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26 Sep 2018

Transcript:   AMA President, Dr Tony Bartone, 6PR, Drive with Oliver Peterson,
Wednesday, 26 September 2018.

Subject:   New Prime Minister, Aged care, Indigenous health, Euthanasia, E-cigarettes.


OLIVER PETERSON:   Joining me live in the studio is the new National President of the AMA - his first visit to Perth as the National President of the Australian Medical Association.

Doctor Tony Bartone, welcome to Perth.

TONY BARTONE:   Good afternoon Ollie, thanks for having me in.

OLIVER PETERSON:   Now, you have been the President since May. What's it like?

TONY BARTONE:   It certainly is full on. There's never a dull moment. It's extremely busy. I've got to thank my patients in particular for having the patience …[Laughter]… increasing absence from the surgery and the clinic, but it's an opportunity to really advocate on so many fronts and on so many issues and really have the ear of the decision makers that are ultimately for the benefit of our patients.

OLIVER PETERSON:   Okay. You've come in at an interesting time in the Federal political landscape, as well; a brand new Prime Minister with Scott Morrison. Greg Hunt is still the Health Minister. Have you had an opportunity to meet the Prime Minister since he has been elevated to that position?

TONY BARTONE:   I haven't had the opportunity to meet the Prime Minister as yet. I've had several meetings last week with various Ministers, Shadow Ministers, and other Members of Parliament. I took the opportunity to write to the Prime Minister already on certain issues but, no, I'm still hanging out for that first meeting.

OLIVER PETERSON:   Okay. He's obviously announced a Royal Commission into the aged care sector. Has he made the right call?

TONY BARTONE:   Look, what we need to remember is that aged care has been in the spotlight for many, many reasons over the last year or two in particular, and media reports such as the Oakden Report has clearly focused the attention on the aged care sector. There have been a number of inquiries, a number of Senate and Parliamentary reviews, all pointing to the same thing - that it's an area that requires additional funding. There's a huge infrastructure, there's a huge workforce gap in that area, and it really is in need of significant, investment and also policy decisions.

Now, the Royal Commission is an attempt to try and harness a lot more activity, a lot more focus on that, but we've got a lot of information already on the table and we can't walk away from that. So we can start the process of trying to right the issues in that sector, but clearly there are many terms of reference to be formally agreed on.

OLIVER PETERSON:   That's right. It was just almost an announcement, and at the time I made the comment, Doctor Bartone, that how about Government just roll up their sleeves and do something about? We have seen so many reports, allegations, and a lot of misconduct within nursing homes, which we all shake our heads at in aged care facilities - we don't like that - but governments need to take on their roles and responsibilities and do some hard work.

TONY BARTONE:   You couldn't have spoken a truer word. There is a lot of information already. We just need to get on and start doing. We need to look at the funding into the area, we need to look at the manpower and the resourcing. We know that, in particular, registered nurses are extremely, almost an absent breed at the moment in a number of facilities. And that's what our members have clearly pointed out in the surveys that we've had, to say that one of the reasons behind the fact that doctors are not visiting facilities as often as they used to is because of the absence of trained nursing staff, especially around the clock, especially in the high care areas, and that's really a consequent reason for that.

But also, if we look at the other issues in terms of telehealth and infrastructure, the- even just the IT resourcing and the ability to actually write up your program notes and your- into your patient and to actually communicate, or write a script into the facility off-site. These are the little things that would just make the ability to have ongoing, continuous care in these facilities so much more resourced and so much more contemporary in nature.

OLIVER PETERSON:   My guest in the studio is the AMA National President, Doctor Tony Bartone - his first visit to Perth, actually. What's brought you to WA?

TONY BARTONE:   Actually, the Australian Indigenous Doctors’ Association's Conference is opening tomorrow and I'll be one of the people addressing the opening in tomorrow morning's conference. But that's one of many reasons - a good opportunity to catch up with a number of the good members that make up the Australian Medical Association over here in WA.

OLIVER PETERSON:   Alright, I'm sure that they will be pressing a number of matters onto your agenda as we head into a Federal election. We are in the midst, as you are well aware, of a Parliamentary inquiry and finding have recently been made into euthanasia and that will now head towards the Parliament debate. This, I suppose, is a massive ethical question for all doctors when it comes to euthanasia. It's been introduced in Victoria, as we know, under very strict conditions. Do you believe it will be introduced in Western Australia as well?

