Dr Stephen Clark, Medicare Schedule Review Board - ABC Radio 3LO

Well, in between his other media commitments, that have now been threatening to swamp him, Dr Sutton will join us again on the program this morning to see where his case is at, but important developments on the political front, within medical politics.

A key government advisory committee seems to have been sidelined, and their job was to try to sort out the sorts of problems that bedevil doctors like Dr John Sutton, we'll learn more about that on the program this morning as well.

JON FAINE: Over the last few days we've been closely following the story of Dr John Sutton, a Melbourne family practitioner, a General Practitioner, a doctor who's been told he's going to lose his Medicare Provider Number because he doesn't see enough patients.

Dr Sutton's now been on most television stations, he's been on the news and in the newspaper after our story about him on the program earlier this week, and he will join us again this morning to tell us where it's got up to because I understand he got somewhat of a reprieve late last night, but only for a few days. He still may have to shut his practice by Friday, we'll talk to him in a moment.

But there is another dimension to the problem that is causing Dr Sutton so much anguish, and his patients too of course. Dr Sutton's problems are, basically, how do you make a living as a General Practitioner whilst delivering quality care to your patients. And that's an issue that's being grappled with by a high-level committee that advises the Federal Government on how much doctors get paid.

A member of the committee, which is called the Medicare Schedule Review Board, a member of that committee, is Dr Stephen Clark, who joins me this morning. Dr Clark, good morning to you.

DR STEPHEN CLARK: Good morning, Jon.

JON FAINE: How long have you been a member of the Medicare Schedule Review Board?

DR STEPHEN CLARK: Six years.

JON FAINE: Who appointed you?

DR STEPHEN CLARK: I was appointed by the previous Labor Government, Carmen Lawrence appointed me after negotiations with the AMA that was then lead by Brendan Nelson.

JON FAINE: During the term of the Howard Government though, you have continued to sit, and your advice has been sought?

DR STEPHEN CLARK: Yes, we've actually had 70 meetings, the Medicare Schedule Review Board, and so we've worked cooperatively to attempt to revise and renovate the Medicare Schedule.

JON FAINE: Has your work been supported by the current Government, and Dr Wooldridge, the Health Minister?

DR STEPHEN CLARK: Up until quite recently.

JON FAINE: How recently?

DR STEPHEN CLARK: Well, for the past six months it's been obvious that the Government bureaucrats on the Board with us have been under instructions not to allow firm recommendations from the Board. But it's come to a head last month when the last meeting of the Board was cancelled because there was quote, 'nothing to talk about'.

JON FAINE: How often do you normally meet?

DR STEPHEN CLARK: We normally meet every month or six weeks and we have been doing so for six years, and we're right at the point of being able to make firm recommendations to the Government in terms of our terms of reference.

JON FAINE: And what are those recommendations, in a nutshell for a lay audience, what are they likely to be?

DR STEPHEN CLARK: Well, essentially we believe that the structure of consultations needs to be radically revised so that patients and doctors get a fairer deal out of it. There are changes in fees to be recommended, in general terms we believe that consultative medicine has been undervalued, we are recommending changes, some up and some down, to procedures.

JON FAINE: It sounds as if you're in fact grappling with exactly the issues that have caused Dr Sutton and his patients such anguish.

DR STEPHEN CLARK: I would have thought so. There are major problems in the current Medicare Schedule. It's been in place for 25 years, when it was put in place it wasn't based on rationality, it was based on a thing called the most common fee, and it's gotten badly out of kilter.

When you have a highly regulated industry such as we do, it's important that there is sensible and fair regulation if the … if the system's going to work, and unfortunately the Medicare Schedule now is just riddled with perverse incentives, such as the ones Dr Sutton's facing.

JON FAINE: Perverse incentives. When's your committee supposed to meet next?

DR STEPHEN CLARK: Well, we're on hold I'm afraid.

JON FAINE: Why do you say that?

DR STEPHEN CLARK: Well, because the Government has suddenly decided that they don't want to hear from us, they don't want to get our recommendations for a … a final Schedule of Fees.

JON FAINE: You've been working on this now for six years?

DR STEPHEN CLARK: Yes, we've been working on it for six years, we've had …

JON FAINE: How … how much has been spent?

DR STEPHEN CLARK: Oh, between $8 and $10 million on consultants alone, let alone the meetings of the committee.

JON FAINE: Would it be fair then, if we can, to speculate about why would a committee that's been given a job that's been working on it for six years, that's spent millions of dollars of taxpayers' money to come up with a solution to a nagging sore in the health system, why would it, at the very end of its task, be told to stop work … what's your theory?

DR STEPHEN CLARK: I think it's about dollars, Jon.

JON FAINE: In what way?

DR STEPHEN CLARK: Well, I think that the Government reckons that they can paper over the cracks in Medicare more cheaply than actually do a proper renovation on the system.

JON FAINE: So, the solutions that your committee's coming up with are too expensive, or hurting too many vested interests, what is it?

DR STEPHEN CLARK: Well, they're hurting a variety of vested interests but those are mainly to do with subgroups of the medical profession that are in a relatively advantaged position. But, no, the … it's about … it's about dollars, and it's about the Government being prepared to keep Medicare intact.

JON FAINE: Have you asked the Government why the Board's work, that you're a member of, why its work is apparently now being sidelined?

DR STEPHEN CLARK: The AMA has asked the Government, and we're not getting any answers. Essentially, the Health Minister is refusing to discuss this with us.

JON FAINE: So are you the AMA representative on the Board?

DR STEPHEN CLARK: I'm an AMA nominee on the Board, yes.

JON FAINE: And you can't find out why you've been sidelined?

DR STEPHEN CLARK: No.

JON FAINE: This strikes me as being bizarre. I mean I'm quite foreign to the politics of the medical profession, but it would strike me as being very unusual for the Government's own advisory board not to be told why its meeting was cancelled, its taskforce has been disbanded, six or more million dollars worth of work is being ignored and you can't even find out why?

DR STEPHEN CLARK: Well, no, we can't find out why, but as I said it's reasonable to infer that it's about dollars. It's about the Government's commitment to Medicare. We believe that these problems, such as Dr Sutton has been facing, and there are lots of other similar sort of , what I said, perverse incentives, in the system, and … to sort that out is going to really require a major renovation of the Schedule Fee and the entire system under which health services are billed for Medicare.

JON FAINE: Well, that gives us even more reasons to want to talk to Dr Wooldridge about this, and the matters raised by Dr Sutton, who we'll touch base with in just a moment, to find out how things are going at his end as well. Thank you for your time this morning, very important matters that you've raised on the program this morning, I'm grateful to you.

DR STEPHEN CLARK: Happy to help Jon, goodbye.

JON FAINE: Dr Stephen Clark, who is the AMA nominee on the Federal Government's own Medicare Schedule Review Board, the taskforce of which has been disbanded and the last meeting of which has been cancelled, and as he said, they can't even find out why.

End.