Dr Kerryn Phelps, AMA President, Dr Bill Glasson, AMAQ President, Dr Michael Sedgley, Chair, AMA Medical Indemnity Taskforce

QUESTION: If the Prime Minister refuses, what happens?

DR GLASSON: Doctors cannot practise without insurance. There's no question of that, and at this stage it seems that the only person who can intervene to mend this situation is the Prime Minister himself, and we're inviting him to do it tomorrow and to do it immediately because we, like him, want to see some positive outcomes instead of this continuing ongoing problem that is getting worse day by day.

QUESTION: The report itself says there's evidence of goodwill on the part of the federal government. Do you refute that?

DR. KERRY PHELPS: There's goodwill, but goodwill is not enough to satisfy doctors that they can work in the security of knowing that they are covered by insurance. Now we're facing a situation where early next week doctors are going to be told whether or not their insurance contracts can be renewed. If they're told that they can't, we are going to have thousands of doctors in Queensland alone who are not going to be able to continue work until they make other insurance arrangements. Now, we don't know what other insurance arrangements are in place.

There is confusion, there is uncertainty, we do not know, despite all the work that has been done, what the timeline is for a solution on this. The Prime Minister has had a range of his ministerial portfolios working on this issue. We need to know what the government's plan is for a solution to this crisis. It has now reached the stage where doctors have said "We've had enough" and unless the Prime Minister is able to come out in the next day or two and tell Australian doctors exactly what the government's plans are, then we will not be able to stop doctors from leaving their posts because they simply cannot afford to continue to work.

QUESTION: Well, what do you need from the government? You know, you're not saying what they've done so far is not good enough, what would the Prime Minister have to tell you tomorrow to satisfy you?

DR PHELPS: Doctors are at the moment completely unclear as to what solutions the government has formulated in order to come to a solution to this problem. We don't only need short term solutions, we need medium term solutions or long term solutions. There are doctors who are right this minute deciding whether they will retire 10 or 15 years early; whether they'll go and do something else; whether they will pack their families up and go and work overseas where they don't have this medical indemnity problem.

QUESTION: So do you need the Prime Minister to come out and say we will guarantee your indemnities unconditionally at least in the short term?

DR PHELPS: There are a number of issues that the government can address. In the short term they can say we will provide individual guarantees to doctors who find themselves in situations of these settlements having to be paid to patients. So the first thing the government can do is to provide individual guarantees to the doctors who are facing claims of settlement. We can ask the government to extend their guarantee beyond June 30, because it's very clear that that tight timeframe is not going to be long enough to solve this problem. And we need a very clear articulation from the government about the direction that they are planning to take and the way they are going to solve this situation, not just in the long term but in the short term.

QUESTION: Is this not just a tactic by the AMA to get the government to cover the entire UMP tail?

DR PHELPS: The government has been working with the AMA on this solution, but the doctors of Australia need to know what the government is going to do. This is not a tactic. This is far too serious for everybody to be playing games of any sort. The situation is now that doctors are considering their futures. We have doctors in a number of regional areas of Australia already who have stopped work. Now, we are simply stating the truth. We are stating the facts and we are stating once again that unless the government takes urgent action - and I mean urgent - we don't have time up our sleeves any more - and the Prime Minister shows the leadership that we are wanting him to show on this issue, there will be a crisis that none of us can avert.

QUESTION: Should the government cover the whole tail?

DR PHELPS: The government must have a solution for the tail. We are not telling them exactly what they have to do to the tail. Michael, you might like to comment.

DR. SEDGLEY: Yes, the cover of the tail of course depends entirely on the future. There's no point in pouring more money, more funds, into a black hole when the future looks so bleak. We have suggested solutions to the government. We wish to work with them to achieve them. But at the moment, in the long term and in the future and even at the present, we have no message from government as to how to proceed. And as we have said, doctors cannot continue to practise without insurance.

QUESTION: What's been the impact on Victoria from this crisis?

