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30 May 2016

Transcript: AMA President Dr Michael Gannon, Radio National, 30 May 2016

Subject: Medicare Freeze, Hospital funding, Asylum Seekers


FRAN KELLY: Well as with most elections, health is one of the big issues for voters as we count down to the second of July, but relations have soured between the Government and the doctors recently over issues including hospital funding, and the Medicare rebate freeze - in fact, GPs have even launched a campaign in this election against the Government's policies on Medicare rebate freeze.

In this climate, the Australian Medical Association has just elected a new President. He's West Australian obstetrician and gynaecologist Michael Gannon, who takes over from Brian Owler. Brian Owler's two-year term ended on the weekend. Michael Gannon has previously criticised the AMA for being, quote, too lefty, and he's vowed to work more constructively with the Turnbull Government. So what is Michael Gannon's agenda for the peak doctors body? He's speaking with our political editor Alison Carabine.

REPORTER: Michael Gannon, welcome to Breakfast.

MICHAEL GANNON: Good morning Alison.

REPORTER: You're taking over the AMA presidency at a critical time, it's the middle of an election campaign - will we see a less adversarial approach from doctors over issues such as the Medicare freeze?

MICHAEL GANNON: Well we oppose the Medicare freeze, and we indeed support the College of GPs' campaign against it. We've got our own campaign, which wants to see the unravelling of the freeze, we support that Labor policy, we would hope that the Coalition would see the value in unravelling it as well.

REPORTER: A few years ago you were in favour of a compromise on the Medicare co-payment which was first proposed by Peter Dutton; would you accept a compromise on the Medicare rebate freeze? Do you want it lifted immediately, indexation resumed without delay, or is there some room for negotiation with the Government?

MICHAEL GANNON: Well, there's always room for negotiation with the Government, and there's always room for discussion with all parties in the middle of an election campaign. The co-payment models were flawed because they didn't give GPs the ability to set their fees appropriate for individual clinical circumstances. What they didn't do is that they didn't necessarily have the right protections in them for the most vulnerable people in our community. They were potentially the starting point for a conversation, but as long as they took away the ability for GPs to make a decision on who they should bulk bill in individual clinical circumstances, and as long as what they were, actually a cut of money out of general practice, an area that's been chronically underfunded. That's why the AMA opposed them, that's why they didn't even become the starting point for a more productive conversation.

REPORTER: But if indeed the GPs are at breaking point, and that's how you have put it, would the AMA therefore advocate a vote for Labor, which has vowed to lift the freeze from next year?

MICHAEL GANNON: Well, the GP freeze is just one of many policies. It's not the AMA's job to play favourites in an election campaign, it's not the AMA's job to play favourites, to play favourite with a government or an opposition remote from an election. We will pressure all political parties at any stage to try and produce good health policy. I'm delighted to see health at the front of the election agenda, hopefully now is the chance to get some improvements in the whole system.

REPORTER: But do you think- can we expect you to take a more softly-softly approach to issues which are contentious to doctors than we saw from Brian Owler? I mean, you did say when you first indicated your intention to contest the leadership that the AMA needs to build bridges with the Turnbull Government - are you hoping for a better hearing in Canberra if you tone down the AMA's criticism?

MICHAEL GANNON: I do believe there's that opportunity. Equally, I believe that this election is well and truly in play and that there's no one who can confidently say where we'll be in five weeks' time. I've met the leader of the Greens, I've met the health spokesperson for the Labor Party, only in recent weeks as part of my campaign. They're people who I look forward to speaking to again in coming weeks. Having said that, I've spoken to the Health Minister already, I've met her on a number of occasions. I do believe there's an opportunity to improve that relationship.

REPORTER: Okay. And so the AMA does need to build bridges with the Government? Is that still your view?

MICHAEL GANNON: I think that the AMA should always try and be constructive when it criticises policy of governments or opposition to come up with alternatives. What we've tried to say for many years now is that successive governments have under-invested in quality general practice. That is the cornerstone of the health system: GPs providing quality care in decent visits will give you a saving. So even if you want to make an economic argument, you will have less people requiring hospital admissions, which are a lot more expensive down the track. Quality general practice is an investment in our community, it's not a cost.

REPORTER: Yeah. And that's an argument that's been prosecuted by the AMA under Brian Owler's leadership also. But are we going to see a less robust advocacy under your leadership on behalf of doctors and therefore on behalf of patients?

MICHAEL GANNON: Well, I would hope to always be constructive. I think that when you criticise government on any area of policy you need to realise that there might be a cost in that area or in other areas of your agenda. That's the way that many doctors practice every day [indistinct] …

REPORTER: [Interrupts] So if you go in too hard - sorry to interrupt Michael Gannon - if you go in too hard over the Medicare freeze it could impact on other areas of health policy?

MICHAEL GANNON: Well that's exactly right, because we've got problems when it comes to public hospital funding, we've got problems in things that we talk a lot about but never actually attribute any dollars to, like Indigenous health and mental health. So the health portfolio is a lot bigger than GP visits, although I would say that that is in many ways the cornerstone of the system - also not forgetting that the MBS freeze affects other specialists as well.

REPORTER: Well, you have said that the AMA needs to be a partner in looking for savings in every area of the system. Where would you recommend cuts can be made if it's not from GP surgeries - could it be hospitals for example?

MICHAEL GANNON: Well, I think we always talk about greater efficiencies in hospitals. The truth is that this is absolutely part of quality practice for doctors. Doctors are not interested in waste, doctors seek to reduce complications from surgery wherever possible, doctors are not …

REPORTER: [Interrupts] So there could be cuts to hospital funding you think that there is room to cut hospital funding?

MICHAEL GANNON: I don't think that there's room to cut hospital funding, in fact quite the opposite. What I do believe is the AMA needs to be responsible in asking for greater funding in the system. I think ultimately responsible governments do try and aim for balanced budgets et cetera. Having said that, there are areas where there's been under-investment, and perhaps both the Commonwealth Government and the State and Territory governments have failed to recognise that there are drivers in the increase in the cost of the public hospital system, things like the ageing population, health epidemics like obesity and drug use.

REPORTER: Okay Michael Gannon. Just finally, the AMA under Brian Owler's leadership was often very critical of asylum seeker policy. You have previously said that refugee politics is not core business for the AMA. Why isn't the health and welfare of people in Australia's care core business for Australian doctors?

MICHAEL GANNON: It is core business for the AMA. What I have said is something that we've already spoken about this morning is that if you are critical of government there might be risks to other elements of your agenda. What the AMA is always strong on, and I've said this to my colleagues at great length over the weekend, this is an important issue to doctors, the AMA is strong when it talks about medical science and has evidence behind what it says; the AMA is strong when it sticks to ethical principles that go back thousands of years. Speaking up on behalf of those who are legally and ethically under our protection is core business, because that goes back to the basics of the doctor patient relationship.

REPORTER: Okay, but just finally and very briefly, can we expect you to tone down the criticism of asylum seeker policy?

MICHAEL GANNON: That might be worthwhile. If you ever hear me talking about it I'll be talking about the health of asylum seekers, I won't be making any comments about broader policy.

REPORTER: Michael Gannon thanks very much for your time.

MICHAEL GANNON: Pleasure, Alison.


30 May 2016

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Published: 30 May 2016