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15 Jun 2017

By Dr Rod McRae, Chair, AMA Council of Public Hospital Doctors

AMA Council of Public Hospital Doctors had planned to meet at the end of April. Unfortunately, like so many circumstances, clinical demand conspired against us obtaining a quorum and we’ve had to postpone our meeting until after National Conference. That certainly did not curb the enthusiasm for the Council of Public Hospital Doctors, which saw a record number of delegates to this year’s National Conference in Melbourne. Note that the Council relates to those who identify with public hospital issues, and it warmly welcomes trainees.  Similarly, all medical practitioners are training throughout their careers, and I encourage all members to “identify” as Doctors in Training, as we are never not training.  I encourage senior members with years of experience in the public hospital system, particularly full timers, to support this Council, lest it wither on the vine, and our organisation loses that perspective. 

National Conference featured an impressive line-up of influential political and health leaders, including the Prime Minister and the Leader of the Opposition, and associated Health spokespersons, speakers and panellists. The high priority of health policy in the current National political debate was evident by the attendance of all the key players in the field.

It is now a great, and indeed important, opportunity to involve ourselves in the issues that matter to our profession and the health of the nation. National Conference is also a great opportunity for networking and finding out what matters to doctors on the ground. I had many helpful, interesting and informative conversations with public hospital doctors from across Australia who are raising a range of important issues. A major one that is about to explode on the medico-political scene is every perspective related to private health insurance, and its interplay with the public hospital sector across Australia. 

A subset is the issue of private patients in public hospitals. This is on our agenda and is an issue which requires more discussion among other groups and at the State/Territory level so we can develop an appropriate response to it. It is of concern to a range of stakeholders and is a key area of discussion for the Private Health Ministerial Advisory Committee which was established in September 2016 to examine all aspects of private health insurance and provide the government with advice on reforms.  The macro- economics have altered radically in less than a decade, as have citizens’ circumstances. 

Similarly, the issue of public/private partnerships to build or operate new hospitals and re-develop existing hospitals is a topic of “interest” to many. There is no easy answer to this challenging phenomenon, which has many facets, but it’s something we hope to discuss in more detail as the year progresses.

Specialist medical training positions remains an area of concern. We need to enhance the quality and number of training positions, particularly in rural and regional areas. Presently in Australia there are well over 3500 medical students graduating each year, while the number of advanced training positions in the various specialties is closer to 1000. To maintain the quality of the medical profession, a fundamental ambition, we need to look beyond universities and medical schools, and start looking at specialist training programs.

On the bright side, this year’s Budget offered a potential of upside in the health area.

The Medicare rebate freeze will be slowly “thawed” stepwise across a range of services over the next couple of years. The AMA’s advocacy for all medical practitioners, including those who don’t directly contribute, has also resulted in other changes, such as reversing proposed cuts to bulk billing incentives for diagnostic imaging and pathology services and scrapping proposed changes to the Medicare Safety Net, which may have penalised vulnerable patients. Great news of course, but more work needs to be done on positive outcomes for overworked public hospitals, Indigenous health, mental health, aged care, rural health, and the medical workforce; plenty of room to improve. It is areas such as these that require strong policy and advocacy, driven by our committed Councils and committees within the AMA.

National Conference has been a great chance for the AMA CPHD to consider the input of new members who identify as public hospital doctors. I encourage you to maintain your enthusiasm for our unique, important group, so we can discuss issues important to us and help guide AMA policy in key areas. 

Published: 15 Jun 2017