Radio Transcript - Dr Capolingua Discusses the Victorian Nurses Dispute and Key Health Issues for the 2007 Federal Election

I'm not sure if that's the view of my next guest.

Dr Rosanna Capolingua is President of the AMA - the Australian Medical Association - one of the key lobby groups when you talk about health policy in Australia. And during a federal election it's great to have her in the studio.

Dr Capolingua, good morning.

DR CAPOLINGUA: Good morning.

JON FAINE: What do you think of nurses?

DR CAPOLINGUA: I think nurses are exceptional people, and indeed, as you've described them, angels. And I think that was a very special interview you had with a patient who's lying in the coronary ward a few days after a heart attack. That was an amazing conversation you just had, reflecting on what the nurses do. The nurses are very important across the board.

JON FAINE: Should the Victorian nurses maintain nurse patient ratios as part of their claim?

DR CAPOLINGUA: I had breakfast with Dr Doug Travis this morning - the AMA Victorian President - and we're very supportive of the nurses claim. I believe the nurses in Victoria are very much underpaid compared to other States, and yet the hospital efficiency in Victoria - which is a reflection of the doctors and the nurses and the structures that you have here - is better than other States - 30 per cent better than New South Wales.

So, it sounds to me that we really do need to support these people who are delivering the services there.

JON FAINE: My question was about nurse patient ratios, specifically. Should they maintain them?

DR CAPOLINGUA: Nurse patient ratios should be maintained, indeed. That is about - and I don't know exactly what they're asking for here - but I know the concept of nurse patient ratios is about patient safety; it's about being able to keep an eye on everyone that you have in your care. And if there are too many patients in your care, the nurse feels as though they've compromised their ability to deliver the best for those patients.

So, ratios are a very important part of the fabric of making sure that people are safe.

JON FAINE: We go through different fads and fashions in health policy, and also in health economics. It used to be doctors ran hospitals, and their word was final. That was it. The chief surgeon was the sort of person who ruled the roost, and so on and so forth; and matron was the next most powerful person.

DR CAPOLINGUA: Mm, indeed.

JON FAINE: Now, these days of course, it's people with MBAs who run hospitals, and they're paid huge salary packages and their KPIs - their Key Performance Indicators - often include slashing costs as a way of running an efficient hospital.

Which is the best way?

DR CAPOLINGUA: The hybrid of the two. The concept in Victoria, I believe, actually has hospital boards - local and regional boards - the concept where you have people from business and clinicians working together, so you get the balance of the influence of understanding how to run an efficient organisation and structure, but maintaining the clinical parameters of what's best for your patient.

And I think that combination is a good one. Maybe that's one of the reasons why the Victorian hospitals are running more efficiently. I don't know for sure, but that is the concept.

JON FAINE: And so, the model we've got here is the one that you in fact advocate for the rest of the country. We've already got it, but here we are, we've got a Labor Government at loggerheads with the nurses union - which is a key supporter - during a Federal election campaign; and I wonder if there's a bit of politics being played here, because it allows Labor during an election campaign to say, look, we can be tough on unions too.

DR CAPOLINGUA: Oh, well that would be a great shame if indeed the nurses and, as you describe, the patients end up the meat in the sandwich in a dispute, when this is about health care and delivery of care to the people of Victoria.

It's obvious that the doctors and the nurses are indeed doing their very best to maintain the services they need to for the patients that are absolutely in need; but we know that beds have closed at the moment in an emergency department that is struggling, and surgery is not being conducted because of the nurses dispute; and that means that there are Victorians who are sitting there, out in the wind.

JON FAINE: Just to clarify, emergency departments are exempt from this industrial dispute, so if they're struggling, they're not struggling because of the nurses dispute, they're struggling because they are just struggling all the time.

DR CAPOLINGUA: Mm.

JON FAINE: As matters stand, I do want to talk about things other than the Victorian nurses dispute, but just finally, the Health Minister told us the day before yesterday, in the long interview, he is not negotiating with the Nurses Association; he's not negotiating with Treasury for more money; it's the hospitals - 134 of them I think, independently and separately - who negotiate with the nurses.

