second round of consultation once it has clarified what action would constitute a breach of guidelines and that action the Board might take in such cases.

The AMA made a submission to the Department of Health and Ageing on 13 April 2011 responding to a proposal that pharmacists could continue prescription medicines to a patient under defined circumstances. The AMA is strongly opposed to pharmacists dispensing prescription medication without a valid prescription and without reference to the patient’s treating medical practitioner. Only medical practitioners are adequately trained to make assessments about a patient’s clinical condition, the need to begin treatment with a prescription medication, and consequently to continue, adjust or cease that treatment.