Doorstop - AMA President, Dr Bill Glasson, Parliament House, Canberra - The crisis facing the medical profession

GLASSON:      First of all they've offered to withdraw the levy notices across the board.  The levy notices that are currently out there will be withdrawn and they will be re-evaluated further down the line ...

QUESTION:     That's even those under a thousand dollars?

GLASSON:      Yep, yes.

QUESTION:     The doctors won't have to pay a cent?

GLASSON:      Doctors will have to pay a cent but not just at the moment, until we've got the reforms in place that we're asking for.  And ...

QUESTION:     When are you having to pay?

GLASSON:      Well, at this stage there's a suggestion of having an expert committee set up that will report in approximately early December.  Those terms of references are just being laid out at the moment.  And that will probably try and address, as I say, some of the broader issues.

The difficulty is that the doctors at the moment have to make a decision on are there sufficient structural reforms in place, or being suggested, to allow them to go back to work with the full knowledge that we've got a long-term affordable and sustainable system?

QUESTION:     And what's the answer to that?

GLASSON:      The answer at this stage is really that we have not got enough on the board.  And we had an urgent meeting of our Indemnity Taskforce this afternoon who have agreed at this stage not to progress - not to accept, I suppose - until we have a full, I suppose, package outlined.

Now, we're going to meet up with the Minister again tomorrow.  We're going to work on this issue, particularly of the limitation - the Statute Limitations - in other words the time frame over which doctors can be sued.  That has to be restricted down to what we say is three years for adults and six years for children.  If the profession and patients are expected to insure beyond that, then essentially the system becomes unaffordable.

If we can get that in place, that will have major ramifications in relation to the insurance that patients have to pay and, as I say, the importance also of people that die, that are disabled or retire out of the system.

QUESTION:     So at this stage, in relation to the request that doctors stay at their post until this is sorted out, what are doctors going to do?

GLASSON:      Yes.  At the moment we're still in negotiation - negotiating phase, as I say.  We've just had a further constructive half an hour with the Minister.  We've made it very clear to the Minister that we need to move forward on this issue urgently ...

QUESTION:     So the doctors who say they're going to go are still going to go?

GLASSON:      Well, at this stage the general membership has not been fully notified, so we'll wait to hear from them.  Obviously we need to inform them, probably, as of tomorrow what we have gained for them and allow them to make that decision. Their decision finally as to whether they're going to continue at work or whether they're going to, you know, retire out of the system.

QUESTION:     Would you ask them to withhold?

GLASSON:      Look, all we can do as a membership organisation is ask the doctors, or indicate to the doctors what proposal has been put.  It's up to the membership then to decide whether they can actually continue to work.  I think, as I said, if we can come back tomorrow with something a little bit more concrete as far as guaranteeing a long-term affordable system, then we can probably move ahead.  But ...

QUESTION:     So you haven't rejected what the Minister said.  It's just stage one of the negotiations?

GLASSON:      Yes.  I mean, this is a long book with lots of chapters and I'd like to think that we're up to about chapter two, with many more chapters to go.  And so I think the message is that we have to continue to negotiate heavily and strongly, indicate to the government that this is having major workforce ramifications and unless something, you know, happens probably fairly quickly over the next week or so then I think that the doctors will ultimately make a decision.  Well they'll make a decision then whether they can or cannot stay.

QUESTION:     Is it true the Prime Minister has taken a tougher line on this than Tony Abbott?

GLASSON:      Well, I think the government - I must say that Mr Abbott has been excellent this morning in listening to our concerns.  But essentially can I say that the government, when discussion was held, you know, broader discussion, I suppose, did, I suppose, modify what we were requesting.   And, as I said, what we've taken back to the members today is not acceptable in the terms of actually providing long-term sustainable reform.

And this is what this is all about.  Unless we have the changes to the structure in the system medical indemnity premiums will rise, and access of patients to doctors will become more difficult, both as they fall out of the system and obviously that will also - the affordability or the cost of seeing the doctor will rise as well.

