The Guardian July 25, 2001


AMA President: Health policy and "desperate needs"

Andrew Jackson

The Australian Medical Association (AMA) has traditionally been an enemy of 
bulk-billing and Medicare but the health scene is changing quickly and the 
AMA has now fallen out with the Federal Government's agenda which is to 
promote the corporate take-over of the health system and medical services. 
The AMA is resisting the Government supported push by big corporations and 
private health funds to introduce the American type "managed care" health 
system which would remove from doctors control of medical treatment and 
fees. The impact of this situation can be seen in the address by the ANA 
President, Kerryn Phelps to the National Press Club on July 18. Below are 
extracts from her speech.

The fact of the matter is that Medicare  the heart of our health system -
- is in strife.

An efficient Medicare sets the Australian health system apart from those, 
say, of the United Kingdom or the United States.

If you tune in to watch Chicago Hope or any of the other popular 
American hospital dramas, you will get a glimpse  a frightening glimpse -
- of the patients' and the doctors' point of view in the managed care style 
of medicine.

This is the system where administrators and clerks  removed from direct 
contact with patients  make decisions about what treatment doctors may 
offer to patients, based on cost.

What is more frightening is that health officials in this country have been 
examining elements of both the US and UK systems to trial here. We must not 
let that happen.

Funding

Some of the problems can be solved by addressing funding shortfalls.

Earlier this year, the AMA presented our Health Budget Submission to the 
Government.

It talked about public hospital funding.

It talked about the need to properly fund and manage health programs for 
Indigenous Australians.

It talked about anti-smoking programs, and programs to combat alcohol and 
drug abuse  some of the biggest killers in our community today.

Needless to say, at the time, the AMA Budget Submission was totally 
ignored.

Aged care

While the public hospital system is in a constant state of crisis, the aged 
care sector is in a state of despair and disrepair.

The number of residential aged care places has risen by less than 10,000 in 
the past six years ... in an ageing population.

Old people are still waiting in hospitals for beds in residential 
facilities to become available  so there is still a high level of unmet 
need.

There also needs to be improved access to aged care services for people 
with special needs, and older Australians in rural and remote communities.

The staff in Residential Aged Care facilities play an essential role in the 
delivery of quality care to older people.

However, nurses in private aged care facilities receive lower wages than 
nurses working in hospitals.

The work is demanding and often demoralising. Little wonder that there is a 
drought of nurses prepared to work in aged care.

We need to see increased wages for nurses which reflects their real worth, 
and a national training strategy for all workers in the aged care industry.

Rural Australia

One of the most glaring inequities is the difference in access for people 
living in rural and remote parts of Australia.

It is impossible to take an economic rationalist view of health provision 
in rural Australia. The tyranny of distance and the small populations mean 
you are working with a completely different set of fundamentals.

We need to develop national standards to ensure equity for all Australians 
and to ensure that governments are held accountable for the delivery of 
quality health services to every Australian community.

It is time that significant elements of health policy in this country were 
treated as a national treasure ... to be elevated as much as is practical 
above party politics.

Health will be the Number One issue for the next election and beyond.

You cannot be a Clever Country or a Knowledge Nation or an Ideas Island or 
a Learning Landmass or a Tax Territory unless you first take care of the 
health of your people.

The next government must put in place a long-term plan for Australia's 
health system, for Medicare.

Indigenous Health

Indigenous health is another area of desperate need.

It is a national tragedy that needs a more dignified response than the 
argy-bargy of party politics.

Indigenous Australians have the worst health of any group in Australia, 
with lower life expectancy at birth. Indigenous parents can expect to lose 
their babies at a rate two to four times higher than the national average, 
and indigenous men and women can expect to live 20 years less than non-
indigenous Australians.

Chronic diseases are the leading cause of premature death.

Other countries have bitten the bullet and significantly improved the 
health of their indigenous populations. Australia has not.

The message received by the AMA Taskforce in Indigenous Health is that 
there needs to be a quantum leap in funding for Indigenous Health if 
progress is to be achieved and the cycle of ill health broken.

At least an extra $245 million per year is necessary to fund Indigenous 
health services.

Such an increase was not forthcoming in the recent Federal budget.

It is also essential that the basic infrastructure such as clean water, 
sanitation, appropriate housing and transport  taken for granted by other 
Australians  is available to all Aboriginal and Torres Strait Islander 
communities irrespective of where the communities live.

Underlying all these matters, however, is the fundamental matter of the 
relationship between Indigenous and non-Indigenous Australians.

The issue of a treaty is being taken forward by ATSIC and by Aboriginal 
Land Councils.

Today I announce the AMA's support of their efforts.

Until there is an unassailable commitment in the form of a contract to 
overcome the poverty and desperation of our most disadvantaged citizens, we 
are not taking the issue seriously enough.

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