Dr Kerryn Phelps, AMA President, Parliament House, Canberra
PHELPS: The AMA has come today to Parliament House to put the case for the health system of Australia. We are looking at making sure that Medicare is fully funded. We want to see medical indemnity issues addressed in this country. We also want to make sure that aged care and our public hospitals are properly funded. We have put our Budget Submission… how it's going on … lacking in commonsense?
PHELPS: There's no question that the ACCC needs to be looked at in terms of the health sector. The AMA wants to see an independent inquiry into the activities of the ACCC and into the implementation of the Trade Practices Act in the health sector, and the time for 'quietly speaking' with the ACCC has well passed, because we cannot get commonsense answers. And in my discussion with the Prime Minister last night, the Prime Minister said that there were some of the scenarios in the health sector with relation to competition policy that failed the commonsense test, and we would have to agree.
JOURNALIST: What are those issues?
PHELPS: Well, one issue, for example, that the ACCC brought up itself was that, say that there were a group of three GPs who perform obstetrics in a local country hospital, and they decide that they can't afford to continue to all continue to provide obstetric services. And so they say 'well, one of us will continue to pay our medical indemnity insurance and continue to deliver babies at the local hospital'. Now, the ACCC said that that is a primary boycott and those doctors would be facing massive fines if they came to that arrangement between them. Now, that's the sort of thing that is pushing obstetrics out of the country, and we cannot tolerate that continuing, because the Australian public are missing out on services.
JOURNALIST: How can the AMA see a way out of that situation?
PHELPS: We have asked for an independent inquiry into the activities of the ACCC in the health sector and particularly into competition policy in health. And there may need to be some changes to the Trade Practices Act which will protect certain activities in the health sector, which include things like doctors being able to discuss rosters and work collaboratively, particularly in country areas.
JOURNALIST: Just on the public health issue - the power lines have had the Health Minister come out and say 'keep your children away from high voltage powerlines' and another report suggesting problems. Do you think anything should happen on this?
PHELPS: I think this is a serious concern for parents of children and what we need to do is to look at the evidence. And, I would have to take that question on notice because I think that what we have to do is to look at not just one study, but the bank of evidence around the world. And, certainly, if we need to do more research in the Australian climate, then we need to do that. But I wouldn't be able to make any kind of firm statement about what should happen to people with children around power lines at this stage until we know more.
JOURNALIST: Just back on the obstetricians - are you saying that the ACCC is the main reason for the small number of obstetricians in the country areas?
PHELPS: There are a number of reasons why obstetricians in rural areas are finding life very difficult, and GPs who are performing obstetrics. And, certainly, one of them is this fear of the action of the ACCC against them for things like rostering. And one of the other major issues, of course, is the problem with medical indemnity, and I'm pleased to see that the New South Wales Government has moved to tort law reform - and that's a very important move. And I also have pressed with the Prime Minister the importance of structured settlements which means that we need a minor change to the taxation laws so that people who take their settlements for major injury over a period of time, year by year, are not taxed - in the same way as a lump sum settlement is not taxed. And that means that they would be able to support themselves, financially, throughout their lives rather than go through the money in the first few years and then be dependent on the system again. So, there is something that the State Governments can do, there is something that the Federal Government can do, and it is now a matter of urgency and it's biting, first, in the country.
JOURNALIST: Is it making life difficult for doctors in the city, as well?
PHELPS: It's making life virtually impossible for some doctors in the city. Obstetricians are questioning whether they can continue to work in the public sector in the cities. And we're also finding our neurosurgeons are questioning whether they can continue to provide services in the public hospitals. And this is why the New South Wales Government has moved swiftly now to introduce tort law reform. And the AMA will be working with the New South Wales Government to ensure that that package is something that will make a difference to medical indemnity.
JOURNALIST: Back on the ACCC, is it making life difficult for city doctors, as well as country obstetricians?
PHELPS: The ACCC is causing tremendous concern for doctors in city and country areas. For example, the AMA in Western Australia has a very serious action against it at the moment by the ACCC, and it is questioning whether it is able to represent doctors in their negotiations in hospitals in city and country areas. We're finding that GPs, for example, who are in a group practice, if they are under one corporation, or in one company structure, then they can talk about their fees and have a sensible fee structure in their practice. If those same doctors, same patients, in the same place, are working as an associateship, then they are in breach of the Trade Practices Act if they even talk about their fees. Now, this just doesn't make commonsense. So we do really need to look at the health sector as different. It is causing serious difficulties for doctors, not only in the country areas, but increasingly in the city.
JOURNALIST: Is Allan Fels a little too focussed on his own PR?
PHELPS: We would certainly like to see Allan Fels looking at the logistics of running a medical practice rather than the logistics of sending out a press release. And we are now looking at a necessity for an independent inquiry into the ACCC and into the Trade Practices Act to make sure that the whole area of competition policy makes commonsense for medical practice.