Introduction

Good morning everyone.

Thank you all for making the effort to be here so early for the annual AMA Parliamentary Breakfast.

I have no doubt the AMA message today will be at the heart of your election prospects this year.

Hopefully we can give you some ideas to win more than a few votes.

The US Democrat Tip O'Neill said all politics is local - and I agree with him.

So, by definition, all health politics is local, too.

A lot of health policy is complicated and hard to fathom - like wading knee-deep in mud.

But I don't want to bore you with the heavy stuff this morning.

Instead, I'll try to convey the key health needs of the community and patients in terms that relate easily to your electorates.

I'll try to explain what doctor shortages and underfunded public hospitals mean to the people in the towns and suburbs of your electorates.

The best political policy comes from the bottom up.

It's still not too late to improve the health policies that your parties will take to the next election.

But it is up to you to improve them.

You must relay the stories and experiences that your voters and your local doctors are telling you up the line.

And I know you are hearing lots of stories - and they are not all good.

The AMA

But first, the big sell.

The AMA has 28,000 members.

They live and work in every corner of Australia. 

They are members of your electorates.

They are specialists, GPs, salaried doctors, teachers, researchers and young doctors.

Our members are the public face of Australian medicine.

Our members see millions of people every week.

Their patients talk about their own health, the health of the health system and the health of the nation.

The AMA is a broad-based, grassroots organisation.

Our members dictate our policy.

Our members influence the public's perception of health policy and the health system.

The AMA has clout.

As everybody in this room does their utmost to do the best by their constituents, it is my job to do the best by my 28,000 members and their patients.

The AMA is not party political.  We are impartial.  We are independent.

We play the policy, not the man or the woman or the party.

But we all have to face the reality that only Government has the power to realistically change policy.

The Opposition only gets a shot at it every three years or so.

The AMA's vigorous lobbying has upset Labor Governments and Coalition Governments alike over the years.

But that same lobbying has pleased and satisfied our members.  We have delivered positive outcomes for our patients.  That is our job.

That is how people like me get elected...or dumped.

That is how you get elected...or dumped.

That's democracy.

Vigorous lobbying does sometimes have its pitfalls, however.

You may recall last year that the AMA announced it would campaign in marginal seats on medical indemnity.

That announcement coincided with a meeting I had with the Coalition backbench.

Talk about entering the lion's den.

Needless to say that various members told me in no uncertain terms what they thought of our campaign idea.

The Member for Hume, Alby Schultz, kindly offered to demonstrate some of the skills he had learned during years working in abattoirs.

He wanted to test those skills on me.  And he probably would have if given the chance.

But I made the point very strongly that the AMA had to campaign locally to get things happening nationally if we wanted better health policy for all Australians.

I'm pleased to report that Tony Abbott came to the party on medical indemnity.

He did the smart political thing.  He listened.  He promised a political solution.

So we deferred the campaign.

That's brinkmanship.  That's politics.

I'll remind Alby that the AMA can play politics hard, too, but our tools of the trade are more subtle.  We use logic and sound arguments.

And Julia Gillard will tell you that the AMA's sound arguments come out every time she tries to use bulk billing as a measure of the success of the health system.

That is the wrong measure.  In fact, it is no measure at all.

We have moved on from bulk billing.  That is yesterday's story.

Above all, the AMA uses ideas.  Ideas and facts.  Facts about how the health system is working and where it is not working.

And I'd like to share a few of those ideas and observations with you this morning.

The AMA hopes you take them on board when discussing health policy in your electorates and with your Parliamentary colleagues.

The key words that pop up every time are access and affordability.

Access and affordability

I'll repeat those words - access and affordability.

Number one - people want to be able to see a doctor where and when they need one.

Number two - when they have found that doctor, they will not tolerate having to pay bigger and bigger gap payments.

And they are the key health problems you will confront in your electorates.

Not enough doctors.

It costs more to see a doctor.

Affordable access to medical services is the big issue.

Access is determined by the size and distribution of the medical workforce.

The fact is there are not enough doctors and the shortages are greatest in areas of health need - rural, regional and outer-urban Australia.

That's a lot of electorates calling out for doctors.

Funding GPs and specialists to serve in these areas - and to keep them there for the long haul - is a huge task and it is going to get tougher.

Political solutions are needed - urgently.

We have to rebuild Australia's medical workforce after nearly a decade of steadily tightening restrictions on doctor numbers.

