Launch of the AMA Key Health Issues for the 2007 Federal Election, Thursday 6 September 2007.

You know we have - Australia has a good health system by world standards, there's no doubt about that. There are certainly a lot of things here that we know are better than people experience overseas in countries that are very comparable to us. But indeed we know also that not all Australians have got equitable access to high-quality health care and services, so that we can improve what we have. With our wealth at the current time, now really is the time to invest and invest substantially and strategically in the future health of our nation and our people. This is the time to invest to take us through the times in the future.

And now, of course, is the time for the Government and the Opposition to put their hands up and to show us, to declare to us, how they will provide that investment.

So the document itself, of course, doesn't cover every nook and cranny of health. We've tried to highlight the key areas that we know will make a real difference, and action in all these areas will improve the ability for Australians to get the quality health care that they should be able to get when they need it, no matter what their means are, and no matter where they live in this country.

The medical workforce, of course, is crucial and we've heard a lot about the doctor shortage at this time. We know that we have got young doctors coming through the system and we have to invest in training for them into the future so that we can deliver to Australia the same quality of doctors that we delivered to Australians in the past.

The public hospitals are the backbone of our system and we know that more beds are needed and more doctors are needed to treat the patients that need treatment in those public hospitals. We know that public health must indeed be invested in and protected as an issue in this country. And the community

has a lot of work to do, particularly around obesity and overweight and, indeed, other clear areas around tobacco and smoking, alcohol abuse and the social and health effects it has on the community.

Recently, we've seen the Federal Government take on an Indigenous initiative in the Northern Territory and the AMA has supported that initiative and we continue to watch it very closely. But we also know that much more is needed in Indigenous health nationally, not just in the Northern Territory. And the Northern Territory intervention must be seen as a beginning for things to go forward into the future. Fixing Indigenous health remains a priority for the AMA and we need to clearly see that it is a priority for whichever party, whoever wins this election.

When it comes to private health insurance, both sides must give rock solid commitment to maintaining the balance between public and private in this country. It is that balance that allows us to run a health system more efficiently and provide services across a broad range.

The private health lifetime health cover arrangements and the private health insurance rebates must be preserved as presently structured into the future. The document also, of course, covers aged care, dementia, primary prevention, rural health, care for our veterans, and other specific issues. The Medicare safety net must be maintained. The Medicare Benefits Schedule must be simplified and must be appropriately indexed and, indeed, there are many issues to be dealt with in the document.

So I urge you all to have a good read. I urge you to refer to it as a document that you can use to comparepolicies that are brought out by the parties leading up to the election to evaluate health announcements as they come through. I'm sure we'll be hearing a lot more between now and election day and I can assure you that the AMA will certainly be scrutinising very carefully what is going forward and pushing indeed the issues that we believe need to be delivered to Australians. Thank you. I'm happy to take questions.

QUESTION:, and would you accept legislation…

DR CAPOLINGUA: The Minister knows full well that we've been working with him on this, and it's been a partnership between the AMA and Government to educate doctors to improve the levels of informed financial consent, and the levels have improved quite considerably from something around the 70 per cent to the 85 per cent mark.

So this started in August last year, so the shift has already been quite considerable.

Now, in reality - so the survey in fact that is quoting where he says the figures have improved very much, the AMA's not seen yet. The survey was done in a very short period of time after the initial assessment so we haven't even allowed a year to evolve for the effects of that education program to go through. So indeed, it may be higher than that 85 per cent, so your number of patients who have not perceived that they received full informed financial consent may be well less than 15 per cent already.

In reality, you're never going to get 100 per cent informed financial consent because there are clinical situations where it just can't happen. For a start, if there is an elected procedure going you may indeed provide the patient with full informed financial consent upfront, but during the episode of care something may happen, something may go wrong, something may be discovered during the procedure that will require further intervention, further medical treatment; it will require another anaesthetist, pathology, radiology, investigations, surgery, whatever.

At that particular point of time the patient is not able - they may be asleep on the operating theatre table, literally - not able or have the capacity to receiving information about informed consent.

So in those episodes it's not going to occur, realistically. Also in an emergency situation where doctors have to act to help a patient, perhaps even to save a life (without being dramatic), you're not going to be able to obtain full informed financial consent. Those issues will have to be dealt after the episodes of care. We're going to continue to work with doctors to get them to do the very best that they can in this area.

But there are two partners in the informed financial consent relationship. The doctor's role is to provide advice on the fee, but it's the private health insurer that provides the patient with the rebate. And the gap is generated because there is a gap between that rebate and the doctor's fee, and that's the bit that scares the patient. When they get those gap costs they - that's the bit that they feel they haven't been informed about and they feel that they needed to have known up front, and so they should.

So the private health insurer is a partner in this relationship. They need to be providing patients with good information - and everyone knows how difficult that is to get out of private health insurers - about what rebates they're going to receive for that episode of care for which they've been given informed financial consent.

QUESTION: Are you saying changes to Medicare?

DR CAPOLINGUA: Is Medicare not serving the Australian public very well? We certainly need some refinements, as I said, some simplifications of Medicare. It also needs to be appropriately indexed so it does serve Australians better, and the out of pocket expenses are kept up with costs and contemporary times. The public hospitals are still crucial in providing services to those who, in fact, do not have private health care, or to - for those who need a tertiary service that isn't provided in the private sector.

As I said earlier, the system itself is admired by many, but we can't rest on our laurels, cause we know that we have serious problems as far as individuals getting access to health care - I won't say it again, through the public hospitals, even in primary care sectors. And we have had an increasing population, an increasing ability to provide care, new technologies and medical treatments that are available to make a difference to outcomes, we have an increasing and ageing population with increasing needs, and then we have the chronic disease issue, with the obesity and cardio-vascular and diabetes, and all of those things.

And over that period of time that all of this burgeoning need and demand has increased, we haven't kept up with our need to deliver. We have the wealth to invest and the ability to deliver. So let's do that.

Okay. Thank you all very much.

Ends