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30 May 2016

Transcript: AMA President Dr Michael Gannon, Dootstop, 30 May 2016

Subject: Medicare Freeze, Hospital funding, Asylum Seekers


MICHAEL GANNON: Welcome everyone, my name's Dr Michael Gannon. I'm the newly elected president of the AMA. I'm humbled by the honour that my colleagues have bestowed on me today. I'm also currently the State President in Western Australia. I'll continue in two roles for another nine days. I want to continue the work I've already started in looking after the patients of Australia. The best way to do that is to look after the doctors of Australia, and I hope to continue a leadership role in this area.

I want to pay tribute to the fantastic work of my predecessor, Professor Brian Owler, who's been a tireless advocate on behalf of the community of Australia, the patients of Australia; had a very strong platform on social issues. That will continue under my presidency. I know we're in the middle of a federal election campaign. This job is intensely political at the best of times. We are right in the middle of a closely fought federal election campaign. Health is at the top of the agenda. Health should remain at the top of the agenda, and the AMA will make sure of that.

We want to improve general practice. We want to start, for the community, and for Governments to recognise the value in primary care, the value in preventative health. We need to have more constructive criticisms about how we're going to fund the cost of public hospitals. That conversation between the Commonwealth Government and State and Territory Governments. I've committed myself to continuing the AMA's long history in trying to close the gap between Indigenous and non-Indigenous Australians. I want to do more on mental health. I want to do more on speaking up for people who can't speak for themselves. I am greatly humbled by the honour bestowed on me. It's going to require a great deal of work. The work starts now.

QUESTION: Dr Gannon, the Government is currently engaged in a fight with GPs over a six year freeze on Medicare rebates. What's your view on that?

MICHAEL GANNON: The freeze is unfair, and it's wrong. It reflects a continued under-investment in general practice; the best value for money part of our health system in so many ways. High quality primary care reduces the need for more expensive hospital admissions. For too long we've under-invested in general practice. Unravelling the freeze is so important. The AMA will continue that campaign. But that's the start of a bigger conversation. We need to do more to properly recognise the value of general practice in our health system.

QUESTION: So the Royal Australian College of GPs will tonight launch television advertisements against the Government's freeze, do you support that initiative?

MICHAEL GANNON: We support the campaign of the College. The AMA has its own campaign, calling for the end to the freeze. We support the ALP's policy in this area. We think there's an opportunity for the Coalition to change tact on this policy, but it should be just the start of a wider debate. Unravelling the freeze is not a solution to the underfunding of general practice. We need to do so much better.

QUESTION: What would you like to see the Government do in this space then?

MICHAEL GANNON: I'd like to see the Government recognise the enormous value for money they get out of GPs. To stop seeing the fees to see a GP regarded as a cost, and not an investment in the health of our community. When GPs get it right we avoid more expensive hospital admissions. Preventative healthcare, the stuff GPs do every day in managing chronic diseases. The way they manage risk factors, for stroke and heart disease. That's an investment in health, it's not a cost.

QUESTION: Earlier in the year you had taken issue with the AMA, saying perhaps that they've not really worked closely with the Government. Do you think it needs to work more closely with the Government?

DR MICHAEL GANNON: I think the AMA needs to dedicate itself with working with all three major parties. I use that language on purpose. The Greens are well and truly in play in this election. It's likely to be close. We might have another hung parliament. The Greens are likely to have a balance of power in the Upper House. It's hard to interpret the politics of a double dissolution election with a half quota. We're ready to talk to everyone. We're interested in putting forward the best policies to improve the health of Australians.

QUESTION: Is it true that you've got some close relationships with some senior Coalition Ministers like Mathias Cormann and Ken Wyatt?

MICHAEL GANNON: I know people from all parties. I hope to build on those relationships. Being from Western Australia, most of the people I know who are in Canberra are members of the Liberal Party, but I am keen to work with all people. In recent weeks I've met with Catherine King, I've met with Richard Di Natale, I hope to continue that engagement with people across Australia. Getting to where we want to get; a better health system for all Australians.

QUESTION: If the freeze isn't lifted, so if the Turnbull Government is re-elected and the freeze isn't lifted, how much extra will doctors have to charge patients?

MICHAEL GANNON: GPs are at breaking point. They can't take too many more cuts. If this is the beginning of a conversation on how we improve our health system and see GPs more appropriately rewarded, that's not such a bad thing. But we must see protections for the vulnerable in society. We must see it be the case, so that people don't think twice before visiting a doctor if they're sick. And the truth is that in our community, there are people who even a three or a six dollar gap is enough to stop them seeking health care. We want people turning up for tests, we want them filling their scripts, we want them keeping their appointments with their GPs.

QUESTION: But there is suggestions that doctors will charge patients an extra $20, maybe $25, if the freeze isn't lifted? Is that right? Is it as much as $20-$25?

MICHAEL GANNON: I think that when individual general practices make the decision to start charging a fee to invest in all those expenses to collect the money and the extra staffing that requires, it might be more than a few dollars. So, the freeze is a threat to the way we look after the most vulnerable in our community by giving them bulk billing.

