Doorstop - Dr Bill Glasson, AMA President, Brisbane City Hall - AMA's Supplementary Submission to the Senate Select Committee on Medicare

QUESTION:       Mr Glasson, what will your submission be today?

GLASSON:        Basically the whole of our aim of this morning is to outline to the Senators the issues in relation to the access to medical services in this country.  There are two arms to that.  The first of all relates to the one of availability - in other words the availability of medical practitioners in this country. 

We are currently sitting in probably one of the - one of the biggest workforce crises this country has ever seen, and it's only just started.  And can I suggest to you over the next two to three years, we're going to see the biggest drop out of both general practitioners and specialists in this country than we've ever seen in our life. 

So the backbenchers are telling me they're not just having concerns about the fact their patients are saying they can't find bulk-billing doctors.   They say they can't find doctors.  And that situation's going to get worse.  So we really want to highlight to them this morning the issues of workforce, and how we might actually try to address that issue.

On the other side of the equation's the one of affordability.  Affordability of services both at the public level and in the private level.  And currently, particularly with the medical indemnity crisis, and the overheads, or increasing cost that doctors are finding in their practices, these costs have to be passed on to patients, and we keep saying that it's the patients that are paying for all this, and particularly paying for this ever-rising medical indemnity bill that we're seeing year after year.

So we have to get this indemnity sorted out, and we have to sort out the workforce combined with it.  So this will be the thrust of our arguments, combined with the whole issues, I suppose, outlining the history of why this has occurred.  And it has been a Government strategy for the past decade or more to actually reduce the medical workforce in this country.

And so they have been - they've done it very well.  It's very effective.  In fact they've done it so well, there's hardly any doctors left in the system.  So to turn it round is going to take quite a time.

QUESTION:       If bulk-billing's not the issue -  I mean, doesn't that all come down to the affordability of service?

GLASSON:        It does.  In reality, bulk billing doesn't represent the cost of providing medical services.  That's our argument.  We're talking about Medicare rebates, we're talking about the Government being the insurance arm for us, the patients. And essentially the current Medicare rebate does not reflect the cost of providing high quality general practice or specialist practice in this country.

So I don't want to hear about bulk-billing.  I want to hear about how this Government is going to address access to medical services, and make it affordable for you and I, the patients.

QUESTION:       So this new Medicare reform package - not - not good enough?  Nothing in it?

GLASSON:        No, no - it - look, the new Medicare - fairer Medicare - fair is the wrong word.  It's full of sticks.  For goodness sake, Government, I want to see some carrots.  I want to see some positive incentives in the system for both patients and for the medical community.  If they come out with a whole lot of sticks yet again, it will not work.  It's as simple as that.

QUESTION:       Health Ministers meeting with the Prime Minister later this week.  Do you think they will be signing that health agreement?

GLASSON:        I think they will.  I think what the traditional history is, they - argy-bargy, and they stand off, but ultimately, because of the penalties involved, I think ACT will sign. Victoria probably won't be far behind, and I'm sure Queensland and the rest of them will follow suit.   So the reality is that that will be signed off.

QUESTION:       So when it comes to the crunch they'll crumble?

GLASSON:        They will crumble.  Unfortunately, they will.  But can I suggest to you that it's time that both sides - that the Federal and the State governments - got together on this and address this issue seriously.  We're sick of this argy-bargy.  The community have had enough.  And really we want some sort of, I suppose, mature approach to addressing the long-term underfunding of our public system in this country.

The other point I'd like to make is in relation to scholarships.  And this will be made to the senators this morning.  And I've made this point before.  That to try and solve the rural workforce shortage in this country the current proposal of the 234 unfunded medical - or unfunded bonded medical student places, will not work.

So we have put a proposal forward, which is based on scholarships, where students actually will receive a payment, towards their HECS, and in return of that, for that, they will actually have to do a - four years of service in needy areas. 

Now the needy areas are actually outer metropolitan areas of Brisbane, Sydney, Melbourne, as obviously as well as rural areas.  And so we're going to push very hard on the issue of - of these - the unfairness, the unjustness, and probably the unconstitutional nature of these bonded unfunded positions as suggested.

Ends