Dr Kerryn Phelps, AMA President with Tracey Grimshaw, Channel Nine, 'Today'

Senator Patterson says non-specialist doctors cannot justify the increase. But the Australian Medical Association argues many general practitioners are simply trying to make ends meet.

We should point out that we did invite Senator Patterson on the program this morning, but our calls were not returned.

To discuss this issue we're joined now from Melbourne by AMA President, Dr Kerryn Phelps. Kerryn, good morning.

PHELPS: Good morning, Tracey.

GRIMSHAW: A bit of background. Who is charging this additional fee and how widespread is it?

PHELPS: Well, it's hard to say how widespread it is. What we can say is that over the last year we have seen plummeting bulk billing rates all around the country, and particularly in rural areas as GPs find that they can't keep up the struggle to continue to bulk bill and maintain their practices and then get hit with this medical indemnity increase.

GRIMSHAW: Why are some practices introducing this fee and not others? How are some making ends meet and not others?

PHELPS: Well, there are some practices where there are a large number of disadvantaged people. They might have high unemployment levels, they might have a large number of pensioners in their area, people who are on sickness benefits and so forth, and the doctors just don't seem to be able to bring themselves to charge the extra, and would prefer to either move out of the area and work somewhere else or just absorb the cost and their practices will go under, eventually. And doctors are trying for that not to happen.

So in areas where they don't want to leave, where they don't want to have to stop bulk billing their patients, they're having to charge the privately billed patients a certain fee to try and cover the medical indemnity costs that are hitting them at the moment, as well as the other costs. This is not just about medical indemnity.

So we are seeing that medical indemnity is really the straw breaking the camel's back.

GRIMSHAW: Kerryn, the Minister has accused these doctors of profiteering, which you take exception to. But can we crunch the figures a little bit? If this extra fee is $6 a patient, at four patients an hour at a 40 hour week and say a 40 week year, to be conservative, that's around $39,000 more a year. That's a fairly heft rise, isn't it?

PHELPS: Well, you have to understand that procedural GPs in rural areas are having to pay that sort of money for their insurance now. And if they're going to be hit with a levy on top of that, and they're talking about a 50 to 100 per cent increase for next year, the figures don't look so silly.

Now, the other thing is that the doctors who are having to increase their fees are, I understand, doing so for their private patients. They might only have 20, 30 per cent of private patients in their practices and they're having to either absorb the rest or put that cost onto the private patients rather than the disadvantaged people.

I mean the situation is this: We've briefed the Minister, we've briefed her department, we've sent them reports, we've talked about the GP workforce problem, we've talked about the problems of red tape, we've talked about the issue with medical indemnity.

Rather than the Minister trying to deflect the issue by accusing doctors of profiteering, which is an insult, it would have been far more useful to say, 'Listen, how can we fast track a solution to these problems for general practice?'

GRIMSHAW: On that, when was the last time you and the Minister sat down and had a briefing on what's going to happen with medical indemnity after December?

PHELPS: It's a few months ago now in Sydney. We met and we discussed a whole range of general practice issues specifically. I mean, we had two of our Secretariat members plus the Director of General Practice, we had the Chair of the AMA Council of General Practice and myself meet with the Minister and her staff. We ran through all these issues.

I tried to get a phone call conversation with Senator Patterson yesterday myself. My call hasn't been returned. I've offered a meeting today. I sent a fax yesterday. And it would just be, I think, far more useful for the Minister to speak to the profession and explain where things are up to with indemnity and come to a solution rather than go to the press making accusations and legal threats.

GRIMSHAW: All right. We'll leave it there, thank you.

PHELPS: Thank you, Tracey.

Ends