Medicos seize the moment
Doctor organisations are pressing the main parties for more health commitments ahead of next month’s poll. Health editor Adam Cresswell reports
BABIES born in hospital toilets or on waiting-room floors, elderly women wheeled into medical store-rooms, operations repeatedly postponed despite hospitals being choked by patients needing help: cases like these have horrified the public and propelled health into the front row of election issues.
As a result, the news spotlight has focused on the federal health minister, his Labor shadow and their teams more intensely than it otherwise might, as they have been busy visiting health facilities, before and since the election was called, meeting doctors, nurses and constituents, hearing their stories, and making policy announcements.
But there have been other teams busy at work, out of the spotlight, as the election campaign gets properly under way: those of the medical organisations, which sense an unusually good opportunity to secure some real wins for the health system generally, as well as for their own pet causes.
In a professional arena that has in the past been riven with rivalries and disunity, the groups in the lead-up to this election are also unusually unified in their positions — particularly on the crucial area of rural health.
Last month the most prominent of the doctors’ industrial lobby groups, the Australian Medical Association, released a 22-page document covering the measures it considers necessary to knock the health system into shape and get health outcomes back on course. The document covers 18 separate issues, from public hospitals to global warming. Some of its recommendations are more vulnerable than others to the charge of selfinterest — such as the request, already agreed to by the federal Government, to pay doctors more to administer the Medicare Easyclaim system, a move interpreted by some as the Government ‘‘ caving in’’ to the powerful doctors’ group.
But plenty of others are aimed squarely at what the AMA and others see as the most pressing gaps in health service provision, and flaws in the system’s structure.
Crucially, the AMA has also mended fences with the peak rural medical group, the Rural Doctors’ Association of Australia, and the two bodies are now singing from the same song sheet. Previously the two groups had been at loggerheads over the RDAA’s 10-year-old demand for a separate set of Medicare rebates that would apply only to rural doctors, and pay them (or their patients, if not bulk-billed) more money in recognition of what the RDAA said were the additional costs and disadvantages of rural practice.
The other main medical group with an industrial voice, the Australian General Practice Network, also released its own list of election priorities last month, focusing on fixing workforce shortages, improving patients’ access to care, and other issues.
Association president and Perth GP Rosanna Capolingua told Weekend Health the main issues boiled down to public hospitals, indigenous health, rural issues, training, helping GPs through measures such as simplifying Medicare, and public health initiatives on smoking, alcohol and drug misuse.
So good is the present opportunity to influence health policy that the AMA’s executive team was this week discussing how to get the association’s message out to voters in crucial marginal seats — as a roundabout way of applying pressure to the policy machinery of each major party.
On hospitals, the AMA supports the current state-federal funding split but says the federal share has slipped too low and Canberra needs to ‘‘ front-load’’ some funding to redress the balance. It also needs to increase the current annual indexation, now 5 per cent, to 8 or 9 per cent to ensure budgets remain adequate.
But the AMA also says the states have been spending ‘‘ too much . . . on plans and reviews’’ and the Government needs to use the next Australian Health Care Agreements to ‘‘ pressure the provide services’’.
On training, the association says Canberra must stump up an extra $100 million over four years to train more medical students in a general practice setting, and another $80 million per year to get more doctors who had not yet chosen their eventual specialty into undermanned GP surgeries.
Capolingua says now the federal Government has increased undergraduate medical school places — which will nearly double by 2012 — Canberra must also help pay for the extra clinical training places in hospitals, which will be required to train these students once they progress through their courses.
‘‘ We now need to see the commitment of the Government in funding (places) and providing support for training of these (new) doctors,’’ she says. ‘‘ We want both state and
states and territories
to federal governments involved in that.’’
Workforce problems are one of the most pressing problems in health — they also come top of the AGPN policy, which calls for a huge increase in GP nurses to help shoulder the load — and this also has important implications for rural health.
After a rural health summit last month, the RDAA and AMA are now jointly backing a new plan to attract more doctors to rural areas by increasing the financial incentives available to them. The RDAA’s old plan, now scrapped, proposed an entirely separate table of MBS items solely for their use. The new plan — which the groups estimate would cost $300 million to $400 million annually — proposes keeping the existing MBS structure, but creating new loadings that will rise in line with the remoteness of the doctor’s location.
The loadings would be paid in two
Campaigning: Rosanna Capolingua’s AMA is looking at how to achieve its goals through campaigning in marginal seats