Australian Medical Association

The AMA submission to the Australian Institute of Health and Welfare and the Royal Australasian College of Surgeons highlights that: urgency categories should facilitate patients being prioritised for surgery fairly and equitably; category definitions should take account of all the factors relevant to a patient's requirement for surgery; the primary driver for surgeons to categorise elective surgery will always be clinical urgency; and elective surgery waiting time should be counted from the time the patient is referred by a general practitioner to a surgeon for assessment until the time surgery is performed.

Achieving high quality supervision and assessment of trainees must be a high priority for the health system. The AMA position statement on Supervision and assessment of hospital based postgraduate medical trainees (2012) outlines the key requirements for effective supervision and assessment of trainees to ensure the quality of medical education and training /remains of a high standard.

The AMA's submission to the Independent Hospital Pricing Authority on a pricing framework for public hospital services calls for hospital services to be funded on the basis of an 'effective' rather than an 'efficient' price. An effective price is one that provides sustainable and equitable access to high quality hospital services. The submission details the AMA's support for appropriate funding of post-hospital care; investment in teaching, training and research; and small and medium sized hospitals.

MJA release - Violence and aggression pose significant problems in hospitals, but a formal aggression management system can help, according to a study published the February 20 issue of the Medical Journal of Australia.

AMA President, Dr Steve Hambleton, said today that the creation of the Independent Hospital Pricing Authority would help to deliver greater transparency in public hospital funding.

The AMA submission on the National Health Reform Amendment (Independent Hospital Pricing Authority) Bill 2011 generally supports the proposed arrangements for the Authority, but recommends changes to strengthen and clarify the Authority’s functions and procedures.

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.

MJA release - Reusable venesection tourniquets may be a source of transmission of multiresistant organisms (MROs) in hospitals, according to research published in the latest Medical Journal of Australia.

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.

MJA release - The hospital standardised mortality ratio (HSMR) is not yet ‘fit for purpose’ as a quality-screening tool for all hospitals, according to an article in the Medical Journal of Australia.

After growing interest in assessing Australian hospital performance, the HSMR has emerged as a potentially universal system-level indicator for comparing death rates between hospitals both within and across different jurisdictions. Australian Health Ministers have endorsed the HSMR as a key indicator of quality and safety, and efforts are currently underway towards its national implementation.

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.