Media Conference - Dr Kerryn Phelps, AMA President

PHELPS: Good morning, and thank you for coming. Today, I'm launching Key Health Issues for the 2001 election. This is an AMA guide for politicians and it's what patients and doctors at grassroots want politicians to understand about the health system and where it should be going.

This is a policy document, a blueprint for the future, for a better Australian health system. And it's obviously aimed at the election just a few months away. It's a grassroots document. The issues in the document are the issues concerning doctors and patients every day in surgeries and hospitals around the country. I've no doubt that health will be the number one election issue at this election. Recent polling puts health and education ahead of tax cuts and rollback, and rightly so. The aim of this document is to convince politicians and their party leaders that health is the number one issue and to do something about it. AMA polling has determined the issues. AMA listening has determined the issues.

Patients want better public hospitals. Patients want their doctors to stay in their country towns. People want higher Medicare rebates. People want to know that ambulances can find hospital beds for quick delivery of patients rather than circling city blocks in vain. People don't want to have to wait for months for elective surgery. Australians in economically depressed areas want their doctors to stay in their communities. Women want to be able to have their babies in their home towns, not in the big cities because obstetricians have been forced to leave because of crippling medical indemnity bills. People want bulk billing or affordable co-payments, not bigger gap payments because Medicare rebates are inadequate.

People want a more compassionate aged care system that is better funded and offers a better quality of life for their parents, their partners and their loved ones. Australians want to see the health of our indigenous population improved. People want their communities safe from alcohol, tobacco and illicit drug abuse. And Australians want young people's health - physical and mental - better looked after. Our future generations should be full of vitality and optimism.

People want access to affordable life saving and life enhancing drugs under the Pharmaceutical Benefits Scheme. People should have a choice between quality public and private health sectors without the intervention of health funds in the doctor-patient relationship. The Australian health system must reject the US style of managed care. We must ensure that the growing corporatisation of medical practice, if it does proceed, does so in a responsible way without threatening the clinical independence of doctors and without threatening the traditional role of the family doctor in the community.

We must ensure that GP training opportunities are preserved and enhanced. Hospitals must act to put in place safe rosters and work practices to prevent junior doctors working excessive hours. Competition policy and the Trade Practices Act must not be allowed to hinder doctors providing around-the-clock quality health care, particularly in country areas. And commonsense must be applied to new privacy laws so that the confidentiality of the doctor-patient relationship is not undermined. These are the issues that people want resolved for themselves, their families and their communities. Tax cuts can wait; rollback can wait. Let's fix the health system first and let's fix it for the long term, not just the electoral term.

This document will help the major parties to formulate policies that patients are calling out for. Policies that might even win a few votes. Thank you.

JOURNALIST: Well, Dr Phelps, the Labor Party has stated that any budget surplus should be ploughed into improving services such as health, as opposed to personal tax cuts. Does that make the Labor Party a better bet for voters at the coming election and would you recommend a vote for the Labor Party?

PHELPS: We're not being political partisan because the AMA is not a politically partisan organisation. What we are doing is drawing out the health policies of all of the major parties to say we have an election coming up. Australian voters want to know what the major parties are going to do about the health system. This document will actually help them to formulate the policies that we believe are realistic and what the grassroots Australians - patients and doctors and nurses - want from the health system. We, when we're looking at the policies that have been so far expressed, there's no doubt I believe in my mind that Australians want a better health system and they want better education. And there is a great deal of insecurity about the future of our health and education systems. Now what I believe Australians are prepared to do is to delay or even forego tax cuts or GST rollback if they can be guaranteed a more secure health system.

JOURNALIST: Dr Phelps, do you know how much it would cost to bring about all these improvements to the health system that you're addressing?

PHELPS: You will see in the document that all of the proposals are costed. We put forward a budget proposal prior to the May budget. And each individual item has been costed out and you will see exactly what needs to be done. If we just look, for example, at the Medicare benefits schedule, that is the foundation stone of the system that we have in Australia at the moment and that is under grave risk. And we have yet to hear a real commitment from either of the major parties about what they're going to do with the Medicare benefits schedule if they are in power after the next election. And that I believe is going to be the lynchpin to the future of Medicare in Australia.

