Doorstop - Dr Kerryn Phelps, AMA President: Veterans will be out of pocket for health care unless the Government sets realistic fees for their medical treatment

For the first time it appears that veterans may have to start paying out of their own pockets for their medical care because the agreement between GPs and the Government has expired, last December. We have now received word that about 15% of GPs who had been involved in this scheme to look after veterans free of charge have pulled out of the scheme.

Our indications are that, unless by June, there is a new agreement that is reached between GPs and government for the care of veterans with realistic fees being set, then at least half if not more GPs will pull out of the scheme and the scheme will fall over.

Do you have any questions?

QUESTION: Is this proper treatment of those Australians who've gone to war on Australia's behalf?

DR PHELPS: This is not proper treatment of the veterans who have gone to war on Australia's behalf. We are being encouraged to support the troops who are going over to the Middle East now and indeed all Australians wish them well. But the Government needs to play its part for the veterans who have already given war service on behalf of Australia.

The Department of Veterans Affairs' scheme was designed to provide private care with medical practitioners for people who had given war service. Now that fee has been set at an unrealistically low level now, and it has not kept up with the pace of providing medical services. And doctors are finding that they are not able to give veterans the care that they need for this unrealistically low fee.

Now the Government has been procrastinating over renegotiating this fee and they are not coming to the party and, unless they do, we are very deeply concerned that this scheme will fall over. And it's important to our veterans.

QUESTION: And what about patients of GPs that have pulled out doing now? Where are they going?

DR PHELPS: A lot of doctors are at the moment still trying to provide that service even though it may be at a loss. But, unless in the next couple of months, this situation is dealt with and a realistic fee level is set, then we believe that the scheme will fall over.

Already 15% of GPs who were involved in the scheme have pulled out and, for those patients, they will be relying on Medicare and in many instances having to pay a co-payment because the rates of bulk billing are dropping.

QUESTION: On another issue, the changes to medical jargon. Do you really think that'll have a psychological effect on patients?

DR PHELPS: I think communication between doctors and patients is very important. And different patients need to have the messages given to them in different ways. I think that we do need to be pragmatic. We need to be realistic. We need to deliver medical information to patients in a way that will make sure that they understand the seriousness of the situation, but not so that that seriousness is necessarily exaggerated.

So that, provided that the language the doctor uses is understood completely by the patient, then I feel that that's appropriate. There are some patients who will want to ask more questions and I think it's very important that those questions are answered in a way that those patients can understand.

QUESTION: So a little bit of sugar makes the medicine go down?

DR PHELPS: I don't know about sugar. I mean it depends on the patient. Some patients say, 'Doctor, tell it to me straight. I want to know exactly what the situation is, what am I facing.' And other patients, you know, will just say, 'Look, just tell me what I need to know, what I need to do.' And I think it really is a matter of appropriate levels of communication between doctor and patient, provided the patient understands exactly the message that they need to understand so that they know what their condition is, what the management is, and that they can play an active role as a partner in their care. Then I think that the message needs to be appropriate for the patient.

If that's happening, then that's terrific. If patients are being unnecessarily worried by medical jargon, then I think it's important that they don't leave the doctor's surgery until they understand exactly how serious or otherwise the situation is.

QUESTION: Are there certain terms and phrases that you believe people more easily misunderstand?

DR PHELPS: I'm sure that there are. But it depends on the patent's level of the understanding of the English language. It depends on their level of comprehension of medical jargon and one of the things that is very important in the doctor-patient relationship is that the doctor pitches their language at a level that the patient understands and that you check back with the patient before they leave the consultation, that they've understood the message that you were conveying.

So if you were to give patients a particular piece of news, you then ask the patient, what do you understand by what I've told you. And if that matches up with you've told them and what you need them to understand, then the mission has been accomplished.

QUESTION: Can you update us on UMP? You've had some concerns obviously with ...... like that. Have we moved forward in any way?

DR PHELPS: There will be a series of meetings over the next couple of weeks looking to progress the medical indemnity issue. We have concerns still over the death, disability and retirement issue for doctors. We are very concerned about run-off cover, that is doctors who might have retired for many years who are now being asked to pay enormous amounts of money to cover their tail. And they may not have worked for 10 years. And you know, this is clearly an unacceptable situation.

Doctors who become disabled, doctors who die and their estates are exposed: We need to make sure that that situation is addressed.

The State Governments have to do their part with the statute of limitations on that issue. In terms of the legal action against UMP that's being proceeded with at the moment, clearly that has to wait until we see what happens with the courts there. But our understanding of the situation is that, if doctors are liable for the call, they do have to pay the call in order to have their tail covered.

And so we'll have to wait to the outcome of that. But we've certainly been giving doctors the message that that call needs to be paid.

QUESTION: And is time running out, I guess, for the Federal Government to make these changes?

DR PHELPS: Well there's no question that time is running out. I think that the short-term measures that the Government put in place last year will start to have an effect. The State Government really must take this matter seriously and make sure that they are doing their part, particularly in tort law reform, statute of limitations.

And we must proceed with the long term care and rehabilitation scheme because it's only through that sort of scheme that we will be able to have any control over the enormous sums of money that are likely to come up in the future for future care costs.

And what we really need to see is that, where people have major disabilities, major medical problems, that they are taken care of, that they get the care that they need and not, you know, in 10 or 15 years when it goes through court but, you know, today when they need the rehabilitation, when they need the care, and that their families are not struggling with that.

Thank you all.

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