The Government's official advisory body - the Australian Medical Workforce Advisory Council - AMWAC - has identified significant GP shortages across the country.

They have also looked at specialists numbers.

Out of the 24 specialist groups it has looked at, AMWAC has confirmed shortages in 23 groups.

That's right - not enough doctors to serve the population in 23 of 24 medical specialties.

That should get alarm bells ringing.

We need more student places.

More training places.

More properly qualified overseas trained doctors.

And we have to stop the accelerating flow of doctors out of the medical workforce.

Doctors choosing early retirement.  Or working overseas.  Or working part-time.  Or going into administration.  Or choosing other less stressful ways to make a living.

GPs trying to eke out a living by bulk billing all their patients will leave.

Doctors working in underfunded public hospitals - the ones who become scapegoats for system failures - will leave.

Rural doctors who work long hours and who cover huge distances - who can't get locum relief to take a holiday - will leave.

And they are leaving.

But there is nobody lining up to replace them.

Many of you here today will know of country towns losing family doctors who have served communities for generations.

These communities are losing more than a doctor.  They are losing an institution.  A local hero.

Two years ago, my predecessor Kerryn Phelps released AMA/Access Economics research that predicted the medical workforce shortages we are seeing today.

That research was released at the Parliamentary Breakfast that year.

Lucky there were plenty of doctors here that day because many MPs almost choked at the news.

The conventional wisdom of the time - including from AMWAC - was that there was simply a 'maldistribution' of doctors, not a shortage.

Thankfully, the conventional wisdom has changed.

There is now almost universal acceptance that there is a shortage.

And I can say that the AMA has led the charge in getting people to accept the unpalatable reality that people are finding it harder to get to see a doctor.

Two years on and the Government and the Opposition are starting to respond to the workforce problems.

Both sides of politics know that their Medicare policies cannot and will not work if people can't find a doctor in the first place.

I won't dwell on the details of the Medicare policies this morning.

There will be plenty of opportunities before the year is out.

Besides, I'm sure there will be changes.  The Medicare policies on show today will not be the Medicare policies doing battle at the election.

There will be changes, I'm sure, in other areas, too.  There must be.

Our public hospitals must be better funded.  Our public hospitals must be national treasures, not national scandals.

Public health issues like child abuse, depression, dementia, vaccination need action.

We must see a greater commitment to maintaining the Pharmaceutical Benefits Scheme - the PBS.  Investing in the PBS is smart health policy.

We have to stop people - especially our kids - from smoking.  The simple truth is that every puff of a cigarette is killing you.

We have to control alcohol and drug abuse, again especially with our kids.

More - much more - needs to be done with aged care.  It is our duty to make the final years of our parents and grandparents more comfortable.

Look at it selfishly.  The changes we make today will benefit us in our twilight years.

And for god's sake let's please bring the health of Indigenous Australians into the 21^st century.

Despite all our efforts, the health outcomes for Aborigines and Torres Strait Islanders are among the worst in the world.  It is a national disgrace.

All these health issues are local.  Good policies in these areas will please your voters.  They will benefit your communities.

The medical indemnity package has shown that Government working with the medical profession can deliver great things for patients.

Doctors - the AMA doctors in particular - make a lot of noise.  But it is well-informed noise.

Listen to us.  Don't yell at us or take the boning knives to us.

Discuss the issues with us.  Don't dismiss us.

Trust us.  We are doctors.  We are here to help you.

We speak on behalf of our patients - your voters.

Before I take questions, can I ask one more favour of you.

Today I call on all Federal MPs and Senators to send a clear and strong message of leadership to the Australian community.

Please sign on as organ donors - all of you.

And make sure your families are committed to your decision.

Set an example for the communities you represent.  Show the way.

Australia has one of the lowest organ donation rates in the world - just nine donors per million population in 2003.

Spain has 33.7.  The United States has 21.5.

In Australia, 107 patients died in 2002 while awaiting organ transplants.

When you consider that just one donor can help up to 32 people, just think what can be achieved with all your political organs.

There was a huge surge last week during Organ Donor Awareness Week with reports of almost 4,500 people registering online.

With your leadership, we can build further on this success.

We can save lives and enhance the quality of life for many Australians.

By donating your organs, you will be leaving more than just your political legacy. 

You will find organ donation forms at the registration table.

I'm happy to now to bring forward early Question Time.  I'm not expecting any Dorothy Dixers from you.

Thank you.