AMA Transcript - New medical school in Western Australia

FRAN KELLY: Well, the often testy relationship between the Abbott Government and doctors has deteriorated further over the last day or two. Treasurer Joe Hockey has lashed the President of the AMA, Brian Owler, for his criticism of a new medical school for WA. Brian Owler had dubbed the Commonwealth's support for this campus as, quote: another calamitous captain's call by Captain Chaos. A reference to the Prime Minister.

[Excerpt]

JOE HOCKEY: And I think Brian Owler's language was extreme, and certainly not fitting for someone representing a great profession. And quite frankly, I think his comments were out of order.

[End of excerpt]

FRAN KELLY: Treasurer Joe Hockey speaking on Insiders yesterday.

Brian Owler, welcome back to Breakfast.

BRIAN OWLER: [Laughs] Thanks, Fran.

FRAN KELLY: Do you take that rebuke from the Treasurer? Is it any way to speak about the Prime Minister, calling him Captain Chaos?

BRIAN OWLER: No, look, the language was colourful, but I think the reason we used that was because this is a really important issue, particularly for medical students and doctors in training. On the face of it, it looked like a good decision to have another medical school, but the problem that we have is that we actually have a huge number of medical graduates, over 3700 coming through each year, and the problem now is finding places to train them. So adding a new medical school only worsens the problem that we have in finding training places to make the GPs and specialists that we need for the future.

FRAN KELLY: But that's a national picture. WA has a particular issue, as I understand it. There's a doctor shortage in WA, between 900 to 1000 doctors, and this Curtin Medical School will turn out 110 new doctors every year to work in WA. Why isn't that a good idea?

BRIAN OWLER: Well, first of all, to actually have a doctor that's a GP or other specialist, it takes a lot more than five years of medical school. You're actually looking at the internship, the residency program, and then at least three to five years of speciality training after that. So it often translates to maybe 13 years before you have those doctors coming through in the future. Now what should be done is to actually make use of the fact that they've increased the numbers of medical graduates in WA from 107 to over 330 each year. And in fact there were 84 places - or 84 extra applicants for GP training places in WA. So, actually funding the training places and the programs to turn the people who are actually out there looking for training in Western Australia would be the right approach, and it's going to translate to more doctors in WA in a much quicker time frame than this idea of the Curtin Medical School.

FRAN KELLY: Well that's also part of this announcement though, isn't it? As I understand it the Prime Minister said yesterday the Commonwealth is working with the WA Government to get a guarantee that it will provide extra training places at Midland Hospital, what has been dramatically expanded, and that's where most of these training places will be. Will that fix the problem?

BRIAN OWLER: No, well, that was just an afterthought, I think, thrown in to say, well, yes we acknowledge that problem, we're going to deal with it. But in fact actually what we need is the training places now. The problem is the training pipeline, as we call it, exists right now. It's not just in WA but right across the country. So instead of investing new money in the medical school, the opportunity is there to actually invest in the training places that we need right now. And I've got to say, in the context of a budget from 2014, where you're actually taking $57 billion out of health up to 2024, the number of training places is going to be limited by that particular budget move. So, the numbers just don't add up, and the policy doesn't add up. And I think what we're seeing here is the politics taking priority over good health policy.

FRAN KELLY: Well, I wonder why you say that, because the Health Minister, Sussan Ley, you have spoken to her about this idea of a new medical school for WA. What did she tell you? She's the Health Minister, what was her view when you talked to her?

BRIAN OWLER: Well, I talked to her about it, and it was very clear - she was essentially quite non-committal, but she'd made it clear that there was quite a lot of lobbying from a number of MPs over the issue. And we know that that's been the case for some time. And I wrote to the Minister for Health in April outlining all of the issues about why there should not be another medical school. And it's not just the AMA that says this, the Australian Medical Students Association, the Council of Presidents of the Medical Colleges, and if you actually read some of the media that's around at the moment from other organisations and groups in the medical world, you'll actually see that all of those groups are agreeing with me as well.

FRAN KELLY: Well, you know your critics say - and there are many of them always - says the AMA has a vested interest in restricting the number of new doctors, because the less doctors there are, the more inflated the incomes of those already practising medicine. I mean, that is a truism too isn't it?

BRIAN OWLER: No, it's absolute rubbish, because it would actually increase the number of medical students or graduates coming through each year from 1500 to over 3700; in the space of just under 10 years we've increased the number of medical schools to 10 to 18, and so adding another one is not the right thing to do. What we don't want to see is a whole bunch of medical graduates come through and then not have positions to actually become the GPs and specialists of the future. All of the projections of Health Workforce Australia, which this Government also abolished and subsumed into the department, previously projected that we were on track to be self-sufficient, and the problem was finding the training places for those graduates that exist already. So rather than creating further problems and chaos in the areas particularly in finding internships and residency places, but also training places, we actually want to make sure those graduates coming through actually are able to become the GPs and specialists that this country needs in the future. So we're actually asking to actually train those people. We're not trying to restrict the numbers, we just want them to be properly trained.

FRAN KELLY: It's 18 to seven on Breakfast, our guest is Dr Brian Owler, National President of the Australian Medical Association, the AMA, and they're in a bit of a contretemps with the Federal Government at the moment over the announcement of a new medical school for Curtin University in WA. It's in the Budget and the Prime Minister has announced this.

Just on this issue of training, we've had a look at the numbers here on Breakfast, there were as we understand it about 3210 state and territory internships offered this year, there's 100 Commonwealth-funded intern positions on top of that, but almost 3700 applicants. I'm not sure if those numbers sound right to you, but there's clearly a shortfall.

BRIAN OWLER: Yep.

FRAN KELLY: Who is responsible for that shortfall though? It's the states isn't it, not the Commonwealth?

BRIAN OWLER: Well that's right. The Commonwealth does come up with some extra funding as you mentioned, because we've been dealing with this, what has been termed in the past a tsunami of medical students or medical graduates coming through. So it's not just - to be a doctor you not only need to actually do medical school, but then you need to be an intern to complete your registration. Now we know that we don't have the number of places that we need, and we've actually now had to say to the international medical students, sorry, you can't complete your training, you've actually got to back home, you've done your degree but you're not going to be able to be registered. Which is a moral problem in itself. But to actually - it's now getting beyond that; so the bottleneck is now not just internships, it's actually then the residency positions, the PGY 2 and 3 as we call them, and then the positions on the training programs to be GPs and the specialists.

FRAN KELLY: Can I just ask you briefly, very briefly and finally though, is this model, with the Curtin Medical School, which is selecting and training students to work in areas of need in WA, so very specific, is that a better answer, is that a better model, specifically drafted students to work in a specific area where there's a need?

BRIAN OWLER: No, because their target is actually even lower than the number of rural medical students that currently exist at the moment. And so what we're actually seeing is a metropolitan medical school being set up in Perth. But the real answer is to actually have the clinical schools for the universities that already exist, that actually could have the infrastructure and investment put into them if they wanted to expand. And rather than producing a focus on rural people, we actually have universities that are already doing that and are quite effective at it.

FRAN KELLY: Do you regret your insult to the Prime Minister?

BRIAN OWLER: Look, you know, colourful language, but this is another problem where you have advice from not only the AMA but every other medical group, and so when you have a position where everyone's giving you this very clear advice based on the numbers and very good evidence, and they continue to go against it, it is very, very frustrating for everyone involved.

FRAN KELLY: Brian Owler, thank you very much for joining us.

BRIAN OWLER: It's a pleasure, Fran.

FRAN KELLY: Associate Professor Brian Owler, President of the AMA.

19 May 2015

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