Putting Health Reform above Party Politics - AMA President addresses AMA Parliamentary Dinner, Canberra

Prime Minister, Opposition Leader, Health Minister Nicola Roxon, Shadow Health Minister Peter Dutton, Ministers, Shadow Ministers, MPs, Senators, AMA Federal Councillors, fellow doctors, colleagues in health, members of the media, friends … good evening and welcome.

We are honoured indeed tonight to have both the Prime Minister and the Opposition Leader in attendance at the biggest night on the AMA calendar – our annual Parliamentary Dinner.

In fact, I believe we have the largest and most senior cross-section of the Parliament to ever attend one of our Dinners.

It must be an election year.

And it must be an election year where health policy will be a vote winner … and loser.

Ladies and gentlemen, our health system is at tipping point.  Believe the hype.

I described the Government’s hospitals announcement last week as the biggest attempt at health reform in this country in 30 years – and that’s exactly what it is.

Whether you agree with it or not – wholly or partially – it represents a quantum shift in thinking.

And that is just what our health system needs right now – BIG REFORM.

The policy debate is well and truly alive – and it will continue until election day.

This is a very, very good thing.  Whatever happens on election day, we will have BIG health reform.

I know that Kevin Rudd sincerely wants to fix our hospitals and our health system.

And I know that his Health Minister, Nicola Roxon, is equally determined.

I know also that Tony Abbott – a former Health Minister – wants to make a real difference in health.

We at the AMA know that he has points on the board with his work on medical indemnity a few years ago.

Peter Dutton has shown that he wants to make a mark in the Health portfolio.

Plus we have other Ministers, Parliamentary Secretaries, and their Shadows here tonight who have policy responsibilities that will swing votes.

Aged care.

Mental Health.

Indigenous Health.

Preventative Health.

Disability services.  May I say quickly that the AMA strongly supports the Productivity Commission feasibility study into funding and delivering long-term disability care and support.

Long-term care has been of special interest to me for a long time, and we have worked closely with Bill Shorten in this area.

I urge all politicians to get behind this important work.

Veterans’ Affairs.

Rural Health.

And the list goes on.

Health policy touches every Australian.

Good health policy makes a difference to people’s lives.

Ladies and gentlemen, health will be THE issue in the forthcoming Federal election – there is no doubt about that.

And I like to think that AMA is the most significant commentator – and the most credible adviser - on health.

I would say that without doubt the AMA’s opinion matters.

In the room tonight we have representatives of the medical profession from every State and Territory.

We have representatives of every medical specialty.

We have the veterans, quite literally, and the new generation – the medical students and the doctors in training.

There is a lot of health policy wisdom in this room tonight.  I urge all the politicians and their advisers to take advantage of that wisdom.  Swap business cards now.

I know it is a big call – especially in an election year – but I would like to see the health policy debate rise above party politics and rivalry.

The AMA would love to see a people-centred approach to health reform across the political divide.

They say that all politics is local.  Well, health politics is the most local of the lot.

We all know somebody who encounters the health system in some way every day of our lives.

Having babies.

A visit to the GP.

Immunisation.  Blood pressure.  Sexual health.  X Ray.  Pathology.

Waiting in emergency with the sports injury or something that shouldn’t have been swallowed.

Helping mum or dad find an aged care place.

All stages of life throughout life.

Wouldn’t it be good if we could work together to get the whole journey right.

I came to the AMA Presidency on a platform of engagement.

Engagement with AMA members and the medical profession.

Engagement with our patients and the community.

Engagement with Government.

Believe it or not, doctors have a good idea of what happens in health.

We know what works and what doesn’t work.

We know what’s good and what isn’t.

We are not the only ones, of course – nurses and allied health workers also see first-hand the joys and the tragedies that make up our health system.

We are worth chatting to.

Worth a chat at your local electorate level.

And worth a chat here at Parliament House.

The AMA, with members in every corner of the country, is worth a good long chat.

I am pleased that Prime Minister Rudd and his Ministers have engaged with the AMA.

I am pleased that Opposition Leader Abbott and his Shadow Ministers have sought our advice.

AMA members have a world of clinical experience.

AMA members help patients in every electorate of the country.

