Dr Kerryn Phelps, AMA President, With John Jost, Radio 3AK, Drive

Because it is a very complicated exercise to be … to run the AMA in Australia, especially in a situation where the health scheme seems to be bits falling off it and things aren't always going too well and there's a lot of pressure everywhere, I guess, every which way you look from where you look. Would that be correct, Doctor?

PHELPS: I think you'd be absolutely spot on. We've got a very big agenda and, of course, in the lead-up to an election it's the job of the AMA to make sure that we do get assurances from the major political parties that they have the interest of the health system at heart for the sake of the public.

JOST: Is there any difference, from your perspective, between any of the political parties?

PHELPS: Yes, I think there are fundamental differences. I believe we have yet to really see the writing on the wall for either of the major parties and we'll certainly be seeking those assurances over the coming months.

JOST: It's a lot easier for the smaller parties to give an assurance, isn't it?

PHELPS: Well, it is, but I think that's critical, as well. I think if you look realistically at the lobbying process in Canberra, at the moment you do have minor parties who have the control of the Senate, and they are able to make or break legislation. And we've seen that quite a number of times just in the last year, with different types of health legislation. We saw it with the GST, of course.

And so you do need to bear in mind the influence of the minor parties and I think it's very important that all of our elected representatives, whether it be in the House of Representatives or the Senate, when they're making laws that will affect the Australian people that they are very well informed. And that's one of the jobs that I do, is to make sure that our parliamentarians are well informed.

JOST: Well, I certainly wasn't being pejorative about the minor parties, because actually I just talked to a Democratic Senator from Queensland, and he's only been in the Senate a month. And what interested me about him, he's written a story to The Age pointing out that food prices have gone up 17% over the last five years and inflation's been 11%.

Now, you know, that is a very useful piece of information for somebody to come up with.

PHELPS: Well, I was at a meeting today and one of the people at this meeting was not a doctor, was not involved in the health sector other than as a potential patient - as everybody is - and she said to me, `Look, how can somebody as an individual have an influence on the health debate?'

And I said, `Well, the most important thing you can do as an individual is to be aware of the issues and to write letters to the editor, to write to your local MPs.' And I also think that you don't have to be a member of a major political party as a politician to have influence. And each individual in a democracy has an equivalent right to the others to have a say in what goes on. Obviously majority rules.

JOST: You know, it's interesting, talking about having an issue … an interest in the issues, because the issues, health issues, are inherently personal. I mean, if you don't need to go into hospital then you're not going to worry about the availability of a hospital bed.

If you need to take cholesterol tablets and Dr Wooldridge says that you shouldn't get them free, or you should pay a bit more for them, then obviously it is a health issue for you. It's really difficult to reconcile the importance of issues, isn't it?

PHELPS: What's unique, I think, about the health sector is that sooner or later - and it's usually sooner rather than later - you will come into sometimes a collision course but you'll certainly have something to do with the health sector. If it's not yourself it will be an elderly relative, it might be one of your children, it might be your partner, a loved one, a best friend. Somebody you know is going to be affected by the health system.

And we saw that, of course, recently with the Leader of the Opposition who had a personal experience with the public hospital system when it wasn't working as well as it might. And I think it's very important that people do take an interest because, for example, it's only going to be a matter of time before you're going to need the services of your public hospital…

JOST: Absolutely.

PHELPS: …or you're going to need to arrange for an aged care facility for one of your elderly relatives or you're going to need to be admitted through an emergency department. You need to care about what's happening in our health system, I believe, for the future of the country.

JOST: You know, it's interesting. I've been through the … we've all … you know, I guess at a certain age we all have parents that go through the aged care system and we have to choose, and sometimes it's quite a fluid situation because you don't know which one to choose. I'm talking about the level of care, whether it's going to be sort of … and I have to say it's a bit of a nightmare.

But really what I wanted to ask you, I guess, was out of all those issues what is the most prevalent issue so far as … or the most common issue so far as the bulk of people are concerned? Would it be hospital availability? Bed availability?

PHELPS: We get a lot of feedback, not only though the letters to the editor columns in the newspapers but also talkback radio, and we get a lot of people writing and emailing me at the AMA. And certainly I think the thing that has really pressed a button most in the last six months would have to be the aged care issue. I've had absolutely heart-wrenching stories from people who have been separated from their partner when one of them needed to go into a high-dependency facility.

I've had letters from children of elderly parents who are absolutely beside themselves because they just don't feel like that they've got a decent choice between facilities in their area, that they're worried that their parents will in fact be dead before they come up on the waiting list to the top of the waiting list of one of the higher quality facilities. And they're very, very worried about their own futures and what the future holds for them if they need high-dependency care when they're elderly. And bearing in mind the majority of our elderly people don't need that sort of care when they get older, but for those who do, I believe we need to focus on that with compassion and with caring and to make sure that those facilities are the sort of facilities we'd each and every one of us be happy to be in if the time and the need arose.

JOST: Well, when I went on my travels looking for facilities in my particular case, I saw some extraordinary places, mainly because, you know, finance wasn't really a problem for my mother but the problem was actually finding accommodation. And as it turned out, something came available.

And I went and saw some places. I mean, clearly they were run by very good people but they were impoverished in their quality and I think most people would be shocked if they'd seen them. And, you know, you see these little places behind a suburban fa ade and it looks quite cosy. You go in there and it's not respectful of humanity.

PHELPS: That's my real concern, is this issue of dignity and respect for those elderly people when they can no longer look after themselves. And I believe that that should be the bottom line for any planning for the future. And we can't just plan for the next election cycle or the next decade, we have to plan for the next generation.

JOST: Yes, and we should build timeless facilities, I think. Incidentally, I'm not … these people … some of the people that I met working in aged care really have the highest motivation, terribly good, you know, people in the best charitable sense at work, I thought.

PHELPS: Absolutely. And I see some wonderful commitment and passion from the people working in the sector. I guess what I'm saying is that the entire sector appears to be under-funded for the amount of unmet need that there is. And- -

JOST: I'm certain. And it's going to get worse, isn't it?

PHELPS: It will get worse unless it's addressed in a very fundamental way. And I think we need to look at the design of these facilities. I think we need to look at whether partners can be accommodated when they have different dependency needs. I think we need to look at a whole range of different factors to do with compassionate aged care. We need to look at different types of facilities so that it's not a one-way street. You might go into hospital for a while, go into some sort of transitional care.

We need more support for people who are able to stay at home, if only they had somebody to do their shopping or, you know, to visit to help them with their medical needs or their nursing needs, and to support the GPs who are also looking after them.

JOST: Yes, look, if any of you have a question for Dr Kerryn Phelps, call us on 9867 1116. are parted in this way.

JOST: Well it is, it's tragedy isn't it Kerryn?

PHELPS: It is, absolutely, and we have to take a holistic point of view. And one of the things that I would like to see, whichever government is in after the next election, and that is sorting out the government … the commonwealth and the states' responsibility for the health system to ensure that there is smooth running at all levels of government.

And there's not this constant shifting of blame between one side of government … one type of government, at state level and the other at commonwealth, as to who's responsible.

CALLER: I think the people working in the health have to get their act together too, because a lot of them work against particular political groups that are in power.

JOST: Oh well I think we've got a bit of political chicanery from two callers in a row here. Kerryn Phelps, thank you very much for coming in today.

PHELPS: My pleasure John.

JOST: Terrific quick half an hour that was.

ENDS