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13 Jun 2019

BY AMA PRESIDENT DR TONY BARTONE  

The AMA has just come through a very busy and productive period.

After being both an interested observer and at times an active participant in the federal election campaign, we moved seamlessly on to our annual showpiece – our National Conference in Brisbane in late May.

The timing could not have been better.

National Conference gave us the opportunity to conduct a public audit of the re-elected Coalition Government’s policies and how we will work on them – and hopefully some new ones – with Health Minister Greg Hunt over the next three years.

The Conference also allowed us to put the spotlight on some of the big issues facing the AMA, the profession, the health sector, and the Australian community. These included mental health, aged care, doctors’ health, gender equity, artificial intelligence, and the future medical workforce.

These issues are core business for the AMA and – along with the continuing work on general practice and private health – will be at the centre of our ongoing policy and advocacy activity.

Importantly, the Conference also gave me the chance to reflect on my first year as President and spell out what I hope to achieve in my second year.

I am immensely proud that the AMA over the last year delivered big time for general practice.

Over one billion dollars in funding for general practice was announced in the 2019-20 Budget and MYEFO – one billion dollars of funding that both sides of Parliament agreed to fund.

This was no accident or lucky occurrence. We put this on the agenda.

The AMA has for years pushed for genuine reform to the way that general practice is funded.

We have advocated for a model that will allow for coordinated, patient-centred care, which maintains GP stewardship of the system.

We have now finally seen real funding for this with the $450 million announced in the Budget for GPs to assist the coordinated care for people over 70.

This is a good first step, but this policy approach must be expanded. We will be pushing the Government to introduce funding for coordinated care for all Australians with a chronic illness.

Our advocacy for more support for GPs to visit Residential Aged Care Facilities was successful. The Government increased funding for GPs visiting Residential Aged Care Facilities and retained the Aged Care Access Incentive.

But we are also concerned about the future of general practice, not just for we GPs who have seen practice costs continue to rise while our rebates have stalled, but for the next generations of GPs.

GP training places have remained undersubscribed for two years running.

This is extremely worrying and an ominous sign. It is further evidence of the declining appeal of a General Practice career for an ever-increasing number of graduates.

On another front, we also had successes with rural health.

There was a very welcome additional $60 million in funding to fast track the National Rural Generalist Pathway in the Budget.

The National Medical Workforce Strategy was also announced.

Both of these measures will help deliver much-needed doctors to rural and remote communities, but they won’t be able to deliver for years.

Our Public Hospital Report Card had quite an impact during the election campaign. It showed clearly that the public hospital sector is not in good shape.

Doctors and nurses are doing more than their fair share – they are having to do more with the funding they have.

When governments underfund, they are making a choice to constrain the supply of public hospital services.

Our advocacy for greater funding will continue.

The other side of the equation – private health and private health insurance – is also unfinished business.

We backed the intent of the Government’s reforms, including the concept of developing the Gold, Silver, and Bronze insurance products.

But the Government reforms do not address affordability in an enduring way – this problem is starkly obvious, even with the slightly smaller 2019 round of premium increases.

It is very difficult to see how private health insurance can stay affordable with increases in premiums averaging 4 to 5 per cent a year, when wages growth is firmly stuck around 2 per cent.

There is increasing corporatisation of private health and the market power is shifting in favour of private health insurers. Insurers should not determine the provision of treatment in Australia.

They should not interfere with the clinical judgement of qualified and experienced doctors.

We will help shape the Government’s private health reforms.

Similarly, we must revive the government focus on preventive health – from all levels of government.

Prevention receives a paltry amount of the total health budget. This completely misses the point of preventive health care.

This time last year, I set out some objectives for the AMA.

Strong advocacy on patient access to primary care, to mental health and aged care, to in-hospital care and for our Indigenous people, as well as those in rural and regional areas. We delivered on many fronts.

Work on improving the collaborative relationships between the Federal and State and Territory AMAs. This is in progress and ongoing.

Ensure steadiness, security, and confidence in the Federal AMA Secretariat amid a period of external and personnel changes. Our systems and processes are working, and a new Secretary-General will be in place soon.

I believe that, overall, we have made significant progress but there is more to do.

In the year ahead, the AMA will be extremely vigilant on private health care. I will ensure the AMA resists any threats to the sustainability of private health care and patient access. It is this access that fundamentally helps underpin access to our universal health system.

We will also raise our focus on doctors’ health and wellbeing. This will include the formation of a coordinated leadership group to implement a national framework to improve and enhance the health and wellbeing of the medical profession.

This will require considerable coordinated action and cooperation between the Federal and State AMAs.

We have a lot to do. The good news is we won’t be distracted by a federal election.

 


Published: 13 Jun 2019