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21 Sep 2015

AMA President Professor Brian Owler says that Medibank Private’s recent actions – highlighted by its contentious list of 165 ‘preventable events’ and its rocky contract negotiations with Calvary Health – have nothing to do with quality.

Medibank Private and Calvary eventually signed a contract, but no details were made public.

The AMA acknowledges that commercial elements of the contract should remain confidential, but any arrangements to do with the list of ‘preventable events’ are in the public interest. Keeping them secret only fans suspicion and undermines trust.

“Medibank is using the cloak of quality to cut costs, to not pay for treatments and procedures, and this is going to put an enormous strain on our hospital system – not just in terms of the private system, but the public system as well", Professor Owler said.

“We know that there will be patients that won't be able to be readmitted should they develop problems with their wound or other complications, and they will have to go to the public hospitals.

“There are other patients that won't be able to afford the out of pocket expenses that Calvary will have to charge, and they will have to be going to public hospitals as well."

Professor Owler is warning that, if the issue was not stopped by the Government, it has the ability to threaten the balance between the public and private system right across the country.

“We've already seen Bupa and NIB line up behind Medibank Private,” he said.

The AMA disputes that Medibank Private’s list of 'preventable events' can be addressed as a quality issue, with studies showing a similar approach taken overseas has not produced any change in outcomes, and questions the various items that are on the list.

“Medibank is continuing to be mischievous with the truth, and they continue to refer to complications as ‘mistakes’,” Professor Owler said.

“These are not mistakes, these are complications that are unfortunate, but part of everyday medical practice.

“While there is a degree of preventability, they are not mistakes, they cannot be completely prevented.

“Medibank Private is unfairly punishing the hospital, blaming the doctors and the nurses that are working and caring for patients in those private hospitals, and going to put an enormous strain on the public hospital system.

“The idea that the Government does not have a role in this dispute is ludicrous.

“First of all, this dispute is in part the creation of this Government.

“It was this Government's policy that actually put Medibank Private on the stock exchange, and created the biggest private health insurer where the responsibility was now the shareholders, and concentrating on returns to investors.

“The Government also has about $6 billion of skin in the game; they pay for the private health insurance rebate, they support private health insurance, and this move by Medibank Private continues to undermine it.”

In welcome news, the Government has fast-tracked a review of preventable events being conducted by the Australian Commission on Safety and Quality in Health Care, and Medibank Private has indicated it will cooperate with this review.

John Flannery

Published: 21 Sep 2015