Launch of AMA Informed Financial Consent (IFC) Campaign

Nineteen per cent of hospital episodes currently don't have proper informed consent around them. We want to improve that dramatically. This is a hard hitting campaign that will, we hope, do that. We believe the education campaign is important, we believe it will be successful and we think it's very important that this campaign is given time and given support, the support of the patients, the support of the insurers and, indeed, the support of the government. The Minister has been very kind to help us working with a group, with the insurers, the hospital and the AMA, and it's very important that we have a chance to make this succeed.

The drive has been from the AMA with the support of the Government and other people and it's very important at the end of the day that patients understand what their fee is going to be.

The gap at the end of the day is made up of the doctor's fee and what the insurers pay is rebates and indeed what the Government from Medicare Australia pays as well. It's important to be clear, to be clear of what the fee is and to be clear about what the rebates are going to be, and that's where we have to work with insurers, so people are clear at the end of the day what their out of pocket costs are going to be.

So 'Let's talk about fees', it's a campaign we're launching today. This is the down payment. We've been saying for some time we're going to do it, so we're doing this now, we'll be working more collaboratively and doing other things in due course with Government, but at this stage this is us saying we're going to do it and we're getting on with it right now.

TONY ABBOTT: I'll just say a few words if that's OK. I'm very pleased to be here with Mukesh this afternoon. I think this is a very important initiative from the AMA. I think that the AMA has grasped this particular nettle and I want to congratulate them for what they've done and what's been launched today.

We can't have an effective public health system without an effective private health system, and we can't have an effective private health system without an effective private health insurance system. And probably the biggest single problem with our existing health insurance system as far as the patients are concerned is the extent of nasty surprises after their procedures are done. We have marvellous doctors, we have marvellous hospitals, they do an extremely good job clinically, patients are invariably happy with the outcomes clinically, but they're often quite dissatisfied with what happens afterwards. So we've got to try to make sure that as far as is humanly possible there aren't any nasty surprises that patients get after the procedure. That's why informed financial consent is very, very important.

Now, we've had a lot of improvements over the last few years thanks to the hard work of the AMA and thanks to the cooperation of the profession, but there's still quite a long way to go. As Mukesh said, 19% of privately insured hospital episodes currently involve a gap for which no informed financial consent has been achieved. And we need to improve that pretty dramatically over the next 12 months.

Now I think this is an important initiative, I think it's a very important first step towards making a big difference over the next 12 months. I'm very happy to be here with Mukesh and I look forward to continuing to work with Mukesh and the AMA, with the insurers and the hospitals, with Bill Glasson, the former AMA president who is chairing a working group how to try to improve this and other issues connected with private health.

And I think this is, as I said, a very important step along the path we need to take.

QUESTION: Asking what something's going to cost seems like a pretty simple thing to do. Do you think the average Australian fears that confrontation of talking about how much something costs? Do you think that's what's contributing to...

TONY ABBOTT: Look, I think all of us sometimes get a bit squeamish about talking about money. I mean I think we all tend to have a 'don't ask, don't tell' approach to this. Now, I think we have to learn to be upfront about it. The patients need to ask and the doctors need to tell. And that's what this initiative from the AMA is going to encourage.

DR HAIKERWAL: We've got to move our business practices of the practitioners into the 21st century. So modern practice demands that you're upfront talking about the elephant in the room - the fees. And I think that this is moving those 19% I suppose at consultation that currently don't have informed financial consent into that arena of having consent.

Now, it's something that we want to encourage doctors to do, but also encourage patients to do because it's important the patients don't feel shy about it, they should ask about it. In fact it should actually be talked about before they have to raise it. But if it's not raised and they want a clarification it's important they do that.

QUESTION: The 19% - is there a reason why patients aren't being informed in those cases?

DR HAIKERWAL: Some of those 19% are cases which will continue not to be able to achieve informed consent because they're emergency situations. The others are on mechanical details, communication between the doctors that are involved in the care, and that's what we're trying to improve. The anaesthetists are really very behind this move, the surgeons are very behind this move.

So I think we've got all people in the boat pushing in the right direction, and we've just got to make sure that we capitalise on it and make the best deal out of this.

QUESTION: So it's not compulsory?

DR HAIKERWAL: We don't believe it needs to be compulsory, we believe that if we educate people, if we make sure people understand is the right thing to do and they feel comfortable doing this then not only will doctors talk about the fees, but so too will patients. And everybody will understand what the outcome's going to be.

QUESTION: What will after a year or within a period of time you set that this is not working?

TONY ABBOTT: Obviously as the Government we reserve our right to do whatever we think is ultimately necessary to bring about a good public policy outcome. We certainly have made all sorts of things over the years mandatory, but I think that what we're seeing today is a very important sign of seriousness from the AMA. I think that a lot's been achieved, I think with today's announcement and things that are going to happen over the next couple of months we can by way of an education campaign get IFC rates up very significantly. So at the moment I think this campaign should be given a chance to work.

But people should be under no illusions, the Government is determined to bring about a situation where IFC is normal standard practice, and only in rare instances doesn't happen, rare instances where there are reasonable explanations such as an emergency, such as some unforeseen and unforeseeable circumstance and the Government and the AMA are today working together to try to bring this about.

DR HAIKERWAL: The AMA's campaign launched today - 'Let's talk about fees' - is very much about making sure the doctors are supported in this role of being able to give good, informed financial consent and making sure people are aware of what fees they're going to be charged, and they're actually comfortable talking about fees.

QUESTION: Hundred per cent of episodes except those emergencies is, it would seem, fairly ambitious, will the Government be monitoring the situation, measuring outcomes to ensure that's the case?

TONY ABBOTT: Yes, look I'm certainly planning to repeat the IFC survey which took place in November/December of 2003, sorry was it 2003? Anyway, the previous IFC survey I'm certainly going to repeat, and obviously that will be a very good opportunity to gauge how we're going and whether we actually are getting the results that both the AMA and the Government want from this education campaign.