QUESTION: [Interrupts] But you can't put a figure as to how much more patients will pay? Labor is saying it's $20 or $25.

MICHAEL GANNON: It might be that much. I wouldn't be surprised if it's that much. I think that once GPs cross the Rubicon and decide it's time to start charging, that they're unlikely to charge a $3 or $4 gap, so we might be talking larger gaps in payments. What I want to see is GPs enjoy the appropriate reward. The patient rebate is the patient's rebate. It's not a fair fee, but what most GPs will do, is they'll acknowledge that that's the appropriate fee to take care of patients. And we must maintain protections for the most vulnerable in society. If we don't index rebates, GPs won't be able to keep taking the hits.

QUESTION: So if the freeze is isn't lifted, doctors may charge as little and $3 or $4, but as much as $25 or more?

MICHAEL GANNON: I would not be surprised if those practices that move away from bulk billing, and decide to invest in the infrastructure required to collect the fees, turn around and collect something like a fee between $15 and $25.

QUESTION: Dr Gannon, has the AMA in the past spent too much time on issues like asylum seekers and their treatment in Nauru?

MICHAEL GANNON: The AMA will always fearlessly speak up on behalf of those without a voice. Asylum seekers and refugees, ethically and under law, are entitled to the ethical protections of the Australian Government, Australian law, the Australian people. That means that doctors must speak up. That is a core ethical principle of medical care, that you speak up when patients are not being treated well. So that whether that refers to asylum seekers under our protection in New Guinea, or whether it refers to people in prisons, whether it refers to other people in our society that don't have a voice, the AMA will continue.

QUESTION: What's made you change your views on that? Earlier in the year you were saying you thought the AMA spent too much time on those peripheral issues that were not its core business. What's made you change your mind on that?

MICHAEL GANNON: What I have said, is that when the AMA speaks up on politically contentious issues, they must recognise that there are risks to other elements of their agenda. So the AMA must always be fearless in speaking up on social issues, even if there is a cost. But we need to be smart, and recognise that there can be a cost to the relationship.

I look forward to working with all parties with constructive policies to improve the lot of all Australians and all under their protection.

QUESTION: Was the AMA too left wing under Doctor Owler?

MICHAEL GANNON: Look, I reject those binary comparisons. I don't stand up here as a specialist president not prepared to talk about GPs. I don't want to talk about left and right. I want to talk about how we take care of our patients. That is a false division in society. We need to be prepared to talk to people whether they're red, blue, or green in this election campaign, to come up with the best answers.

QUESTION: But you did [indistinct] that previously the AMA had a much more combative relationship with the Abbott/Turnbull Government. Is that a fair characterisation?

MICHAEL GANNON: I would love to build a more constructive relationship with the Turnbull Government if they're re-elected, but we will speak up fearlessly when they produce bad policy. If they produce policies that aren't good for the health of Australians, then we will criticise them. But I intend to talk to people from all sides of the political spectrum, issue by issue, one by one, always sticking to the health, always sticking to what the AMA is best at.

QUESTION: So previously the relationship wasn't constructive?

MICHAEL GANNON: I think that there are problems in that relationship? And there is room for improvement. I think that both sides should reflect on that. I would invite members of the Government to see this as a new opportunity to improve the relationship. I promised Minister Ley that I will contact her this afternoon. I'm ready to talk to everyone. I'm aware we're in the middle of the election campaign. But we want to talk to everyone to get the right results for the doctors of Australia. That's the best way to look after the patients of Australia.

QUESTION: What would you do differently to work better with the Government?

MICHAEL GANNON: I will pursue a consultative style. I think that respect is important in any relationship, and I will do whatever I can to listen, to agree that people can have different points of view, but try and find constructive ways forward. I don't think it's beneficial to pick favourites. And I don't think it's beneficial to criticise. I think that you focus on each issue, and try and come up with workable solutions.

QUESTION: So you won't criticise the Government?

MICHAEL GANNON: I will criticise the Government, issue by issue, when they deserve to be criticised. If it gets reported, I will commend the Government or the Opposition when they do things well. That's an observation I'll make as an AMA spokesperson, often when we commend something, it doesn't get reported as well as we'd like. So we will go issue by issue, not playing favourites. It's about getting the best health outcomes for everyone in our community.

QUESTION: Dr Owler described the last two years of the Coalition Government, the other day, as a period of lost opportunity in health policy. Do you share that assessment?

MICHAEL GANNON: I think there's been many policies in this Government that we lament, and could have been better. I think we need to reject this idea that health is a cost, that health is just another budget line that can be cut or controlled. I think that we need to make our contribution to improving the relationship. I would invite the Government to listen to the arguments of the AMA. We speak fairly and honestly on behalf of our patients. There are smart investments in areas like mental health, Indigenous health, and in general practice, that make the whole of the health system work better.

Alright. Thank you very much for your time.


29 May 2016

CONTACT: John Flannery                            02 6270 5477 / 0419 494 761
                Kirsty Waterford                       02 6270 5464 / 0427 209 753

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Published: 30 May 2016