Australian Medical Association

AMA President Dr Steven Hambleton said tonight that the government had done the right thing by sparing health from broad funding cuts to provide a budget for tough economic times and to fund a budget surplus.

“Health has generally been sheltered from the budget cuts,” Dr Hambleton said.

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.

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.

On 2 August 2011, the Commonwealth, State and Territory governments finalised the National Health Reform Agreement. A summary of the Agreement's key points can be found here.

The AMA opposes Government decisions to defer listing of medicines on the PBS that have been recommended by the independent Pharmaceutical Benefits Advisory Committee (PBAC). The Government is leaving itself open to accusations of political interference by ignoring the PBAC assessment and pricing process which is fair, equitable, evidence-based and transparent.

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 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.

Medicare Locals have the potential to impact on a wide range of health care services.  The AMA believes they should be introduced in a manner consistent with the AMA's overall health vision and which is respectful of the exisitng role of the General Practitioner and other community based specialists.   This position statement includes details of the AMA position on the governance, functionality, accountability, fundholding and boundaries of Medicare Locals.

This position statement sets out the principles the AMA considers should underpin the national introduction of time-based targets for public hospital emergency departments (EDs) in order that patient safety and outcomes, quality of care and the training of doctors are not compromised.

The Council of Australian Governments (COAG) Agreement 2010 outlines the agreement reached by all jurisdictions, except Western Australia, to establish a National Health and Hospitals Network (NHHN). The NHHN Agreement incorporates structural reforms as well as additional investments in hospital, primary and aged care services, and preventive care in mental health and diabetes health care.

Further initiatives announced in the Commonwealth Government’s Budget on 12 May 2010 include support for practice nurses, improved primary care infrastructure and the roll-out of electronic health records, bringing the total new health investment over the next five years to $7.3 billion.