Interview with Dr Kerryn Phelps, AMA President, ABC Radio 2BL - Discussion of the new Bill for changes to the medical indemnity insurance

As you know the government has been under pressure particularly from specialists working in the public hospital sector, Angela, that they have to consider whether or not they are going to continue.

Because the type of insurance that they pay, the premiums have been going through the roof and the Government's come up with this reform package, which hasn't actually pleased everyone.

But the reform package is along the lines of the medical, motor accidents insurance scheme and they're talking about capping damages for people who sue doctors. They're also talking about regulating the insurance industry.

It's an interesting one, they predict a 12 per cent cut in premiums if this reform package goes through. But there's a lot of water to go under that proverbial bridge before it comes to legislation, Angela.

A. CATTERNS: We've apparently got Kerryn Phelps and Nick Marr from the Law Society on the line, we might talk to Doctor Kerry Phelps first, the Federal President of the AMA. Good morning, Doctor Phelps.

PHELPS: Good morning.

CATTERNS: Do you support these proposed reforms?

PHELPS: Yes, we do. Of course it's early days yet and we need to work out a few of the details. We had to do something. The Government had to act because the situation with medical negligence and the legal system had come so out of hand and the premiums had reached a stage where doctors were simply dropping out of practise in higher risk specialties and there was no other solution. Because the legal system that governs this particular area of law is just a farce, it's ludicrous the way it's currently administered.

CATTERNS: Nonetheless you understand the argument against it.

PHELPS: I understand that the lawyers are a bit upset about it because they've been making a lot of money out of this area of law.

CATTERNS: Yes, but some patients may be upset by it too.

PHELPS: Well, I think the patients realise that the current system is very cumbersome, it lacks the elements of social justice in that a lot of people are spending a great deal of money for no results when, quite often what they want is an answer to why things went wrong in their treatment.

At the moment the only way of getting those answers is you go through the very expensive and very distressing adversarial legal system where nobody is prepared to talk to anybody because they're concerned about how that will come out in a legal sense, when it goes to court and how it will look. For example, if somebody apologises for a bad outcome, does that mean therefore that it's going to impact adversely on them when it comes to court.

One of the reforms that was being talked about is compulsory mediation between the doctors and the patients who've had a bad outcome so that the patients can understand what went wrong.

There is going to be a reform of the expert witness situation so that expert witnesses are exactly that and recognised as such by their peers. And also so that the judges and the judicial officers who are involved in these cases know what they're doing. That they are also well trained experts in their field. That is not consistently happening at the moment.

CATTERNS: What about the government regulating the insurance, Doctor Phelps, as Steve Chase mentioned earlier this morning, they used to cherry pick, the insurers would cherry pick the doctors. Do you like the idea of the government regulating the insurers now?

PHELPS: I think what they're trying to do is to prevent cherry picking happening in the future. It's not happening at the moment, but we are getting some new commercial insurers sniffing around the market and looking at picking off the lower risk specialties.

At the moment here are some cross subsidisation between the specialties and if we didn't have that, then areas like neurosurgery and obstetrics would be unfordable for patients. Because the cost of the actual insurance, without the cost subsidisation between the different specialties would have to be passed onto patients and they would find that average people would simply not be able to afford to have their brain tumour or their spine operated on, or have their baby delivered.

CATTERNS: Well, Dr Phelps, what do you say to the lawyers who disagree with damages caps for patients?

PHELPS: Well, lawyers get a cut of the action and in fact over a half of awards made to patients go to lawyers. So, I think, that you can see their argument and where it's coming from and I don't have a great deal of sympathy for it, frankly.

But a lot of the more sensible lawyers that I speak to and I've discussed this with a number of lawyers. They see that mediation is a more humane way to proceed. They see that changes to law reform will sustain patient's rights in the future. And doctors are also interested in sustaining patients rights to being able to get answers and to get appropriate and adequate compensation where there has been negligence.

But now where there has simply been an adverse outcome because the patient has had an illness, a disease or medical problem that has meant that they didn't do well and unfortunately that's one of the realities of being a human being is that things don't always go well in the human body.

Doctors are not always at fault when things go wrong, sometimes it's the systems, sometimes it's other factors entirely, but because doctors have this insurance scheme, it seems to come back on doctors to have to be the ones that pay out where there has been a problem.

CATTERNS: Alright, thank you for joining us.

PHELPS: My pleasure.

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