DR PHELPS: Victoria knows that the crisis is coming their way, and I believe that the Victorian government is now looking at their options for tort law reform. The Victorian doctors are 100 per cent behind the doctors in the other states. They have stated so this morning at Federal AMA Council. We expect that every doctor in Australia will come in behind whatever solutions we are able to propose and work out with government, but we have to get answers and we have to get those answers today. This is not just about doctors making individual decisions whether they stop practise, whether they continue or not. This is about private hospitals now saying that as of two weeks time, any doctor insured with UMP will not be allowed to work in certain private hospitals. So doctors are now being told that without comprehensive insurance in place they won't be able to do their work. Do you want to comment on that?

DR GLASSON: Ladies and gentlemen, this is like a carriage going down the hill. At the moment the AMA are keeping the brakes on it, and simply we've been trying to keep the brakes on it because the membership at large have had enough. We have 8,000 doctors in Queensland at the moment who are waiting for the direction of what the government's going do. And as the President has said, unless that direction is very clear - and we've been getting so many mixed messages recently that they're totally confused. And the simple message is that they are not going to go on strike, they're going to close their doors. They are going to go and practise somewhere else around the world. You're going to have the biggest workforce crisis in this country that you've ever ever seen. And so what we're saying is for goodness sake, provide the leadership that we're asking for. Please come along and signal exactly what you're going to do to address the problem and give us the structural reform we're asking form. And what we're saying is this is more than just medical indemnity; this extends across the whole issue of liability across the spectrum. And so the government really has to look at this in perspective. This is not a doctors problem, this is a community problem, and as such it is for the government to get behind and solve it. We have given them a number of solutions but we've gotten little or no response at either level, and at particular state levels as well.

QUESTION: Has it not become a problem because UMP members did not pay enough in the last decade for their premiums like other state funds have?

DR GLASSON: No, the problem relates to the system. So no point in looking at UMP and saying - - -

QUESTION: Well then, why are there not other funds gone broke?

DR GLASSON: They will go broke. I can tell you within the next 12 months unless those structural reforms are in place, there will be no such thing as indemnity insurance in this country. We do not have a commercial insurer in the market. We only have these mutuals, and essentially they will all tip in the 12 months or longer unless the structural reforms are in place. Now, can they just increase their premiums? Of course they can. Obstetricians and neurosurgeons, they'll be like dinosaurs. They'll be extinct. So you won't have your brain tumours operated on, you won't have your babies delivered unless you go and lay under the tree. So essentially this is a serious issue about workforce. You won't have a medical system. So don't come out and try and suggest that the AMA's driving this or trying to make a big issue out of this for their own gain. This is a community problem. We've been telling the government, we've been telling the community about it, and we want them to get off their backsides and come out with a solution.

QUESTION: What is the AMA telling doctors to do now following today's decision? What are you saying to your members?

DR PHELPS: We are saying to our members wait until you get a message from the Prime Minister in the next couple of days. We - - -

QUESTION: So stop practising?

DR PHELPS: No, we are not. We are saying if you can look at your individual circumstances and you consider that your risk is low enough that you can continue to work, then please keep on working. On an individual basis we cannot give direction to doctors because they have to decide on the basis of their own situation whether they can continue to work. We are pleading with the Prime Minister to address the doctors of Australia at the conference here tomorrow. He has that opportunity, we are offering him the platform, to outline the government's solution to work with us, but he also needs to show the national leadership that we now are saying is essential to avert this crisis.

QUESTION: What happens if the Prime Minister gives the guarantees you want but the court still fails to include the government's comfort agreement?

DR PHELPS: I think that there are certain doctors who will not be able to continue to work. The doctors - it will be on a case by case basis. At the moment, as Dr Glasson has said, there are 8,000 doctors in Queensland who are waiting for a direction from government as to whether they are safe to continue to work next week. But we hit the brick wall middle of next week.

