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Reorganisation: Final Decisions

The major agenda item for the November meeting of Federal Council was to make final decisions on the draft constitution prepared by the meeting in September. After a process that the record suggests was as tiring as that in September, the Council had retained much of what had been proposed then. But it had added elements that had the effect of neutralising the main point that Cotton had proposed, and that the federal leadership supported. In addition, it had couched the proposal for reorganisation that would need to be put to members in such a way that, whatever they decided, the status quo ante would be protected.

First, it was decided (on a split vote – eight to four, with three abstentions) that Federal Council define a preferred restructured federation option and, second, that a plebiscite be organised urgently by which members could choose between this preferred option and retention of the existing structure. The preferred option contained major changes from what had been decided in September, including that:

  • there would be two representatives on Federal Council nominated by each state and territory;
  • there would be 10 special group representatives on Council elected by AMA members identified as members of the groups (physicians; psychiatrists; GPs; pathologists; radiologists; surgeons, including ophthalmologists; obstetricians and gynaecologists; anaesthetists; full-time salaried doctors, including academic and research doctors; and doctors in training);
  • Executive Officers and Federal Council members would be elected or nominated annually, with no limit to their term on Council, as the September meeting of Council had resolved, but that the President would be elected annually but only for a maximum of two consecutive years; and
  • there would be an annual forum (convocation) at which members could discuss topical issues, the forum to be chaired by the chair of Federal Council and to have an advisory role to Council.

Thus, representation of the branches on Federal Council would be doubled to 16; that of the special groups would be increased from six to 10. Branch representatives would continue to be nominated; special group representatives would be elected. In reality, whatever option members chose, the plebiscite would result in the AMA structure remaining basically as it was. The Council authorised the President and the Secretary General to have preliminary discussions with the AMA’s legal advisers about a new constitution “based on the preferred option”. It is no surprise, therefore, to find that Dr Pickering was “terribly uncomfortable, even dismayed” by the outcome of the meeting. On his assessment, the membership was in favour of the Cotton model and so were the special groups; but the branch councils were opposed. If the branches’ domination was to be broken, he said later, “there must be at least equal representation from the branches and the craft groups, or at least a preferred balance”.

Dr Pickering was not alone in his view. The 1987 Annual Report records strong objections “from many quarters, particularly the craft groups” to what the Federal Council had wrought. Dr Michael Jones, a Federal Councillor from Western Australia, gave notice that he would move for rescission of the Council’s decision. He was supported by a fellow Councillor, Dr Peter Joseph from South Australia. Having discussed these developments with Executive Officers of the Council, rather than organising the plebiscite, Dr Pickering instead called an Extraordinary General Meeting of Federal Council for 23 December; “not a good time to arrange a meeting,” he said later, “but the situation was critical.”

In the meantime, he decided to act on his view that, if real reorganisation was to be achieved, it would need the clinical colleges – many of whose members were members of the AMA – to join the effort. Dr Jack O’Loughlin was at the time chair of the Committee of Presidents of Medical Colleges (CPMC), President of the Royal Australasian College of Obstetricians and Gynaecologists, and an advocate for meaningful craft group representation on Federal Council. He agreed that Dr Pickering come and explain to a CPMC meeting soon to be held in Melbourne what was happening to the Cotton report. He told the meeting of his concern at the direction in which the proposed new AMA constitution was going, especially the risk that was being posed to adequate representation on Federal Council of the craft groups, and asked CPMC members to encourage their Fellows to support an AMA constitution that would allow proper representation at the federal level of the entire profession. The meeting resolved that the CPMC supported Dr Pickering’s view.

The next stage in Dr Pickering’s strategy depended on there being considerable cross-membership among the branches, craft groups and the membership at large, and the fact that the Federal Council decision had denied direct representation on it of the members generally. In the latest draft of the new constitution, the branches had two nominees each on Federal Council. Dr O’Loughlin agreed with a suggestion by Dr Pickering that, if one of the branch representatives was elected by the branch membership rather than nominated by the branch council, the branches and craft groups would have equal opportunities to fill the position. Dr Pickering invited him to explain the views of the colleges and propose this new concept of Council representation at the EGM. Dr O’Loughlin agreed and asked that Dr Durham Smith, then President of the Royal Australasian College of Surgeons, come to the EGM with him. The EGM heard from Dr Pickering, Dr O’Loughlin and Dr Smith, agreed with their proposition and amended the Federal Council draft accordingly. It now proposed that Federal Council comprise one nominee of each of the eight branches and one representative from each of 10 special interest groups, elected by AMA members who identified themselves as members of the group concerned, and one representative elected by and from the general membership in each of these six areas: New South Wales (including the ACT), Queensland, Victoria, South Australia (including the Northern Territory), Western Australia and Tasmania. Thus, Federal Council now had 28 members, the majority directly elected. Dr Pickering recognised that 28 was “unwieldy, and not ideal for decision-making”. But this problem would be overcome by the Executive Committee having full power between Council meetings to deal decisively with emergent problems demanding prompt answers. The reorganisation process had taken the best part of three years. All that was needed now was the approval of AMA members. It would require a two thirds majority at an Extraordinary General Meeting of members. The EGM was arranged for 25 May. But there was yet one more problem to be solved before this could be organised.

The Victorian branch – which, with New South Wales, had the largest bloc of AMA members and therefore huge influence on whether or not the draft constitution would be approved – still firmly opposed that part of it that defined the division of autonomy between the federal AMA and the branches, and with some reason. For most of its existence, the branch had legal standing in the State’s industrial relations system as the recognised advocate for doctors in industrial matters in the State. It had legal advice that the proposed new autonomy provisions would vitiate its legal standing on these matters. Legal advice to Federal Council was that the draft constitution would not have this effect. Nevertheless, both sides agreed that the relevant passage be amended to make it clear that the powers of Federal Council would be over national medico-political and international issues, powers that did not derogate from the powers, function and responsibility of the branches. The relevant passage was thus almost exactly that which was in the existing constitution. Federal Council ratified the agreement with Victoria at a meeting three days before the EGM. The Victorian problem was overcome. But this then led to another: the draft constitution thus amended was not the one that the other branches had approved to be put (and had been circulated) to members. The branches had given their approval to the amended draft before the EGM, but it would have been new to members. The EGM had to go ahead on 25 May because due notice of it had been given to members. But notice had not been given to the amendments negotiated between Federal Council and the Victorian branch. So Federal Council decided that the EGM should either be adjourned or a new EGM convened not later than 17 August.