Dr Kerryn Phelps, AMA President, with Philip Clark, Radio 2GB
CLARK: Yesterday we saw an important debate - health policy. Now, that's what we should be getting down to - the tintacks, the nitty gritty. Health policy has been at or near the top of the issues list of every opinion poll published this year, and yesterday we finally had some nuts-and-bolts focus on health policy in the federal election. That was not before time, in my view. Kerryn Phelps joins me on the line. She is the AMA's Federal President. Dr Phelps, good morning.
PHELPS: Good morning, Philip.
CLARK: You saw the Michael Wooldridge Jenny Macklin health debate, yesterday. The competing policies are out on the table. What do you think?
PHELPS: I think it was quite an interesting debate in that we were seeing a minister - who's not going to be there to implement any policy and so was taking, I think, more of a retrospective view, and an aspiring minister. And we were able to see, I think, some differences between the two parties. And I think, first of all, I guess, in terms of what is the same, neither party appears at this stage to have a strategy for addressing increasing patient gaps because of the deficient Medicare Benefits Schedule and therefore a decline in bulk billing rates. Both parties have the same policy on private insurance at this stage. There appears to be no difference between them. But where we start to see some differences is with the attitude of the two parties to fairly major structural health issues like how the Commonwealth and the States relate to each other on health funding, public hospitals and aged care. And I think at this stage you would have to say that the ALP has more substantial policies on those areas.
CLARK: With the rise and rise of the GST in future years, this will see more money going to the States, unquestionably. Where the States spend it, of course, is another thing. Is health going to share in that bounty?
PHELPS: This is what makes it so vital that the Commonwealth and the States get together and work out some accountability measures, because at the moment a great deal of Commonwealth money is going into public hospital spending. In fact, the entire health budget of $29 billion and increasing every year, as it must. But at the moment, in terms of our public hospitals, there is no national standard for public hospital care. There is no accountability of the States in terms of what they spend on public hospitals and what sort of outcomes there are expected, what sort of quality measures are in place. And unless we get the Commonwealth and the States sitting down together and working out what happens with that money and working out some national standards, then I think that we will continue to have a place for states to hide if they're not doing the right thing by hospitals.
CLARK: Okay. Now, you say on that critical area, Labor's got a better approach than the Coalition.
PHELPS: Well, they have an approach, which is a great start. They have announced the concept of this Medicare alliance, which is the notion of the Commonwealth and the States agreeing on what needs to be spent on hospitals and how it ought to be spent. And I think that whichever party is in power after the next election should really look at getting together with the States and trying to work up an agreement so that there is accountability. And I think that that would be a big step forward, and we've been saying it for quite some time.
CLARK: All right. On the critical issues of bulk billing though, no change you say. On the critical issues of a greater number of people taking up private health insurance, no change - well, no difference between the parties?
PHELPS: No. Well, if you look at the bulk billing issue, both parties pay lip service to supporting Medicare and having universal access to affordable health care, which sounds great, in principle. But unless you're prepared to say, 'well, okay, we've got a universal insurance scheme in Medicare'. I mean, if this was a public company, this was not a monopoly insurer for general practice, then they'd be out of business because they're really providing less than half of the value of the general practice services now, and that's why bulk billing rates are declining. And both parties are saying that they support universal access but neither of them are prepared to put the money in that's needed to continue to sustain the system, and we will see over the next couple of years the virtual disappearance of universal bulk billing.
CLARK: Will we see … maybe this is an impossible question to answer. Is it possible to make a judgment over either the Coalition or Labor's health policy as it's on the table right now, in your view? Is it possible to make a judgment as to whether waiting times for elective surgery and treatment times for emergencies in public hospitals will be the same, better or worse?
PHELPS: The ALP has a policy. It's been costed out at $545 million over four years. But about half of that money comes in in the fourth year, which is in the next electoral term.
CLARK: Exactly. It's all in the never-never, isn't it?
PHELPS: It is, and so that's disappointing. But as I said, they at least have a public hospital policy. The problem with the Coalition is that they're saying that it's the States' responsibility. And frankly, speaking for the medical profession, we're sick to death of hearing that the Commonwealth say that it's the States' responsibility. We'd like to see some national leadership on this issue. It's a nationwide effect and if we're not spending enough on health, then let's have that debate.
CLARK: All right, Dr Phelps, good to talk with you.
PHELPS: Thank you.
Ends