QUESTION: Is there any reason for AMA to become a party to the court proceedings to press the urgency of this issue, or - - -

DR PHELPS: At this stage the issue is between the UMP liquidator and the Commonwealth Government. We would certainly, as we have been, likely having input into what is happening. But the court proceedings are a matter between the government and the liquidator.

QUESTION: But why invite Helen Coonan or Kay Patterson to have their say…

DR PHELPS: Well, the problem is this is not just about the Treasury and it's not just about health services. It crosses four or five different government portfolios. I mean, last week we had a meeting with the heads of Health, Treasury, Finance, Attorney General's Department and the Prime Minister's Department, and they all need to co-ordinate together. Now, unless we get leadership from the top - maybe the right hand doesn't know what the left hand is doing at the moment and we want to make sure that there is clear leadership to government by the Prime Minister and clear leadership to the community by the Prime Minister. The doctors of Australia want to keep providing services to our patients; that is given. But what we can't do is guarantee that we can provide those services if we don't feel secure and confident to continue that work if we don't have insurance cover. If you haven't got insurance cover, you can't keep working.

QUESTION: The Government have given a guarantee, which the court hasn't accepted. You're expecting something wider and bigger from the Prime Minister, right?

DR PHELPS: Yes, we are.

QUESTION: What?

QUESTION: What advice would you give to a woman who went into labour this weekend? Go to a public hospital?

DR PHELPS: Michael is an obstetrician.

DR SEDGLEY: Quite a few doctors are actually giving that advice to their patients: that they will have to go to a public hospital because they feel unhappy to look after them in private, yes.

DR GLASSON: The message in Queensland to all women who are going to deliver by 30 June is that they should register at a public hospital. Certainly up in Toowoomba, the four obstetricians up there have directed all their pregnant women to register in the public system. But the truth is the public system will last about 24 hours. Our junior doctors have had plenty of signals as well that they're not happy with the system at all. They feel their future is being threatened as well and essentially, because most of the hospitals give discretionary cover to their public doctors, the public doctors feel as though that they're unsafe as well.

QUESTION: Dr Glasson, are you critical of Peter Beattie then?

DR GLASSON: Peter Beattie has not shown the white of his eyes. Peter Beattie has been playing ducks and drakes and essentially I've asked for Peter to provide the leadership and I haven't got it yet. And so, yes, I am critical of Peter Beattie unfortunately, because I thought he was beyond that. So we're meeting with the Attorney General next week at a state level. Whether that's enough, I'm not sure. But I can tell you from the Queensland point of view unless Peter Beattie can come out with a clear direction as well, the medical service in both the public and private system in Queensland will simply have to close down because the doctors will just close their doors.

QUESTION: Dr Phelps, can I ask you your personal position on euthanasia and the AMA's position, if it has a formal stance?

DR PHELPS: The AMA has a formal policy position statement. We will be reviewing our policies at the preliminary session and I would not like to pre-empt the deliberations at national conference.

QUESTION: And what's your personal position on euthanasia?

DR PHELPS: I said that we will be deliberating this weekend on the issues and I'll make a statement after that preliminary session.

QUESTION: Dr Phelps, if Dr Segal was to win the vote on Sunday, would that undermine the AMA's attempts to solve the indemnity crisis?

DR PHELPS: I think it's fair to say that we are in the midst of the greatest threats to medical services that this country has ever seen, and it does require continuity, it does require stability of leadership. However, we have a tremendous federal AMA team. This is not about individuals; it is about teams. The AMA membership will decide its leadership on Sunday and then we'll see where we go from there.

QUESTION: But do you think it will help your leadership cause?

DR PHELPS: I think this is well beyond any personal ambitions. I'm sorry, that's a ridiculous question.

QUESTION: Are you the underdog for the vote on Sunday, or - - -

DR PHELPS: I'm not prepared to call this vote. I think it's unreasonable to pre-empt the decision that the membership might make. You might like to ask others that question.

QUESTION: Thanks.

QUESTION: Thank you very much.

ENDS