Interview - Dr Kerryn Phelps, AMA President Channel 7, 'Sunrise' Major product recall; proposed changes to Medicare

KOCH: A lot happening on the medical front today, isn't there? This big medical recall has to be a worry. It's reported people are being warned to avoid all herbal, vitamin or nutritional supplements until further notice.

DOYLE: Well, let's try to find out more. Dr Kerryn Phelps is President of the Australian Medical Association. Good morning to you, Kerryn. Thanks for joining us.

PHELPS: Good morning.

DOYLE: These allegations against Pan Pharmaceuticals are really alarming, I think, to most people. Just how serious is this?

PHELPS: I think it's extraordinarily serious. The allegations that have been made against Pan Pharmaceuticals, I think, are a scandalous breach of duty to the Australian public, and I think that Australian consumers have every right to be outraged by what they've heard about what this company has been doing.

KOCH: Kerryn, it also puts a real doubt in your mind about whether other pharmaceutical companies are doing the same thing. Is this industry-wide or just a rogue company, do you think?

PHELPS: Well, as far as we know from the Therapeutic Goods Administration this is one company. Unfortunately, it happens to be the major manufacturer of these products in Australia and is also a major exporter. So I think, if we really concentrate on the health concerns, Australian consumers depend on quality pharmaceuticals and quality nutritional and vitamin supplements for their health.

Now, unless they are getting what they're paying for, unless they are getting what the manufacturer is saying is in that product, then there are very serious potential concerns for people's health.

One is that you may not be getting any therapeutic benefit at all. Another problem is that you might be getting far more than you need and therefore suffer greater side effects. And one of the allegations was that the company wasn't cleaning out the machinery in between batches and so there could have been contamination of some products. So, I mean that raises the whole issue of the potential for allergy reactions too.

DOYLE: It's just horrifying. What should people do then this morning? If they normally wake up and take their vitamins, particularly I know that there's about 200-odd that have been released, names that you should avoid. But there's talk of thousands more could be affected. So should people avoid everything this morning until we know for sure?

PHELPS: A number of companies have said that they don't use any product from Pan Pharmaceuticals and the ones that have announced that have been Glaxo Smith Kline who make Panadol, Herron and Blackmores.

So I think that any product that you're taking, other than the ones that have been announced to be free of Pan Pharmaceuticals products, the warning is don't take those. Speak to your pharmacist and have a look at the newspaper. Check the registration or listing number. Every bottle of medication has either an AustR or an AustL number on it, on the front panel of the medication. You can check that against the list that's in the newspaper.

But it's going to probably be several days before we know exactly what medications are going to be involved in this recall and it could amount to thousands of brand names.

DOYLE: So Blackmores and Herron, sorry, they're the two at this point that are okay.

KOCH: And Kerryn, we just got a graphic on the screen at the moment with the website and the number for people to call if they want to check it out there and the full list.

Let's get on to the other big health issue today. And this is Medicare. Now I've read a lot about these changes in the 24 hours since it was announced, and I still can't figure out what it all means when I actually go to a doctor. How will it change?

PHELPS: Well it can be confusing for people to understand what goes on under the surface of Medicare. Because, if you get bulk billed, you go along to the doctor, you sign a form and that's the end of it. If you have a private bill, then you pay the doctor and you go to Medicare to get your rebate back.

But under these changes, people are going to have to understand a little bit more about what actually happens under the surface. And the way the bulk billing works, the doctor accepts the patient's rebate from Medicare as their full fee. Now the full fee, which is worked out by the relative value study which was a government-involved study that went over seven years, found that the proper fee to see a GP should be around $50. But Medicare only reimburses 25.

Now, under these arrangements, if doctors agree to bulk bill all of their pensioners and concession card holders, they'll get anything from $1 to $6.30 if they're in a very remote area of Australia extra per consultation.

Now you can do the maths and figure out that it's still a fairly major shortfall. So GPs are going to have to do their sums and they're going to have to work out whether it is worth their while to continue bulk billing all of these patients; to bulk bill only some of their patients, that is the health care card holders; or to move to completely private billing.

DOYLE: Labor is saying this is the death of Medicare. Is that right?

PHELPS: Well, I think for Medicare to thrive and survive, we really had to see full funding of the Medicare Benefit Schedule. I think it remains to be seen what happens to Medicare ultimately. But we are certainly seeing a seismic shift in the philosophy of Medicare. Rather than it being, as it was intended in the beginning, to be a substantial insurer for all Australians where it covered most of your health care costs, it only ever did cover 85% of the scheduled fee and not the whole scheduled fee.

It's really moved to being a partial contributor as an insurer and there's also been a move to allow the private health insurers to come in for being able to provide insurance for people who spend more than $1,000 a year on gap payments.

KOCH: Kerryn, the people I really feel for in all of this are low income families, people on the average wage with two or three kids that might have allergies or suffer from asthma. They are going to be hit like blazes with this, aren't they? They are going to find a really big increase in their health costs.

PHELPS: I think it is going to be a concern for some families. I have to say that traditionally my colleagues in general practice have subsidised families in that sort of predicament where they have children with a high burden of disease or where they have chronic illness in the family and discounted their fees, effectively subsidising Medicare which is what a bulk billing doctor has been doing.

And many will continue to do that, but it becomes an economic reality after a while that there're only so many people that you can subsidise before it becomes economically unviable for a practice.

So doctors are simply going to have to do their sums and I think that the really important thing for Australians is, when you have someone in your family who is sick, can you get into see a doctor? Do you have access to a GP?

And so these workforce measures that have been announced, we do welcome more medical students, more GP trainees and ultimately more GPs coming in to work in general practice. But in the long term I think it's really important that the Government gets to grips with making sure that general practice is an attractive specialty for young doctors to go into.

KOCH: I know our local doctor is actually full. You can't get in as a new patient. They're so good. And it's a problem all over the place at the moment. But Kerryn, just to wind up, tell me what happens to my Medicare levy? We all pay one and a half percent of our salary. The budget raises over $5 billion a year. We're encouraged to take out private health insurance and the system still doesn't work.

PHELPS: Once again it comes down to the numbers. The Commonwealth health budget is $30 billion so the Medicare levy only goes a very small way to covering the cost of providing a health care system. If we were to pay the full cost of health from the Medicare levy, we would be paying a greatly increased percentage of our salaries into a Medicare levy than we're currently paying.

It's just a small contribution. And so people, if they want the public health system, they are contributing to it through their Medicare levy and through their taxes, but it doesn't cover the full cost just from the Medicare levy. And even then, what we're now being asked to do as taxpayers, is to also contribute at the point of seeing the doctor.

DOYLE: So it still doesn't sound like it's fixed by any means. Dr Kerryn Phelps, thank you for your time this morning. We do appreciate it.

PHELPS: Thanks.

DOYLE: As David said, a big issue. I'm sure this is not the last that we'll be talking about it in the very near future. We'll talk to you soon.

PHELPS: Good morning.

DOYLE: If you'd like some more information though on the herbal drug recall that we talked about a bit earlier, you can call the number on your screen. This is a helpline, 1800 22 000 7 or you can log on to www.tga.gov.au and there are also lots of ads in major newspapers today across the country listing a lot of those drugs that have been recalled. But, obviously, more will be coming out over the next few days.

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