Dr Kerryn Phelps, AMA President with John Gatefield, Sky Television, 'Vote 2001'

The Australian Medical Association says most of the package is well-targeted but it still falls short on the issue of doctors' pay. David Spears spoke to AMA President, Dr Kerryn Phelps, in Sydney.

SPEARS: Kerryn Phelps, let's look firstly at the size of this package, $545 million over four years. Does that go far enough to address the problems in the public hospital system?

PHELPS: It's better than nothing but it's not the $900 million over two years that the public hospital system has been recognised to need, so it will be interesting to see just how much change we can achieve with a smaller amount of money.

SPEARS: Are you saying $900 million over two years, though, looking at the size of the budget at the moment, we're on a wafer thin surplus. Is that going to be economically responsible?

PHELPS: I think that we need to look at government expenditure overall and I don't think there's any question that health should be at least one of the top priorities for spending over the next three years.

SPEARS: Kim Beazley's is an eight point plan. Some of the things he's targeting include waiting lists, emergency departments, aged care. Is there anything here that he's forgotten, that Labor's missed out?

PHELPS: The targets are right but they have missed out doctors and there's no question that just like there is a workforce crisis with nurses in the public hospital system, similarly there's a crisis with doctors who are leaving the public hospital system. They're leaving for a number of reasons. One is the working conditions and remuneration in the public hospital sector and the other is the lack of decent equipment and proper funding for them to be able to do their work there and so they've become incredibly frustrated. So while this package does address a lot of those issues, such as waiting times, crowded emergency departments, elective surgery lists, it doesn't fundamentally address the medical workforce issue.

SPEARS: So the Medicare rebates, what exactly are you looking for there from both sides?

PHELPS: That's in terms of out of hospital services and what we need to do is to look at the policies of the major parties and whether they're really serious about Medicare. And if they're really serious about Medicare, they must address the Medicare benefit schedule, to look at Medicare rebates and increase them because that one factor alone is the reason behind declining bulk-billing rates and increasing patient gaps for services.

SPEARS: And how about doctors' working hours, in particular young doctors' working hours? Is that an area that should be addressed?

PHELPS: Young doctors' working hours is a very important issue but it's not purely for the Federal Government. It's also for the state governments who administer and fund the hospitals at state level to also address. What we need to do is to look at the hours that are being worked to make sure that they're safe, not only for the doctors but for the patients. And, at the moment, too many young doctors are working unreasonably long hours under very difficult conditions. That's an issue that does need to be addressed by state and federal governments and I think that the principle of the Medicare alliance is to be applauded, where the Commonwealth and the states get together and they work out the standards for our hospitals on a national level and they put an end to cost shifting.

SPEARS: Labor's made a big deal about this Medicare alliance that Kim Beazley has signed with the state Labor leaders. How realistic is it to suggest that that could make a big difference and do you think a Federal Labor Government with so many state labor governments, would make a big change?

PHELPS: I think this could possibly be a revolution in the way health is financed in this country and administered and, at the moment, we have the Commonwealth and the states traditionally fighting each other every few years when the Medicare agreement comes around. In fact, it's more like a Medicare disagreement because they disagree on more things than they agree on. What we do need to see is the Federal Government sitting down with the state and territory governments and working out who is exactly responsible for what, having some accountability checks to make sure that we have national standards for our public hospitals and that the state and territory governments meet their commitments to make sure that their hospitals, wherever they are, meet appropriate benchmarks for quality.

SPEARS: At this stage we're yet to hear much from the Coalition on their health policies, but can the AMA at this stage give a tick to either side?

PHELPS: There's no question, in terms of the public hospital policy, that Labor has edged well ahead of the Coalition. We have yet to see a comprehensive public hospital policy from the Coalition. It's not good enough to say we've brought in a GST, that's enough, the states can do it. We do need to see cooperation between the Federal Government and the states so that everyone takes their share of the responsibility. When the Coalition does eventually, if it does, release its public hospital policy and its health policy generally, we'll be doing a check list and coming up with a report, fully costed, between the ALP and the Coalition policies.

SPEARS: You haven't had the best working relationship with Michael Wooldridge. Are you looking forward to him leaving at the election and is there any other Coalition replacement that you would favour?

PHELPS: I'm looking forward to working with a new Health Minister and I'm prepared to wait to see who that is and we have every intention of having a constructive relationship.

SPEARS: Kerryn Phelps, thanks for your time.

Ends