The AMA was the only group, to my knowledge, that produced a substantial policy response to the report of the National Health and Hospitals Reform Commission.

I personally handed a copy to the Prime Minister down the road here at Canberra Hospital.

On behalf of the AMA – while there is still a lot of detail to work through and specific issues to be further addressed - I can say with some pride that a lot of our policy was reflected in the Government’s policy last week.

The blame game has to end.

From the top, the Commonwealth must have a greater funding and national planning role.

And from the grassroots, there must be more local clinician input to decision-making at the local level, to ensure funding meets local needs.

There must be National Targets to provide nationally consistent goals for our hospitals.

And there must be independent auditing of our hospital system to measure what is working and what isn’t.

By the same token, the AMA notes the Opposition’s policy to reinvigorate local hospital management by emphasising the importance of engagement of local communities and doctors and nurses in hospital management.

The Prime Minister has said the Government has more policy announcements to roll out in coming months.

And I am sure that the Coalition is fine-tuning its health policy armoury.

We are heading for a once-in-a-generation change to the way health services are delivered and funded and managed in this country.

We have the best doctors and health professionals in the world.  Australians deserve the best health system too.  To achieve this, we need the best health policy.

So, policy advisers, please take notes, here is some free advice from the AMA …

Major health reform requires more capacity.  To help achieve this we will require:

• More overall resourcing,
• National targets to meet capacity targets that are set with input from the AMA, and
• A national target of no more than 10 per cent of the health budget on administration.

We accept casemix for the majority of funding, but our experience tells us that it doesn’t work everywhere.

There must be flexibility and exceptions – for example, for rural hospital services, teaching and research.

But casemix will only work if it is set using a transparent process and comes up with a ‘fair’ price to reflect true costs.

If there is to be casemix funding, no caps – I repeat, no caps!!

We need more hospital beds.

And we need the staff, infrastructure and other resources required to treat the patients in those beds.

We will only see better access to public hospital services in this country if:

• One, we have sufficient funding to expand the current capacity of our hospitals to ensure that they do not operate above 85 per cent average bed occupancy and that waiting lists actually do get shorter, and
• Two, we have the guarantee of an effective payment for every service that a hospital provides to patients, with no artificial limits to constrain the overall number of services.

But the health system is more than hospitals.

Do not forget general practice and community care.  Let’s help keep people out of hospital.

There are practical ways to strengthen general practice.

Legislate to allow pharmacies to be co-located within or adjacent to general practices.  You say you want improve convenience for patients – well, here is a practical solution to do just that.   

Provide new infrastructure funding for existing general practices.

Build on our world class general practice arrangements to provide more, bigger and better primary care in the community for patients.

Provide more support for general practice nurses.

How about a long term funding solution to guarantee enough medical training places and training support to meet our future health care needs?

We are training more medical students than ever before but medical training does not stop at the university gate.

How about a funding model that delivers health dollars where the care itself is delivered?

And how about a governance model that allows clinicians to take responsibility for the services they provide?

Let me stress one important point – any health reform must involve ongoing review with clinician involvement.

Health reform is a challenge for everyone.  We have to get it right.

There are no free kicks.

Everyone will feel some pain.

Politicians will feel pain.

Departments of Health will feel pain.

I know that our doctors will feel pain.

What makes the pain acceptable is if we bear it in order to benefit the Australian public - our patients.

If we see genuine progress in making high quality health care accessible to all Australians when and where they need it – no matter their means and no matter where they live - the pain will have been worth it.

The AMA has engaged in the health reform process, and will continue to do so.

Our credibility hinges on supporting what is right and opposing what we feel is wrong.

Last week the AMA at all levels put its support behind big bold health reform.

We reserve the right to be critical of detail.

And we reserve the right to be critical of stalling, of delay, of nitpicking.

We have supported the Government for having a go.

We will support the Opposition, too – as we have done – when it puts out good health policy.

The AMA stands ready to be Chief Health Policy Adviser to all parties.

The AMA’s message to all of you tonight is that health reform cannot wait.  Big reform is needed.  The Australian people deserve and demand it.

No change is not an option.


10 March 2010

CONTACT:        
John Flannery            02 6270 5477 / 0419 494 761
Peter Jean                02 6270 5464 / 0427 209 753