Dr Kerryn Phelps, AMA President, Canberra

QUESTION: What would be the practical outcomes that you'd put into a treaty?

PHELPS: We need to see a practical outcome that looks at the types of health outcomes that we want to see. I mean, for example, we need to see benchmarks on the availability of health services for indigenous people, the numbers of health care workers available, the health resources, the funding levels, but with any contract it works both ways. So there are rights and obligations on both sides, and I think the important thing is that we get the dialogue happening, that consultation progresses, and so that governments at all levels, and indigenous people are happy with the contract or the treaty, and that the obligations are clear.

But we need to do this to restore any sense of justice, to actually establish any sense of justice for indigenous people.

QUESTION: Dr Phelps, how confident are you that something will be done, considering the Federal Government has five reports about indigenous health and they haven't acted on any of the recommendations?

PHELPS: We're up to our eyeballs in reports and rhetoric. What we now need to see is commitment in terms of funding and in terms of what the government is prepared to do in terms of meeting its social justice commitment to Australia's indigenous people.

Their record is just not good enough. We see examples from countries, which are similar to Australia - like Canada, New Zealand, and the United States - where they have been able to improve their record. They've been able to improve life expectancy and infant mortality rates. In Australia we have not been able to make those sorts of improvements and it's inexcusable because it is achievable.

QUESTION: You see it as a two way street, what are you expecting from the indigenous population?

PHELPS: What we expect from the indigenous population is accountability, leadership and guidance so that communities are able to take leadership in areas where, for example, they need to deal with specific public health issues, violence, alcohol and substance abuse, but those ideas and that leadership, and the carrying out of those programs needs to be led by the indigenous communities themselves.

QUESTION: How much of an increase do you expect funding to require, to make this sort of thing happen?

PHELPS: There has been a range of assessments made. John Deeble, some years ago, estimated that we would need an extra $245 million per year just to bring Aboriginal health up to an acceptable standard so that there was some equity. So that's the range of funding that we're looking at, at the moment.

Clearly there needs to be an emphasis on preventive strategies on public health and on primary health care access. We also need to look at a range of infrastructure measures and those would include basic things like sanitation, sewerage, housing, fresh water - things that every other Australian quite rightly takes for granted. These things can't be taken for granted for many of the remote Aboriginal communities particularly, but there is no excuse for those things not being available. It's a matter of funding and of commitment.

QUESTION: Dr Phelps, just on another issue. Is anything being done regarding the Government and the Gold Card?

PHELPS: I'm meeting with Dana Vale shortly, and we will be discussing the issue of the Gold Card. As you would be aware, the Gold Card has really reduced very much in its value for our veterans, our returned soldiers, because the Medicare rebate has not kept up to pace with providing the service, and the Gold Card rebate is linked to Medicare.

So unless we get some negotiations around that issue progressing - I believe it's been to Cabinet and been bounced back to the Department - and unless we get some action there, unfortunately doctors will have no choice but to treat veterans as public patients under Medicare or as private patients under their own funding.

QUESTION: So are doctors justified in refusing the Gold Card at this stage because of the situation?

PHELPS: Well, the Gold Card has reduced in its value and doctors are less, are acknowledging the Gold Card less and less because the difference between the amount provided for treatment under the Gold Card and the amount that that service is worth has been becoming ever greater.

Unfortunately, unless this issue is addressed - and it's not just about procedures and about specialists, about surgeons - it's about general practitioners as well, because the amount that they receive to take care of veterans - while it's more than the Medicare rebate - is nowhere near the cost of providing that service. And so the Department actually has to get a grip on this, Cabinet has to get a grip on it, otherwise the Gold Card will become virtually meaningless.

QUESTION: Kay Patterson yesterday in the Senate was saying that the Government's committed to the Gold Card, but it seems that what's actually happening doesn't seem to echo her sentiments.

PHELPS: The Government says they're committed to the Gold Card, they also say they're committed to Medicare, but we have yet to see the runs on the board. It's all very well to say you're committed to something but unless you put in place the funding and the commitment, then it's just empty words.

Thank you all.

Ends