QUESTION:     Was there any move from the government on assuming liability for some negligence payouts?

GLASSON:      Yes, there has been.  For the larger claims there has been a movement in that area.  But what we really - our really main demand was obviously in relation to them accepting care costs and, secondly, trying to accept all claims that fall out by the three and six years.  And that's the problem, two sticking points.  But in reality there are two major areas that the profession wants accepted.

And so the decision to, as I said, to go back to work will really rely on them actually assessing what has been offered at this stage, and in reality the two major issues we have not delivered on as yet.

QUESTION:    

GLASSON:      Hang on, I'll just answer that.  Is this a blank cheque? Sue, at the end of the day I don't believe it's a blank cheque.  I believe it's whatever requires to fix the system.  And as I say, that the - I suppose the details of what it's going to cost haven't really been worked out. 

But what I do suggest is once the tort law reforms are in every state  - at the moment they are not.  Probably New South Wales and Queensland are the only ones that do have some sort of effective tort law reform - then - then I think it will impact on the amount of money that it will cost the system.

And so - but in the short term I suppose what we're asking the Government even for the short term - they said we'll cover those amounts for awards outside of three and six years, and we'll cover all the care costs until we can review the system, then that would even be another strong signal.

So as an interim measure it will send a signal that they're serious about it.  But if you've got a system whereby the doctors and the patients are expected to continue to cover that overhead, then the unaffordability and the unsustainability is the major issue.

QUESTION:     Dr Glasson, you say that doctors have to decide over the next couple of days what they're going to do - if they're going to leave the profession or not.  Many of the - the doctors who have resigned already say the IBNR levy was the last straw.  With that levy now gone, what is the impetus for doctors to decide over the next couple of days?

GLASSON:      Okay, I think that the real issue is obviously - doctors - the other - come this far down the road, in reality, they're withdrawing from public hospitals.  To get them back there they want to make sure that there's been restructuring of the system.

In other words there's no point in going back to work and find that there's been no restructuring done, and you'll turn round in twelve months or two years time and have to revisit this situation again.

So for doctors that are currently in the system - that are considering - that were considering leaving as a consequence of the levy, obviously will reconsider that in view of the withdrawal of the levy notice.  Now that doesn't mean the levy's disappeared. It just means it's been withdrawn.  It will be re-evaluated after this expert committee reports.

QUESTION:     And that's going to report when?

GLASSON:      Supposedly by December the tenth.

QUESTION:     Aren't you holding taxpayers to ransom here?

GLASSON:      No, look, the - the real issue here is we're trying to make sure that the taxpayer, or the public, have doctors to service them.  And so there's no point in us sort of beating round the bush.  It's all about making sure that you and I have a doctor - whether that be a general practitioner or a specialist - in the next, you know, one year to the next decade.    

And I keep saying unless we do something about it, more and more doctors will fall out of the system.  And as I said, what's happened today, I think has been positive in the sense that - that Mr Abbott has really tried to, I think, address our major areas of concern.  I don't know whether, you know, we were able to convince all those around him of that issue, and I suppose it's up for us now to continue to negotiate and continue to exert pressure on our - on the other members of Parliament as to the importance of getting this issue once and all signed of on.

QUESTION:     Why should taxpayers bail you out, if you're not prepared to offer them something in return by improving your own standards of practise to reduce the $4.5 billion worth of medical misadventure that happens every year?

GLASSON:      Can I suggest to you that the process by which doctors are accredited in this country, and the process by which we remain skilled, is probably the best in the world.  You have one of the most highly skilled and highly trained workforces anywhere in the world, and I think that's a credit to this country.

My concern is that what the indemnity is doing is it is deskilling that workforce such that you're removing the expertise of various specialists and GPs that we require.

And so I think that the answer is that you live in one of the safest systems in the world. You have access to some of the best doctors in the world.  And we're trying to preserve it.

Okay?  Thank you.

Ends