Transcript - SKY News, pathology services

JIM MIDDLETON:​The AMA, for one, is not convinced that Mr Turnbull has come up with a cure. And joining us now is AMA President Brian Owler. Professor Owler, thank you very much for joining us, taking some time out of your Saturday afternoon to talk about this. On this very question of pathology services first of all, the Prime Minister suggesting that this guarantees affordable pathology into the future. Why are you less than convinced?

BRIAN OWLER:​Well, it doesn't guarantee anything. What the Prime Minister announced last night was that the concern over pathology was gone. But actually when we read the Minister's media release after about 9pm last night, we found that in fact the cuts to bulk billing incentives for pathology has merely been deferred for a matter of, as the Minister has suggested, three months. Which means the cuts are still there, they're still taking $650 million out of health over the next four years. 

And Pathology Australia have said to me that they have not guaranteed that there won't be a change in bulk billing rates by pathologists. They don't have the ability to make that guarantee and it will be up to the individual pathology companies to actually make that decision over time. Now there is easing of cost pressures on pathologists through this regulation in regards to the rents that they pay for pathology collection centres to landlords. But at the end of the day the issue around bulk billing incentives is still there. It's just deferred until after the election. 

JIM MIDDLETON:​Pathology Australia do say that this will enable pathologists to more readily maintain the current high rate of bulk billing. Why don't you accept their assurances on that score? 

BRIAN OWLER:​Well, Pathology Australia have said to me last night, and again this morning, that they are not able to give any guarantees. 

What they have said is that there will be some easing of costs pressures through this change to rents, by scaling back some of the costs associated with those rents, but at the end of the day they are still experiencing a very significant cut. And it will be up to the pathologists and the pathology companies themselves to make a decision about how they deal with this issue. 

So to suggest that somehow the concern is now gone I think overstates the results of the agreement that was reached between the Government and Pathology Australia.

JIM MIDDLETON:​Isn't there a more general problem here, which is that Medicare treats pathology as if it were still a cottage industry, whereas it's now much less labour intensive, machines have taken the place of workers, and that therefore the cost per unit or the cost per test is much lower than it was and that the Government should be able to recover some of those costs rather than it going into the pathologists' pockets?

BRIAN OWLER:​Well, I think that oversimplifies what pathology is. First of all, yes, a lot of tests are automated and rely on machines, and certainly there is a lot greater efficiency in pathology. But you've got to remember that pathology, for instance, has not had any indexation in the Medicare rebates for more than 16 years. It also has had cuts year after year, it's had coning of the way that the items can be built. 

So pathologists have had to endure very significant cuts as they've become more efficient, in fact they've had to become more efficient to be able to maintain their viability. But also pathology is much more than machine-based medicine. It is the actual individual, a highly trained pathologist, that sits down and looks at people's results, look at the histology, that is the biopsy samples that are given to them, and they've got to get it right 100 per cent of the time, which is not always easy when you're looking at difficult cancers or whether you're in a pre-cancerous stage, whether it's a pap smear, a breast cancer, a brain tumour, a whole range of pathology. So it's much more complicated than simply suggesting that the companies run the blood samples through a machine and get a result.

JIM MIDDLETON:​Now Dr Owler, tomorrow the AMA is launching a campaign against the Medicare patient rebate freeze, the extension of it announced in the Budget, designed to save the Budget around $1 billion, out to 2020. What will patients, people who turn up at GPs offices, to clinics, see as a consequence of this decision?

BRIAN OWLER:​Well patients are already seeing material that has been supplied by a number of groups in their practices. And certainly that is very effective. The AMA has been asked for material as well, from its members, so we'll be putting material together- we have put material together which we'll be releasing tomorrow and plan to distribute not only to GPs, but other specialists right around the country as well. 

Now, the issue here is about the Medicare rebate freeze and the recent extension of the freeze out to 2020, which means almost seven years of a rebate freeze. Now there's no way that you can continue to maintain quality General Practice or other services without passing the cost onto patients at the end of the day. And for all the talk about primary care, the importance of General Practice, all that we've seen is money being taken out of health, more costs being put on to patients' pockets. And particularly for the poor, the sick, and the most vulnerable in our community, that's something they can't afford. It makes no sense in terms of health policy, in terms of trying to keep people- particularly with the growing burden of chronic disease, keeping them well and keeping them out of hospital. 

JIM MIDDLETON:​Professor Owler, this campaign and what you're doing on pathology, very clearly allies you with the Labor Party. Are all your members, all your doctors, perfectly happy to be used in this particular way? Or is there a chance that there could be a backlash, for example when the Presidency comes up. You're about to retire in a couple of weeks' time? 

BRIAN OWLER:​Well I'm retiring in two weeks' time, that is true. But I can tell you that everything I say and do is approved by my colleagues on the AMA Federal Council. So I don't act alone.

And I've got to say that I think the Government has underestimated the anger that is out there in the medical community, particularly amongst GPs.  

We are getting inundated with calls from angry GPs asking us what we're going to do. Now I have to make it very clear, because this issue comes up, the last two years have been spent arguing against a policy. It's not about aligning with one side of politics or another.  

The Government is a Coalition government. It is their policies, particularly from the 2014 Budget, but also beyond that, that have been harmful to medicine, harmful to patients, and that's what I've been arguing against. 

We still have yet to see Labor's proposals when it comes to the Medicare rebate freeze, when it comes to public hospital funding, and we'll be asking them the same questions as we've been doing all along and waiting to see what their policy announcements are going to be as well. 

JIM MIDDLETON:​Professor Owler, thank you very much for your time. 

BRIAN OWLER:​Thank you.

JIM MIDDLETON:​Brian Owler, President of the AMA, soon to retire.

14 May 2016

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