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AMA President Breakouts: Reforming Health Care

It is indeed a great honour for all AMA presidents to represent our profession and, in a sense, be seen as the public face of the medical profession.

Without doubt, the defining issue for the AMA and my Presidency was the health reform agenda of the Rudd Labor government. Rudd had correctly identified the widespread dissatisfaction from patients and health professionals with the increasing failure of the health system to cope with the community’s healthcare needs.

Identifying that a problem exists is one thing, fixing it is another.

The AMA did its best to help steer the reform process in a direction that would allow doctors to deliver the best care that they could for their patients, while not themselves having to pay the price of health reform. It was important that the AMA was seen to be part of health reform, rather than an obstacle to it.

History will judge the success or failure of the health reform initiatives. At present, it appears that the only significant outcomes of the process were to introduce activity-based funding in those states where it had not previously been used, and the move to increase local decision-making via the appointment of local governing councils to oversee local management of health district hospitals. Medicare Locals provide an opportunity for sensible structured assistance to our long-suffering general practitioners, but also for difficulties if they are not properly run.

It was inspiring to me to see the passion and dedication of doctors at all levels and our AMA secretariat work to improve the health system.

I was proud of how they rose to the challenge of working with sometimes unsympathetic political and bureaucratic systems to provide constructive solutions to problems not of their own making. For example, the AMA’s consensus document on training of the future medical workforce remains the single concise template for an effective training system from medical school intake to vocational specialist training, which will provide the doctors that our communities need.

The opportunity to promote and advance the cause of a National Disability Insurance Scheme was a personal highlight. A journey that for me had begun a decade earlier as a struggle to address the unaffordability of the medical indemnity insurance system now took on more widespread significance as the AMA championed support for disability based on need rather than blame.

The Productivity Commission delivered visionary and aspirational recommendations recognising that the political realities of a federated system should not forever condemn Australians with disabilities to fragmented and inadequate support. An opening now exists for a once-in-a-generation opportunity to progress a problem that has remained in the too-hard basket for too long.

Should a National Disability Insurance Scheme proceed, I believe all AMA members can be proud that the AMA played its part in assisting our most vulnerable patients.

Dr Andrew Pesce: AMA President 2009-11