TONY BARTONE:   Essentially, that'll be up to the community and to the Government to lead that debate in the community and make that decision appropriately. Ultimately, the decision whether it should become law is a matter for community, for Government, and then at the end of that and once that's made into law, if it is progressed that way, it needs to be appropriately resourced and enacted to ensure that everyone in that space is protected and allowed their freedom to vote from their conscience point of view and vote from an access point of view, have the freedom and the certainty to act in the best interest of their patients.

OLIVER PETERSON:   At the moment the AMA - what's its stance?

TONY BARTONE:   Clearly our stance is that no doctor should be involved indeed with any intention that is ultimately designed to bring about the ending of a person's life.

OLIVER PETERSON:   On Sunday night, 60 Minutes ran a story. Doctor Alida Lancee, as well, here from Western Australia, made some pretty startling claims about assisting people die, essentially, and named those people. Do you think police will be investigating? Is she just really thumbing her nose up at the current laws?

TONY BARTONE:   Look, in regard to this issue, that's obviously a State issue and the authorities of this state will have to look at whether laws have been broken and what they plan to do about that, but that I'll leave to the State authorities to make that decision. But clearly we have a Position Statement and that Position Statement guides our members in the way that they should act, and no doctor should be above the law and, ultimately, all doctors should act in the best interest of their patients, and especially at a difficult time, especially at a time when we need to be aware of and compassionate to our patients' needs.

OLIVER PETERSON:   If they're breaking the law, should they be deregistered by the Medical Board?

TONY BARTONE:   As I say, that is for the authorities to decide whether there has been a law broken, and then, if that is the case, then the appropriate processes followed.

OLIVER PETERSON:    E-cigarettes; should we accept these cigarettes into Australia?

TONY BARTONE:   This is the ongoing furphy that continues to dog me wherever I go. And let me be particularly clear about this, the research - the evidence clearly shows that e-cigarettes can be a gateway drug into taking up normal smoking in its traditional habit. What we need to be clear of is that the evidence has shown that it's not without harm, it hasn't been proved to be safe, and that with that potential for gateway- as a gateway drug, especially for our young population, especially for young adults, it is associated with too much risk to entertain that prospect, especially when we've significantly reduced the rate of smoking in this country. Our advances over the last decade or more, to almost 11 per cent of the population only now being smokers, compared to the mid-20s a decade or more ago, has been at the forefront of a lot of public health debate, and a lot of public health outcomes in Australia. And also, we're the envy of the rest of the world when it comes to intervention in public health issues such as this.

OLIVER PETERSON:   So, a lot of my listeners will call me now and say: Ollie, I've told you time and time again, e-cigarettes have helped quit smoking cigarettes. It's been the avenue I have used to quit this deadly habit of smoking tobacco. Do we, therefore, need to conduct research here in Australia that might show that this is a way of weaning yourself off smoking full strength cigarettes?

TONY BARTONE:   What we need to understand is that anecdotes in this area continue to be- you can find them anywhere, but the important thing is the evidence and the research. You clearly point out that we do need further research, and that is going on in many centres around the world. And if and when that evidence shows that there is a particular role for e-cigarettes to play, we'll, as significant advocates in this area, we'll play a role in that process. But until that is the case, we cannot allow the situation, whether to allow increased harm for the proportion of the population that's currently not smoking.

OLIVER PETERSON:   Alright, what is top of the agenda for the AMA, particularly heading into an election, probably, within the next six to 12 months?

TONY BARTONE:   So, it's got to be before 19 May, I think, is the latest it can be. Clearly one of the issues that I'll look strongly at, and our Association will look strongly at, will be public hospitals. So, increasing our patient appointments and elective surgery waiting lists, making sure there's enough funding in that space. But also the other side of the equation, in private hospitals and private medicine, in terms of private health insurance. If we don't have a strong product that offers transparency and value to the population, more people will opt out of private health insurance, and that's going to put an increasing burden on the public sector. But the other area that we're particularly strongly advocating for is the funding into primary care; some long-term, transformational funding to allow chronic complex care, and the funding of that care around the patient over time, to ensure that we keep patients out of hospitals. But let's not forget aged care, and the rural health divide that is such an enormous issue right around Australia.

OLIVER PETERSON:   And the agenda continues to get longer and longer. Dr Tony Bartone, I wish you luck in the role, and thank you very much for coming to the Perth Live Studio this afternoon.

TONY BARTONE:   My pleasure. Thanks very much.

OLIVER PETERSON:   Dr Tony Bartone there, he is the National President of the Australian Medical Association.

27 September 2018

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Published: 26 Sep 2018