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28 Oct 2013

Transcript: AMA President Dr Steve Hambleton, ABC 666 Canberra, 28 October 2013
Subjects: Medical tourism and private health insurance

ROSS SOLLY: Dr Steve Hambleton is President of the Australian Medical Association. Dr Hambleton, good morning to you.


ROSS SOLLY: Do you have any figures? Do you know how many people actually do head overseas at the moment to have procedures done?

STEVE HAMBLETON: No, we don't. It's hard to measure that, but they most certainly are growing numbers. There's lots of companies popping up and doing it. But we don't have those figures, because none of it goes through our usual regulatory systems, through Medicare or any of those other systems. So it's hard to measure.

ROSS SOLLY: So what do you think, Dr Hambleton, about this private health insurer offering up these medical tourists’ packages?

STEVE HAMBLETON: Well, we are concerned about it, and I guess there's a couple of reasons for that. I mean, we already know that Australia has some of the best outcomes in the world, and you can get treatment right here and be pretty confident that you're going to get high standards of medical practitioners.

I mean, our training is very, very high in terms of world standards. You know that the hospital you go to is accredited and that it has good infection control systems, and those, again, are at a world standard. And we don't have multi-resistant bugs that you see in other parts of the world.

And I guess the main thing is, we're talking about people who are already perfectly well submitting themselves for an elective procedure, and we've got to keep the standards for that sort of treatment really, really high.

ROSS SOLLY: There are, though, some really, really, really good medical practices in parts of Asia, aren't there? Some outstanding - some world leading surgeons.

STEVE HAMBLETON: Oh yes, there's no doubt. There's no doubt there's some excellent, world-class surgeons in India and Asia, and I've met some of the people through the World Medical Association, but the systems here are different to the systems overseas. And you know, when you see someone here, you can rely on our systems. If you go overseas, you're going to have to rely on yourself. But in this case, NIB appears to be prepared to take that risk. And again, it's just a risk.

ROSS SOLLY: Is there, though, a silver lining if it does take some of the pressure off waiting lists, if it takes some of the pressure off surgeons who are struggling to sort of - to meet deadlines and to get people through by promised dates etcetera, is there not a positive that might come out of this?

STEVE HAMBLETON: Well, there's possibly a positive, and I guess we don't really know the impact. What we do know is that there have been people go overseas and get, like, joint replacements. And we've had some terrible failures, because if you have a bleed into a joint, or you get an infection in a joint, that really is a failure, and those people then end up being - relying on this system.


STEVE HAMBLETON: If you don't have a surgeon to follow you up, and you don't have someone standing by you to try and minimise those negative outcomes, and we do see them occasionally, you then have to rely on someone else who didn't do the surgery who may not know you very well at all.

ROSS SOLLY: We had a caller a few minutes ago, Jim, who is heading over in January to have a procedure done in Thailand. In the end, for him, there was only one other surgeon in the whole of Australia that could do the work that he wants to have done, and the price was half as much. Now, when you're up against that, it does make it pretty attractive, doesn't it, for people who are going under the knife?

STEVE HAMBLETON: Well, it certainly does, and look, the price is, if you like - as a result of our high Australian dollar, and a lot of our internal things that we - manufacturing here and selling here and it's difficult to compete when our dollar is so high. But it's not just the price. It's really the follow-up, it's really the quality, and it’s really all of those other things that wrap around. And it's probably a truism that you do get what you pay for.

ROSS SOLLY: And I suppose there are other overheads here in terms of having to meet criteria and regulations that are set in place by the Government.

STEVE HAMBLETON: Well, there are, some of those are very good. I mean, we have high standards of training. We have continuous professional development requirements. People can't stay registered in this country unless they keep up to date. The College of Surgeons in Australia in 2010 said every single surgeon had to do an audit, a personal audit on their own outcomes. And these are to improve the outcomes for patients. So those are the sort of things we have here. You've got to rely on the regulatory systems overseas, and they're simply different.

ROSS SOLLY: That's interesting, isn't it. Now, what do you tell people, Steve Hambleton? If you had a patient come to you and - wanting to have a bit of work done, maybe, you know, a hip replacement or something, and they said to you - and you could only get them in to see someone, you know, in 12 months, 18 months time, and they said to you, oh I might go overseas and get it done, if I can get some good insurance from this insurance provider. Why would you advise against it?

STEVE HAMBLETON: Well, I guess I'd raise all the cautions about quality of output, and again we do know there's absolutely excellent surgeons, and so we can't have a blanket rule. But the problem is, it's very hard to pick between the two. And when you do think about cosmetic surgery, and many of these things are cosmetic procedures, you've got to work through about why someone wants to have something done.

And we know in this country, we've got this preoccupation with perfect body, the perfect face and the perfect figure. And that's the same for men and women, it seems. Now young boys are using anabolic steroids and other things to try to create something that maybe they genetically weren't supposed to have. We need to think about their body image issues. And maybe the right answer is to say, you don't need the surgery at all. This isn't going to solve your problem. And that's a big challenge.

I did go to a meeting recently where there were some surgeons present, and they said the definition of a surgeon is someone who can do the surgery, but is prepared to say no, you don't need it.

ROSS SOLLY: Mmm. It's a good test. Good to talk to you, Steve Hambleton. Thank you.

STEVE HAMBLETON: Thank you very much.

ROSS SOLLY: Dr Steve Hambleton, who is President of the Australian Medical Association

28 October 2013

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

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Published: 28 Oct 2013