JOURNALIST: Not having a calculator here, is there a figure, a total figure of all those costs to programs?

PHELPS: Well, it depends on whether each and every item is going to be taken up as policy immediately in one term, in one year, in an electoral term. So it will depend on what is taken up at what stage.

JOURNALIST: Political parties are going to have lots of these sort of documents lobbing on their desks from various organisations right now. Why is this one any more persuasive than other public utterances that you've been making on these issues in recent months?

PHELPS: I believe that this document states in no uncertain terms what the major political parties have to do to gain the confidence of the Australian voters prior to the next election with regard to what we consider to be the number one election issue, and that is health.

JOURNALIST: Is it possible to identify which health issue in particular is of most concern to Australians?

PHELPS: I think if you look at the overall structure of the Australian health system, it is very much valued by Australians and we do have the basis for the best health system in the world. But it is in grave danger of running down by neglect. I'm yet to be convinced and the AMA is not convinced at all that we are spending enough on health. There is so much un-met need. And the areas that I could particularly point to are the Medicare benefits schedule, public hospital funding, aged care and indigenous health. Now those are the areas that I think really need a fairly substantial injection of capital in order to bring them up to Year 2001 levels.

JOURNALIST: Health spending is already at historical higher levels, you've got, and it's debatable, but you have quite a significant real increase in public hospital funding from the Commonwealth, and in the end where do you think this money is going to come from and would you go along with an increase in the Medicare levy, for example?

PHELPS: I'm always amused at the expression 'health spending is at historically high levels' because every year…

JOURNALIST: Well it is according to budget figures, Dr Phelps.

PHELPS: Well of course it is because very year, unless you actually cut back the health budget against the CPI…

JOURNALIST:.

PHELPS: I think that is a very mischievous way of dealing with this particular issue.

JOURNALIST: But you haven't got the evidence that they have acted.

PHELPS: Oh yes we have. We are not able to actually - we're not able to actually give you case studies right now but, when there is an inquiry, those case studies will come out. Doctors are afraid of putting their heads up in case they get them chopped off at the moment. But the trouble with the Trade Practices Act, let's say with an authorisation, if you apply for an authorisation, you're basically saying, look we're breaking the law but tell us that it's okay. And if they say it's not okay, then you face prosecution. Now doctors are rather instead just changing the way they practise or leaving rural practice.

JOURNALIST: And who will do this inquiry, do you know?

PHELPS: That's yet to be finalised.

JOURNALIST: I thought the Government had already said it was willing to have an Inquiry into the effect of the TPA on doctors. Have they not done anything since?

PHELPS: Oh yes, it's progressed but it is just yet to be finalised.

JOURNALIST: Just on one current issue, Dr Phelps. Do you think hip replacement patients with this French, whilst it's found to be faulty, should they be alarmed by that failure rate?

PHELPS: I think, when you have a hip replacement operation, it is an enormous investment in your own discomfort and in your future. Not only is the cost of hip replacement high but people quite often have to wait for years in pain to get the operation. To then find out that it may fail in 13 to 18 months, I think is rather frightening. Whether a person should be alarmed or not, I think they should get advice from their orthopaedic surgeon about the type of appliance that they've had put in. And I think that we need to, as a community, look at the quality of the products that are being provided to Australian patients and to make sure that we're not going for the cheapest model but we're going for the models that are going to last the distance.

JOURNALIST: That's been a problem, has it?

PHELPS: Post-marketing surveillance is always important. I don't want to comment on this particular product because we have yet to see the actual evidence and, as yet, there have been no complaints in Australia which I think is wonderful. But I think that, if we do have evidence overseas that there is a problem with a particular type of appliance or prosthesis, then we do need to take that on board here in Australia and perhaps look at - if it looks like it's not the right appliance to be used - then it should be changed.

Thanks all.

Ends