Interview - AMA Vice President, Dr Haikerwal with Paul Bongiorno, Michelle Grattan & Jennifer Hewett - Channel 10 "Meet the Press", Sunday 8 August 2004

COMPERE:                                    You're on Meet the Press, and the biggest doctor organisation in the country, the AMA, has been critical of the free trade deal from the outset.  The doctors claimed early that if the Government was serious about protecting the pharmaceutical medical scheme, it wouldn't have been on the table in the first place.

                                                         Today, AMA vice-president Dr Mukesh Haikerwal meets the press.

                                                         Thanks for joining us doctor.

DR MUKESH HAIKERWAL:        Good morning.

COMPERE:                                    I wonder if you could give us the basis of the AMA's concerns.

DR HAIKERWAL:                          Well, as you said in your introduction, the AMA would have preferred that the Pharmaceutical Benefits Scheme was off limits as far as a free trade agreement was concerned.  It's always been a target of big farmer in the US to knock on the head the PBS, because it's such a fantastic system that affords every single citizen of Australia access to drugs at a reasonable price with a reasonable cost to our PBS budget.

                                                         And that model has been taken up overseas.  Other countries want to take it.  And so to do some of the health management organisations in the USA as well as some of the states in the USA.  And that's why we're a target.  Not so much because of the one per cent of the international budget on drugs that we make up.

COMPERE:                                    Would that have been realistic, though, for our Government to say sorry, no, we're not going to talk PBS, it's not on the table?

DR HAIKERWAL:                          Well, it's certainly some of the American House of Representatives people have said the same thing - some of the people in the American Parliament - and their senators said the same sort of thing.  That it should have been off limits. The health of a nation is not the business of trade.

MICHELLE GRATTAN:                 Are you satisfied with the compromise that seems to be evolving?  I know we haven't seen the amendments yet, but we've just heard from Stephen Conroy the thrust of Labor's amendments.  Do you think that these will be adequate?

DR HAIKERWAL:                          Look, we've been out there shouting and screaming about the need for transparency in the whole PBS system, and also about the way in which the PBS - a review process that's been put in place by the free trade agreement - has been rolled out.

                                                         So we had - we were reasonably comfortable with the way in which the Government had responded to the concerns of the community, and certainly our concerns.  But what we see with the suggested changes from the Labor Party are very similar to the position that we put forward to the Senate and to the Joint Standing Committee.

                                                         So yes, we - we see some greater improvements to the system, because what's ultimately the goal here is to make sure the PBS stays intact.

MICHELLE GRATTAN:                 Do you think there's a danger that the drug companies will crash through, however, whatever safeguards are put in over the next week?

DR HAIKERWAL:                          Look, I think there is some common sense with the Medicines Australia as well - they have to work with the system, they have to work with the Government, and they've got to have the public on side as well.  And if they do do things that are particularly out of order, I think that they will pay for that in a different way.

                                                         I think what's important is that there's a cross sector way forward through this, and that's to make sure not only are the prescribers and the dispensers and the consumers happy here, but the people who pay for it - the Government in the main, and the manufacturers - actually understand why the PBS is such a good system.

MICHELLE GRATTAN:                 But the ...

DR HAIKERWAL:                          They claim they're not getting good money.  They're actually getting pretty good dollars for the drugs that we pay.  It's not the same as in the USA.  But it's certainly - they're not getting ripped off.

JENNIFER HEWETT:                   But the generics industry here actually seems to be a lot less concerned about this than, for example, the AMA.  Why is that?  Are you saying they're wrong?  They're the experts, aren't they?

DR HAIKERWAL:                          Well, the generics industry was also happy with the compromise that the Health Minister laid out in his discussions around the review process.  And also their statement towards the end of last week confirmed that.

                                                         I think that at the end of the day there is a greater threat, and that greater threat is something that hopefully will be addressed by these suggestions that we've made and that Labor seem to be moving towards.

MICHELLE GRATTAN:                 So you think that it's - that actually in the end you'll get a pretty good result?

DR HAIKERWAL:                          Look, I think so.  I think that what we're seeing is a cross community realisation of the very importance to us, as a society, of decent medications, of access to those medications to keep our health intact, and also to prevent us from getting ill in the first place.  And that's the PBS, and that's something that's almost sacrosanct, and I think that's where it should remain.

COMPERE:                                    From the AMA's point of view would it be better for the free trade agreement not to go ahead if Labor and the Government can't agree on a safeguard amendment?

DR HAIKERWAL:                          Look, the AMA's brief is look after the interests of our members and the patients that we look after.  And we can really comment on the PBS specifically, and also with intellectual rights.  We really can't comment on the whole of the FTA.  That's a bigger than the medical association kind of picture.

MICHELLE GRATTAN:                 Could we just change to the issue of health in the coming election.  Do you think that the Government with its changes has managed to neutralise the health issue?

DR HAIKERWAL:                          Look, I think there was an obvious move to make sure health comes off the agenda, but quite clearly it's never going to get off the agenda.  It's clearly one of the most - if not the most important people - concern to people coming up through  to the election.

MICHELLE GRATTAN:                 So what about bulk billing?  Where are we up to on this?  Do you think more should be done, or has the Government done sufficient?

DR HAIKERWAL:                          Yeah, look, we need to move away from bulk billing as being any kind of an index of how good the system is, or how accessible the system is.  What is important is that people actually get access to seeing a doctor, getting access to the medical services in hospitals, and having services to make sure they can remain at home when they're elderly, and all stages of their life.

                                                         So the system needs to be integrated.  It needs to be something that people can move through without too many snags along the way.

MICHELLE GRATTAN:                 Sounds like Labor's scheme.

JENNIFER HEWETT:                   Yeah.

DR HAIKERWAL:                          Well, not necessarily.  I mean, I think that both - what we saw the health ministers come together at the AHMCS meeting the other week with a - a view of reinvigorating the previous efforts, and working well together.

                                                         You know, if there is a big bang and there is only one tier of Government, which has been mooted over recent months, that's not going to happen tomorrow, and in the time it takes to move - in the transition towards that stage we're going to have to continue the states and the Federal Government working together.  And that's important.

                                                         And when we do have the big bang, if there is a big bang, and there's one tier of government, we're still going to have local offices of that one agency, which is not going to see a complete removal of the number of people working in the bureaucracies.

JENNIFER HEWETT:                   Is there one side or the other that has a clear advantage as far as the AMA's concerned, going into this election with health policy?

DR HAIKERWAL:                          It's too early to call from a party political basis.  We've put out a key facts brochure that we've - Dr Glasson, our president, highlighted the Press Club speech.  And those are the things that we're going to be looking at when the policies are put on the table.

                                                         But what we say quite clearly is that people want access, and a poll that the AMA did shows that they are very concerned about accessing a doctor.  They also want choice.  And they also want things to be cost effective and affordable.

MICHELLE GRATTAN:                 Sounds great if you can get it.

COMPERE:                                    Just to - just very briefly, because we're just about out of time, there are some in the Government that are suspicious that the AMA has changed sides - that it used to be more user friendly for the Coalition, but it seems to be more user friendly for Labor now.

DR HAIKERWAL:                          We've tried assiduously and will continue to do so to be totally bipartisan here.  We are ...

COMPERE:                                    Okay.

DR HAIKERWAL:                          ... a medical political organisation, but we're not party political.

COMPERE:                                    Thank you very much.

DR HAIKERWAL:                          And we'll listen to both sides.

COMPERE:                                    We're right out of time.  Thank you very much for joining us today, Dr Mukesh Haikerwal, from the AMA. 

Ends