Should the Minister get involved?

DR CAPOLINGUA: I think the buck stops with the Minister, and he should be involved.

JON FAINE: So until you get the politicians involved, do you think you won't get a resolution to this?

DR CAPOLINGUA: I would need to look more carefully at how this is playing out as far as the Victorian nurses dispute is concerned, but health responsibility lies with government. And this particular issue is with State Government and the State Health Minister.

JON FAINE: Well, they quarantine themselves from it. They say no, nurses are employed by hospitals and hospitals and nurses go off to the IRC. The government's not even a party to it.

DR CAPOLINGUA: Well, in that case, we are seeing the blame game played within the State, let alone between State and federal.

JON FAINE: Let's turn to the federal election campaign; what's the AMA's wish list for policy from both the major parties for this election?

DR CAPOLINGUA: The wish list is a comprehensive one. But I guess if we wanted to look at the top two issues - the public hospitals has got to be number one on our wish list; addressing the concerns that we have there; the concerns that Victoria is feeling, and the other States across Australia are feeling, which stems across emergency departments, bed numbers, and retaining and recruiting staff across the board - doctors and nurses and other staff in the hospitals.

So, number one is the public hospital sector.

Number two is the training. We know everyone talks about the workforce shortage as far as doctors are concerned, and in the allied professions - nursing is also right up there with us. We've got to make sure that there is a serious investment in training for our new medical graduates going forward, so that they are of the high calibre that we've been lucky enough to have in Australia in the past. I want to ensure that that goes forward. And that's going to need a Federal Government commitment in the future.

And we can go on from there - we've got Indigenous health; we've got general practice...

JON FAINE: Rural health it works in remote communities, it can also work in the suburbs.

DR CAPOLINGUA: But it works under doctor supervision; they're isolated events, and the doctors are very much engaged in what evolves in those areas.

And then let's talk about rural Australians and their rights to have an access to a doctor; and let's talk about what we need to do for rural doctors across the country.

JON FAINE: What's going to happen in Tasmania? Have they worked out yet who's best to run the hospital in key marginal electorates?

DR CAPOLINGUA: Well, you know, the AMA never...

JON FAINE: The Mersey Hospital.

DR CAPOLINGUA: ...we never look a gift horse in the face, and funding into hospitals is essential, and we'll take the money, thank you.

But, we've got concerns about the integration of how that is going to work into the future.

We need lots of rural hospitals in Australia funded. You know, the States have ripped infrastructure and funding out of rural hospitals and closed them, and our doctors tell us they want their local hospitals, rural hospitals open again.

So I could give them a list.

JON FAINE: But with the Mersey Hospital there were two studies done, by external consultants and the Tasmanian Government into the future of two hospitals in close proximity to each other; and surely there's no clearer example of pork-barrelling, contrary to all advice, than the bail out of the Mersey Hospital.

DR CAPOLINGUA: It's an election. Isn't this what we see at this time of the year? And ask the people in the local area what do they want? They want their services.

So, you've hit the nail on the head as far as that particular episode of what's going on. But again, the money is needed. This is election time, and election time is when we have got to get out of government - Coalition or Labor - what we see is best for the health system in Australia going forward. So I'm going to use every opportunity and every promise and leverage off those.

JON FAINE: More calls in just a moment. Last question Dr Capolingua, Federal President of the AMA, who's in the studio this morning - Indigenous health has been an embarrassment and national disgrace for pretty much as long as I can remember. The latest intervention by the Commonwealth is said to be a circuit breaker.

From your members, who are taking part in the intervention, is it working; is it living up to its promise?

DR CAPOLINGUA: The feedback from the doctors that have been on the ground, is extremely positive. They are overwhelmed with the fact that they have been so well received. They've had to work hard to build the relationships, but the people are bringing their kids to them, and what they're finding is a whole lot of clinical issues that we now need to put in place the framework ongoing into the future to actually treat and manage.

JON FAINE: Thank you for your time this morning; whilst you're in Melbourne. It's good to catch up with you face to face instead of always on the phone.

DR CAPOLINGUA: Thank you.

Ends