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Unfinished Business

As you read this, I will be into my second month in the top job.  It has not been dull.

03 Jul 2011

By AMA President Dr Steve Hambleton

As you read this, I will be into my second month in the top job.  It has not been dull.

I am very fortunate to have served for two years as deputy to Andrew Pesce.  Andrew’s integrity, gentle manner and political instincts brought the AMA and the profession great success and respect from the community and politicians of all persuasions.  I learned a lot.

While we have achieved much in shaping and influencing the health debate in difficult and uncertain times, there is still so much to do.  There is a lot of unfinished business.  Your leadership team will be working hard to get this business sorted in a way that provides most benefits to patients.

The first priority is to convince the Government to rethink its proposed model for Medicare Locals.  We have written to all MPs and Senators with our concerns, and we have written to the CEOs of the first tranche of Medicare Locals.

We are demanding a strong GP presence on all the boards of Medicare Locals, and we are seeking assurances from the Government that the GP leadership role in primary care is not diminished and that fund-holding arrangements will not be introduced by stealth.

Medicare Locals will fail if doctors are not directly involved in planning and the ongoing management and decision-making.  If our concerns are not acted upon, the AMA at Federal and State level will be campaigning strongly on Medicare Locals until the next election.

Similarly, we will be urging the Government to spend its GP Super Clinics money more wisely.  It is clear that the Clinics are not turning out the way that the Government intended or anyone imagined.  They are poorly planned and expensive and, to date, are not delivering on the Government’s promise of better access to primary care.

We want the Government to draw a line under its GP Super Clinics policy and redirect the funding to existing general practices.  It makes more sense to build upon what has been working for years, and sometimes generations, than to promote subsidised unnecessary competition.  Fill access gaps, sure, but don’t force viable practices out of business.

The AMA will also be continuing our push to have the Government reverse its decision to cut Medicare patient rebates for mental health care plans.  This is bad policy.  It is blocking patient access to quality mental health care from GPs and it is treating mental health as a lesser issue than physical health.

We are still working with the Government to make improvements to their arrangements for after-hours GP care and for the employment of general practice nurses.  It is our view that practices already supplying after-hours services should not be disadvantaged and that practices that already employ a number of practice nurses should not be penalised if they choose to employ more.

There is unfinished business in the hospital sector as well.

While the AMA has been broadly supportive of the Government’s new funding arrangements for public hospitals, so far that is about all we have achieved – funding arrangements, a new way of financing.

It is time now to see some practical changes on the ground.  We need to see some positive patient outcomes from every one of the substantial new health dollars that the Government has allocated to hospitals.

The Government has injected significant new funding into public hospitals but we are yet to see a dividend from this investment.  The most recent hospital statistics show that things are steady, not really improving – not getting worse necessarily, but not getting better.

It is the challenge of all governments to make the COAG reforms work.  It is my job – the AMA’s job – to keep the community informed about how the reforms are working, and let people know if they are getting better access to quality hospital services.

Our hospitals need more doctors and more beds, not new bureaucracies and bureaucrats.

Our towns and suburbs need more GPs, not GP substitutes.

There is a lot of unfinished business.  It is my intention to stay engaged with the Government to ensure we get successful outcomes from health reform – but I do not intend to stay a silent partner if the reforms keep going in the wrong direction.

Published: 03 Jul 2011