Speeches and Transcripts

AMA Transcript - AMA President, Professor Brian Owler, Doorstop, MBS review

Transcript: AMA President, Prof Brian Owler, Doorstop, Sydney, 27 September 2015 

Subject: MBS review, ICE

 

BRIAN OWLER: Alright, well thank you very much for coming out today. Obviously there's been some media comments by both the Prime Minister and the Minister for Health in relation to the MBS review and the medical profession. The AMA is deeply disappointed by the approach of the Prime Minister and the Minister for Health in terms of the MBS review.

The profession, the AMA, agreed to sign up to a review that was about modernising the MBS, modernising the way that we approach remuneration for doctors, and the services provided through the MBS, to make sure that we were getting an efficient delivery of services and the best services for our patients.

We have known for some time that the MBS is outdated, but what we cannot accept is the narrative that has been set up by the Minister for Health today, and the Prime Minister, that the profession is somehow using the MBS, performing unsafe and unnecessary procedures, palming patients for financial gain. This is a direct attack on the integrity of the medical profession. It is an approach that undermines the confidence that patients have in their doctors. It's unacceptable. The AMA is very happy to work with the Minister, to review the evidence, to come up with a review that reaches an outcome that is best for patients, but we cannot accept this attack on the medical profession. Some of the comments that were made today, about only patients knowing when they're well enough, for instance. Others completely false. We have every faith in our patients in being able to report their outcomes, but we don't perform procedures just to make patients better.

Often we perform procedures and provide treatments to stop people from getting sick. We don't wait for diabetics to get diabetic retinopathy, that is go blind from their diabetes, to go blind before we provide them with a treatment. We don't wait for patients that have previously had colon cancer to get metastatic disease or a recurrence of their cancer, that's why we do colonoscopies. The Government itself has taken an approach of doing screening through colonoscopies. So to turn around and accuse the medical profession of somehow providing inappropriate and unsafe treatment for these patients is completely unacceptable, and very deeply troubling to the AMA and to the medical profession.

QUESTION: [inaudible]

BRIAN OWLER: We've been working with the Minister for some time. The Minister only two weeks ago provided me with reassurances that there would be a mechanism to put new items on the schedule. Being able to put new items on the schedule means that we can actually get a more modern MBS. The review that's been set up has always had our support with the proviso that it was not just simply a cost-cutting exercise.

Yet today we see the discussion paper released without any ability to put new items on, except for the existing MSAC process, which is long, which is expensive, and is not acceptable to the AMA, as a result of this review. If we're serious about getting a modern MBS, then we need the ability to put new items on.

Simply, what we've got now is a process through which the Government is attacking the medical profession, cutting services to patients, and cutting health funding. And this from a Government that has already tried to cut funding for general practice, from a Government who has our public hospitals in a position where they are facing a funding cliff, and now they're attacking the integrity itself of the medical profession, and using the MBS review not to come up with a more modern schedule for the benefit of patients, but to come up with another savings exercise, cutting services to patients and cutting health funding further.

QUESTION: [inaudible]

BRIAN OWLER: The Medicare co-payment is something completely different. The Medicare co-payment was simply about general practice. That was a completely ridiculous policy, that's why it was dropped, because no one could ever argue for that policy in a serious way if they were serious about looking after people with chronic disease, and preventative healthcare.

What we are doing with the MBS review, is coming up with a review of the items that need to be reviewed, to make sure that we are getting, yes the best value for the health dollar, but making sure that our patients have access to modern medical services as well. So it's very different from the co-payment, it looks at a whole other range of health services, particularly procedures and operations that are often offered by specialist providers.

QUESTION: [inaudible]

BRIAN OWLER: It's a completely ridiculous, ludicrous comment by the Minister, and shows how little understanding the Minister has gained from her process of consultation. To suggest that 30 per cent of the items have little or no value is a figure that comes from the United States.

Now no one has been able to provide any evidence that that number is applicable to the Australian healthcare system. That number in the United States is, of course, subject to controversy, and to somehow try and export that 30 per cent to the Australian healthcare system, which delivers some of the best health outcomes in the world, we have the fourth-highest life expectancy of any country, we actually have the average of OECD spending on health.

So not only do we have an extremely effective healthcare system, but we actually already have a very efficient healthcare system. Now if there are savings to be made, then we will review the items, we'll go through the evidence, and we're happy to make adjustments where they can be justified. But to suggest that you're going to cut 30 per cent of the items, to suggest that you're going to find 30% of savings through the MBS, the only way you can do that is by cutting services to patients, and cutting health funding.

And that means that this country will have a two-tiered system. Those that have money will get access to health services, and those that don't will suffer, be debilitated, and will be confined to the scrap heap.

QUESTION: [inaudible]

BRIAN OWLER: Look, I think it's a good thing that this is recognised as a problem for our doctors and nurses working in our emergency departments. We hear stories from our colleagues working in emergency departments about the impact that ice addicts have in emergency departments, on the dangers to health personnel, but also on the time that it takes in terms of subduing these people, particularly when they're in extremes of psychosis. It's very disruptive for the emergency department, and of course dangerous to the staff that are working there. So measures that make it safer for staff, make it easier to provide treatment for these people, are something that the AMA does support.

 

 

27 September 2015

 

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